{"id":2914,"date":"2015-06-17T00:47:04","date_gmt":"2015-06-16T23:47:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=2914"},"modified":"2015-06-17T23:51:19","modified_gmt":"2015-06-17T22:51:19","slug":"prostitution-harm-and-disability","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2015\/06\/17\/prostitution-harm-and-disability\/","title":{"rendered":"Prostitution, Harm, and Disability: Should Only People with Disabilities be Allowed to Pay for Sex?"},"content":{"rendered":"<p>By <a href=\"http:\/\/oxford.academia.edu\/BrianEarp\">Brian D. Earp<\/a><\/p>\n<p><strong>Introduction<\/strong><\/p>\n<p>Is prostitution harmful? And if it is harmful, should it be <em>illegal<\/em> to buy (or sell) sexual services? And if so, should there ever be any exceptions? What about for people with certain disabilities\u2014say\u2014who might find it difficult or even impossible to find a sexual partner if they weren\u2019t allowed to exchange money for sex? Do people have a \u201cright\u201d to sexual fulfillment?<\/p>\n<p>In a <a href=\"http:\/\/jme.bmj.com\/content\/current\">recent issue<\/a> of the <em>Journal of Medical Ethics<\/em>, Frej Klem Thomsen[<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>] <a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.full\">explores<\/a> these and other controversial questions. His focus is on the issue of <em>exceptions<\/em>\u2014specifically for those with certain disabilities. According to Thomsen, a person is \u201crelevantly disabled\u201d (for the sake of this discussion) if and only if:<\/p>\n<blockquote><p>(1) she has sexual needs, and desires to exercise her sexuality, and<\/p>\n<p>(2) she has an anomalous physical or mental condition that, given her social circumstances, sufficiently limits her possibilities of exercising her sexuality, including fulfilling her sexual needs. (p. 455)<\/p><\/blockquote>\n<p>There is a lot to say here. First, in order to figure out the merits of making an <em>exception<\/em> to a general ban on prostitution (for people with disabilities or for anyone else), we have to start by deciding what to think about the advisability of such a ban in the first place. For, if we don\u2019t think it\u2019s a good idea to begin with (spoiler alert: this is my own view), then we can skip all the talk about making exemptions, and just argue against the ban.<\/p>\n<p>But Thomsen doesn\u2019t pursue that route. Instead, he wants to make a case for an exception. So, he has to try to convince his reader that a general prohibition makes at least some kind of moral and\/or practical sense. How does he go about making this argument?<\/p>\n<p><!--more--><\/p>\n<p><strong>A case for prohibition?<\/strong><\/p>\n<p>It\u2019s actually pretty straightforward. Thomsen spells it out like this:<\/p>\n<blockquote><p>(1) Prostitution is bad because it causes harm to prostitutes.<\/p>\n<p>(2) We have reason to avoid harm to persons.<\/p>\n<p>(3) Prohibiting prostitution will reduce harm to prostitutes.<\/p>\n<p>(4) Therefore, we have reason to prohibit prostitution. (p. 453)<\/p><\/blockquote>\n<p>Is this a good argument in favor of prohibition?<\/p>\n<p><strong>The harm of prostitution<\/strong><\/p>\n<p>Let\u2019s take it one step at a time. We can start with the first claim: that prostitution is bad because it causes harm to prostitutes. Is that a convincing claim?<\/p>\n<p>It does have a certain intuitive appeal, and most people would probably say \u201cyes.\u201d But in another recent essay (also published in the <em>JME<\/em>), the philosopher Ole Martin Moen has <a href=\"http:\/\/jme.bmj.com\/content\/early\/2012\/08\/27\/medethics-2011-100367.short\">put forward<\/a> a powerful set of arguments that call into question the conventional wisdom.[<a href=\"http:\/\/jme.bmj.com\/content\/early\/2012\/08\/27\/medethics-2011-100367.short\" target=\"_blank\">2<\/a>] According to Moen, while it is true that prostitution is not a <em>harmless <\/em>line of work:<\/p>\n<ul>\n<li>(1) it is no more inherently harmful (on balance) than a long list of other occupations which we do not see fit to ban, but instead choose to regulate; and<\/li>\n<\/ul>\n<ul>\n<li>(2) most of the harm that <em>does<\/em> go along with prostitution is actually a <em>consequence<\/em> of its being illegal (and otherwise socially stigmatized)\u2014i.e., contingent, external factors that have little to do with prostitution per se.<\/li>\n<\/ul>\n<p>Let\u2019s take a closer look at Moen\u2019s argument. To do this, we can start by considering one specific type of harm as an example: the apparently higher rates of physical and mental health problems among sex workers compared to members of the general population.<\/p>\n<p>As Moen argues, this purported harm of prostitution might be due\u2014at least in part\u2014to the <em>legal prohibition<\/em> against the activity, which prevents sex workers from taking certain actions that would predictably improve their lot. For example: \u201cjoining labour unions, organizing their work in brothels, renting a place where they can work, hiring security agencies, advertising and forming work contracts (regarding salary, working hours, working conditions, health insurance, retirement savings, and so on)\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/early\/2012\/08\/27\/medethics-2011-100367.short\" target=\"_blank\">2<\/a>], p. 3).<\/p>\n<p>In fact, Moen does a good job of addressing most of the arguments that claim to show that prostitution is inherently harmful (including in ways that are not just physical, but also more abstract, or \u201cmoral\u201d), by performing a similar analysis for each one. <a href=\"http:\/\/jme.bmj.com\/content\/early\/2012\/08\/27\/medethics-2011-100367.full\">Click here<\/a> to take a look at Moen\u2019s paper.<\/p>\n<p><strong>Thomsen&#8217;s critique<\/strong><\/p>\n<p>Now, Thomsen actually considers Moen\u2019s argument. But he doesn\u2019t find it entirely convincing. Among other issues, his main objection that even if \u201cextrinsic\u201d factors like social stigma and legal prohibition were responsible for <em>some <\/em>of the harms associated with prostitution, they wouldn\u2019t necessarily account for <em>all<\/em> of the harms associated with prostitution. (As far as I can tell, Moen doesn\u2019t dispute this claim, but let me set that aside for now.)<\/p>\n<p>To support his position, Thomsen cites an empirical study by a researcher named Vanwesenbeeck.[<a href=\"http:\/\/link.springer.com\/article\/10.1007%2Fs10508-005-7912-y#page-1\" target=\"_blank\">3<\/a>] According to Thomsen, this study showed that \u201croughly half\u2014<em>but no more than half<\/em>\u2014[of] the variance in [certain negative emotional outcomes] experienced by indoor prostitutes in the Netherlands was explained by external factors including stigma, lack of control and poor working conditions\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 453, emphasis added).<\/p>\n<p>The implication, then, is that the other half of these negative outcomes (for example, emotional exhaustion) must be due to something intrinsic to prostitution.<\/p>\n<p><strong>Intrinsic vs. extrinsic<\/strong><\/p>\n<p>There are a few ways to respond to this line of thought. First, there is the problem of non-random sampling: some people turn to prostitution because of pre-existing issues with addiction or mental health, and so the arrow of causation is not entirely clear. Second, it seems unlikely that the study by Vanwesenbeeck measured every possible \u201cexternal factor\u201d that could be responsible for the various harms of prostitution, which introduces a further limitation to what we can infer from these results. But even if it did\u2014so, even if we were justified in saying that \u201croughly half\u201d of the variance in (say) emotional exhaustion experienced by this particular sample of Dutch prostitutes was due to something intrinsic about their selling sex\u2014we would still have to put this information in context.<\/p>\n<p>What sort of context do I mean? Well, consider the fact that <em>many<\/em> careers contribute to, e.g., emotional exhaustion (and other negative emotional outcomes): just think of the burn-out that grief and trauma counselors experience, for example, which is probably due to factors that are (at least in large part) intrinsic to that particular line of work. Or think of the various harms that are \u201cbuilt in\u201d to any number of jobs, like the dangers of construction work, or professional boxing; or the job-insecurity of being an actor (unemployed after every show); or the \u201cdegrading\u201d nature of, say, collecting people\u2019s garbage or cleaning out their toilets.<\/p>\n<p>When it comes to these careers, however, no one thinks we should <em>prohibit <\/em>people from choosing to pursue them, just on account of the fact that they carry some degree of risk, or are stigmatized, or are otherwise less than ideal. Instead, we try to think of ways of <em>reducing<\/em> the various risks that are involved, and\/or we compensate people\u2014usually monetarily\u2014for the harms and difficulties that do in fact come along with their choice of employment.<\/p>\n<p><strong>The importance of choice<\/strong><\/p>\n<p>Note that I do mean <em>choice<\/em> here. My position has to do with people\u2014men, women, or intersex people\u2014who freely choose to sell sexual services in exchange for money. If someone is <em>forced<\/em> to sell sexual services, that is sexual slavery, not prostitution, and that is a different matter entirely.<\/p>\n<p>Now, someone might argue that prostitution is so inherently harmful or degrading, that someone would only \u201cchoose\u201d to exchange sex for money if in reality they were forced by their circumstances (i.e., extreme poverty). A similar argument has been made about the prospect of establishing a market for selling kidneys: only people who are pressured (by their circumstances) to sell their kidneys would end up doing so\u2014the argument runs\u2014so this kind of vending is not really a free \u201cchoice.\u201d<\/p>\n<p>This takes us to yet another recent <em>JME <\/em>article, by Luke Semrau, entitled, \u201c<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/443.full\" target=\"_blank\">The Best Argument Against Kidney Sales Fails<\/a>.\u201d[<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/443.full\" target=\"_blank\">4<\/a>] Semrau points out that there are two types of pressure to tease apart here: a specific pressure to sell one\u2019s kidney (or to engage in prostitution), which <em>would<\/em> in fact be directly coercive\u2014and which could conceivably be relieved by prohibiting the activity in question\u2014and a more general kind of pressure (i.e., economic insecurity), which, by contrast, could actually be relieved by any number of activities, including not only selling one\u2019s kidney or engaging in prostitution, but also other types of employment.<\/p>\n<p>In this latter case, however, prohibiting the activities in question does not actually relieve the more general pressure. Instead, it may actually compound it\u2014because it would take away otherwise viable employment options. So, if someone has another way of relieving their poverty apart from kidney-vending or prostitution (or collecting garbage, or cleaning toilets, or filling out spreadsheets, or flipping burgers)\u2014but regards one of those options as being preferable to the alternatives\u2014then it\u2019s hard to see how we could say that they had been specifically pressured into choosing that career.<\/p>\n<p><strong>Harm and prohibition<\/strong><\/p>\n<p>All of which is to say the following. Even we if were to grant the first point from Thomsen\u2019s argument\u2014the one that says that prostitution causes at least some intrinsic harm to prostitutes\u2014this wouldn\u2019t necessarily mean that we should favor a ban on prostitution. For one thing, if Moen is right, a ban might actually <em>increase<\/em> the level of harm to prostitutes, compared against the alternative policy of not having a ban, and setting up reasonable health and safety regulations, encouraging de-stigmatization, etc. And for another thing, as Thomsen himself points out, even if a ban did not have this harmful effect, we might still have other reasons to argue against it.<\/p>\n<p>For example, we might endorse what Thomsen calls the \u201cantipaternalist challenge.\u201d This view holds that \u201cprohibition constitutes an unjustifiable interference in the freedom of consenting adults\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 454). Peter de Marneffe[<a href=\"http:\/\/www.oxfordscholarship.com\/view\/10.1093\/acprof:oso\/9780195383249.001.0001\/acprof-9780195383249\" target=\"_blank\">5<\/a>] puts the view like this:<\/p>\n<blockquote><p>Discretionary control over one\u2019s own sexual activity [is] central to sexual autonomy, [to] control over one\u2019s body, and so to personal autonomy. \u2026 It is important that adults have the discretion to make personal choices about the kind of sex they engage in with other adults, even if these choices are unwise. So it is objectionable for the government to prohibit a person for using her own body and sexuality for prostitution. (quoted in [<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 454).<\/p><\/blockquote>\n<p>As it happens, I tend to agree with this kind of analysis.[<a href=\"https:\/\/www.academia.edu\/12055156\/Born_this_way_How_high-tech_conversion_therapy_could_undermine_gay_rights\" target=\"_blank\">6<\/a>, <a href=\"https:\/\/www.academia.edu\/10270196\/Female_genital_mutilation_and_male_circumcision_Toward_an_autonomy-based_ethical_framework\" target=\"_blank\">7<\/a>, <a href=\"http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/21507740.2013.863242\" target=\"_blank\">8<\/a>, <a href=\"http:\/\/journal.frontiersin.org\/article\/10.3389\/fnhum.2014.00953\/full\" target=\"_blank\">9<\/a>] Just think: adults are allowed to have sex with someone they might otherwise find unappealing in exchange for literally anything they desire except money: promises of emotional support, the prospect of economic security, or maybe just a few drinks at the bar. This doesn\u2019t mean those are good <em>reasons <\/em>to engage in sexual intercourse\u2014but it\u2019s up to you how you negotiate your needs and desires.<\/p>\n<p>More generally, however, when it comes to prohibition, one has to remember that it\u2019s no small step from (on the one hand) getting your ethical analysis in order\u2014in terms of establishing if a given practice is in fact harmful, and in what particular way\u2014to (on the other hand) determining what kinds of social and legal changes would best reduce the harm, with the least amount of collateral damage.[<a href=\"http:\/\/blog.practicalethics.ox.ac.uk\/2014\/03\/things-ive-learned-so-far-about-how-to-do-practical-ethics\/\" target=\"_blank\">10<\/a>]<\/p>\n<p>To put it simply, prohibition is often a bad idea, <em>even if <\/em>the targeted activity is harmful.[<a href=\"http:\/\/jme.bmj.com\/content\/39\/7\/418.extract\" target=\"_blank\">11<\/a>]<\/p>\n<p><strong>Back to Thomsen<\/strong><\/p>\n<p>Now, Thomsen actually appears to agree with this. So, after taking several pages to try to convince us that prostitution can plausibly be regarded as bad (because it\u2019s at least somewhat intrinsically harmful), and that the best arguments to the contrary are not as strong as they may seem\u2014he nevertheless concludes that the \u201ccase for [actual] prohibition is murkier and weaker than its proponents sometimes suggest\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 455). A mere three sentences later, however, Thomsen shifts gears rather awkwardly and asks us to go ahead and just \u201cassume for the sake of argument that the balance of reasons favours a general prohibition of prostitution\u201d (<em><a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">ibid<\/a>)<\/em>!<\/p>\n<p>Now, for my money, if <em>that\u2019s<\/em> what he wanted us to accept, he should have just started the paper with that assumption\u2014however unreasonable it may be\u2014and then proceeded to tell us his thoughts about an exception for disability. But let&#8217;s go along with the shift in gears.\u00a0What is Thomsen\u2019s case for a \u201cdisability\u201d exception to a ban on prostitution?<\/p>\n<p><strong>Buying sex\u2014for disabled people only?<\/strong><\/p>\n<p>Thomsen points to two facts that lay the groundwork for his position:<\/p>\n<blockquote><p>(1) Many or most persons have a sexuality that generates strong needs for sexual relations, and<\/p>\n<p>(2) Some disabled persons are partially or entirely incapable of satisfying this need except through the purchase of sexual services from a prostitute. ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 455)<\/p><\/blockquote>\n<p>Let me give you an example of what he means. Quoting from another source,[<a href=\"http:\/\/myweb.dal.ca\/mgoodyea\/Documents\/Sexuality\/The%20politics%20of%20sexual%20citizenship%20Sanders%20Disability%20Soc%202007%2022(5)%20439.pdf\" target=\"_blank\">12<\/a>] he cites the case of a man who \u201ccouldn\u2019t walk and his carer would bring him. You had to lift him out of the wheelchair and into the Jacuzzi and he was stiff because he didn\u2019t move his arms or legs. He couldn\u2019t move, could get an erection but that was about it\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 455).<\/p>\n<p>Evidently, in exchange for money, someone was willing to have sex with this man under the stated conditions, and this was helpful for resolving his \u201cneeds for sexual relations.\u201d (Note that Ezio Di Nucci has suggested a very interesting alternative: namely, establishing non-profit charities whose members would <em>voluntarily<\/em> provide sexual pleasure to the severely disabled.[<a href=\"http:\/\/jme.bmj.com\/content\/37\/3\/158.abstract\" target=\"_blank\">13<\/a>] For a related story, see the fascinating autobiographical account, \u201c<a href=\"http:\/\/www.bioethics.northwestern.edu\/docs\/atrium\/atrium-issue12.pdf\">Head Nurses<\/a>\u201d by William Peace in <em>Atrium<\/em> magazine.)[<a href=\"http:\/\/www.bioethics.northwestern.edu\/docs\/atrium\/atrium-issue12.pdf\" target=\"_blank\">14<\/a>]<\/p>\n<p>What should we say about a case like this? The first thing to point out is that the man\u2019s disability didn\u2019t make it so that he <em>physically couldn\u2019t have sex<\/em> (if that were the case, hiring a prostitute would not help his situation); instead, the issue was more that he <em>couldn\u2019t find a willing sexual partner<\/em> \u2026 <em>for whatever reason<\/em>.<\/p>\n<p>Now, it seems reasonable to conclude that\u2014in this particular instance\u2014the \u201creason\u201d had something to do with his physical disability. In other words, it is likely that (all else being equal) relatively few people would maximally\u00a0desire to form a sexual relationship with someone who could not \u201cmove his arms or legs\u201d (although I imagine that there are many exceptions).<\/p>\n<p>But that\u2019s a very specific issue\u2014and it glosses over a more general point. And that is that <em>all sorts of people<\/em> find it difficult to find a willing sexual partner\u2014or enough willing sexual partners\u2014to \u201csatisfy\u201d their sexual needs, for a<em> whole range of reasons<\/em> that have nothing to do with physical (or mental) disability of the \u201cobvious\u201d kind exemplified by this man. They may just be perceived as unattractive. Or they may be shy. Alternatively, they may be very attractive\u2014and not at all shy\u2014and just have an insatiable sexual appetite. Are all of these people \u201cdisabled\u201d on Thomsen\u2019s account?<\/p>\n<p><strong>Defining disability<\/strong><\/p>\n<p>It\u2019s hard to tell. On the one hand, Thomsen could define \u201cdisability\u201d in a very narrow sense that captures only the \u201cobvious\u201d cases that everyone would recognize\u2014perhaps typified by the man in the example. But this would result in an extremely unreliable, and indeed almost absurdly arbitrary proxy for the \u201creal\u201d underlying issue at stake, which is the difficulty that some people have in finding a willing sexual partner(s) sufficient to meet their sexual needs without having recourse to prostitutes.<\/p>\n<p>After all, innumerable people with physical and\/or mental disabilities have extremely satisfying sexual relationships, so the connection between \u201chaving a disability\u201d (of some kind) and \u201cbeing perceived as sexually unappealing\u201d is so tangential as to be almost offensive.<\/p>\n<p>On the other hand, Thomsen has the option of defining \u201cdisability\u201d in a very broad sense\u2014which is what he does in fact choose\u00a0to do\u2014which carries\u00a0its\u00a0own set of problems. For one thing, it refers to an extremely vague and amorphous group of people who (to quote from Thomsen\u2019s definition) have \u201can anomalous physical or mental condition that, given [their] social circumstances, sufficiently limits [their] possibilities of exercising [their] sexuality, including fulfilling [their] sexual needs\u201d ([<a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\" target=\"_blank\">1<\/a>], p. 455).<\/p>\n<p>But that could include just about anyone! For one thing, there is the nearly boundless room for interpretation surrounding most of the key terms in Thomsen\u2019s definition: \u201canomalous,\u201d \u201cphysical,\u201d \u201cmental,\u201d \u201ccondition,\u201d \u201csufficiently,\u201d and \u201cfulfill.\u201d For example, what is \u201canomalous\u201d \u2013 ? Statistically rare? How rare? As measured along what dimension? Also, why should the condition have to be \u201canomalous\u201d in any event? Isn\u2019t it the (lack of) functional outcome that is the morally relevant concern here?<\/p>\n<p>Or think about the word \u201ccondition\u201d \u2013 meaning what? Is shyness (to repeat that example) a \u201cmental condition\u201d that counts as a disability? And what about \u201csufficiently\u201d? How shall we determine the cut-off? In other words, just how \u201chard\u201d does it have to be to find a willing sexual partner before one is allowed to register oneself as \u201csexually disabled,\u201d say, and pick up her \u201cprostitution exemption\u201d card? And finally\u2014\u201cfulfill.\u201d Wouldn\u2019t, say, most married couples report that their sexual needs were not \u201cfulfilled\u201d in some relevant way? Indeed, one <a href=\"https:\/\/www.prepare-enrich.com\/pe_main_site_content\/pdf\/research\/national_survey.pdf\">survey<\/a> puts the figure at 57%.[<a href=\"http:\/\/enrich.com\/pe_main_site_content\/pdf\/research\/national_survey.pdf\" target=\"_blank\">15<\/a>]<\/p>\n<p><strong>Conclusion<\/strong><\/p>\n<p>So this doesn\u2019t seem to be the way to go. Either the definition of disability is so narrow as to be unjustifiably arbitrary as a proxy for the real underlying moral issue, or it\u2019s so broad as to include almost anyone. Why not\u2014instead\u2014just argue against a general prohibition, and let mature individuals decide for themselves (a) what kind of consensual sex they wish to engage in, and (b) in exchange for what.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References<\/strong><\/p>\n<p>[1] Thomsen, F. K. (2015). <a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/451.abstract\">Prostitution, disability and prohibition<\/a>. <em>Journal of Medical Ethics<\/em>, <em>41<\/em>(6), 451-459.<\/p>\n<p>[2] Moen, O. M. (2014). <a href=\"http:\/\/jme.bmj.com\/content\/early\/2012\/08\/27\/medethics-2011-100367.short\" target=\"_blank\">Is prostitution harmful<\/a>? <em>Journal of Medical Ethics<\/em>, <em>40<\/em>(2), 73-81.<\/p>\n<p>[3] Vanwesenbeeck, I. (2005). <a href=\"http:\/\/link.springer.com\/article\/10.1007%2Fs10508-005-7912-y#page-1\">Burnout among female indoor sex workers<\/a>. <em>Archives of Sexual Behavior<\/em>, <em>34<\/em>(6), 627-639.<\/p>\n<p>[4] Semrau, L. (2015). <a href=\"http:\/\/jme.bmj.com\/content\/41\/6\/443.full\">The best argument against kidney sales fails<\/a>. <em>Journal of Medical Ethics<\/em>, <em>41<\/em>(6), 443-446.<\/p>\n<p>[5] De Marneffe, P. (2009). <em><a href=\"http:\/\/www.oxfordscholarship.com\/view\/10.1093\/acprof:oso\/9780195383249.001.0001\/acprof-9780195383249\" target=\"_blank\">Liberalism and prostitution<\/a><\/em>. Oxford University Press.<\/p>\n<p>[6] Vierra, A., &amp; Earp, B. D. (2015). Born this way? How high-tech conversion therapy could undermine gay rights. <em>The Conversation<\/em>. Available at <a href=\"https:\/\/www.academia.edu\/12055156\/Born_this_way_How_high-tech_conversion_therapy_could_undermine_gay_rights\">https:\/\/www.academia.edu\/12055156\/Born_this_way_How_high-tech_conversion_therapy_could_undermine_gay_rights<\/a>.<\/p>\n<p>[7] Earp, B. D. (in press). Female genital mutilation and male circumcision: Toward an autonomy-based ethical framework. <em>Medicolegal and Bioethics<\/em>, in press. Available at <a href=\"https:\/\/www.academia.edu\/10270196\/Female_genital_mutilation_and_male_circumcision_Toward_an_autonomy-based_ethical_framework\">https:\/\/www.academia.edu\/10270196\/Female_genital_mutilation_and_male_circumcision_Toward_an_autonomy-based_ethical_framework<\/a>.<\/p>\n<p>[8] Earp, B. D., Sandberg, A., &amp; Savulescu, J. (2014). <a href=\"http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/21507740.2013.863242\" target=\"_blank\">Brave new love: The threat of high-tech \u201cconversion\u201d therapy and the bio-oppression of sexual minorities<\/a>. <em>AJOB Neuroscience<\/em>, <em>5<\/em>(1), 4-12.<\/p>\n<p>[9] Maslen, H., Earp, B. D., Cohen Kadosh, R., &amp; Savulescu, J. (2014). <a href=\"http:\/\/journal.frontiersin.org\/article\/10.3389\/fnhum.2014.00953\/full\" target=\"_blank\">Brain stimulation for treatment and enhancement in children: An ethical analysis<\/a>. <em>Frontiers in Human Neuroscience<\/em>, <em>8<\/em>(953), 1-5.<\/p>\n<p>[10] Earp, B. D. (2014). Things I have learned (so far) about how to do practical ethics. <em>Practical Ethics<\/em>. University of Oxford. Available at <a href=\"http:\/\/blog.practicalethics.ox.ac.uk\/2014\/03\/things-ive-learned-so-far-about-how-to-do-practical-ethics\/\">http:\/\/blog.practicalethics.ox.ac.uk\/2014\/03\/things-ive-learned-so-far-about-how-to-do-practical-ethics\/<\/a>.<\/p>\n<p>[11] Earp, B. D. (2013). <a href=\"http:\/\/jme.bmj.com\/content\/39\/7\/418.extract\" target=\"_blank\">The ethics of infant male circumcision<\/a>. <em>Journal of Medical Ethics<\/em>, <em>39<\/em>(7), 418-420.<\/p>\n<p>[12] Sanders, T. (2007). <a href=\"http:\/\/myweb.dal.ca\/mgoodyea\/Documents\/Sexuality\/The%20politics%20of%20sexual%20citizenship%20Sanders%20Disability%20Soc%202007%2022(5)%20439.pdf\" target=\"_blank\">The politics of sexual citizenship: commercial sex and disability<\/a>. <em>Disability &amp; Society<\/em>, <em>22<\/em>(5), 439-455.<\/p>\n<p>[13] Di Nucci, E. (2011). <a href=\"http:\/\/jme.bmj.com\/content\/37\/3\/158.abstract\" target=\"_blank\">Sexual rights and disability<\/a>. <em>Journal of Medical Ethics<\/em>, <em>37<\/em>(3), 158-161.<\/p>\n<p>[14] Peace, W. (2014). <a href=\"http:\/\/www.bioethics.northwestern.edu\/docs\/atrium\/atrium-issue12.pdf\" target=\"_blank\">Head nurses<\/a>. <em>Atrium<\/em>, Winter, 12, 20-22.<\/p>\n<p>[15] National Survey of Marital Strengths. Available at https:\/\/www.prepare-enrich.com\/pe_main_site_content\/pdf\/research\/national_survey.pdf.<\/p>\n<p><strong>Acknowledgments<\/strong><\/p>\n<p>Thanks to Julian Savulescu, John Danaher, Michael Hauskeller, and Ole Martin Moen for feedback on these ideas.<\/p>\n<p><strong>About the author:<em>\u00a0<\/em><\/strong><\/p>\n<p><em>Brian D. Earp is a researcher in science and ethics at the University of Oxford, and an Associate Editor\u00a0at the<\/em> <em>Journal of Medical Ethics. He blogs regularly at the <\/em><a href=\"http:\/\/blog.practicalethics.ox.ac.uk\/author\/brian-earp\/\"><em>Practical Ethics blog<\/em><\/a><em> hosted by the Uehiro Centre for Practical Ethics at the University of Oxford, and contributes a monthly blog here at the JME Blog as well. <\/em><a href=\"https:\/\/twitter.com\/briandavidearp\"><em>Follow Brian on Twitter<\/em><\/a><em> at @briandavidearp.<\/em><\/p>\n<p><strong>* Note that this entry is being <\/strong><strong>cross-posted at the\u00a0<em>Practical Ethics<\/em> blog<\/strong><strong>.<\/strong><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Brian D. Earp Introduction Is prostitution harmful? And if it is harmful, should it be illegal to buy (or sell) sexual services? And if so, should there ever be any exceptions? What about for people with certain disabilities\u2014say\u2014who might find it difficult or even impossible to find a sexual partner if they weren\u2019t allowed [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2015\/06\/17\/prostitution-harm-and-disability\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7933,443,328,475],"tags":[395,137,7935,7925,615,383,381,7939,690,7942,7937,787,7938,7936],"class_list":["post-2914","post","type-post","status-publish","format-standard","hentry","category-brian-earps-posts","category-jme","category-philosophy","category-politics","tag-bioethics","tag-ethics","tag-harm","tag-journal-of-medical-ethics","tag-medical-ethics","tag-medical-ethics-blog","tag-principles-of-biomedical-ethics","tag-prohibition","tag-prostitution","tag-research-ethics","tag-sex","tag-sex-education","tag-sexual-autonomy","tag-thomsen"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Prostitution, Harm, and Disability: Should Only People with Disabilities be Allowed to Pay for Sex? - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2015\/06\/17\/prostitution-harm-and-disability\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Prostitution, Harm, and Disability: Should Only People with Disabilities be Allowed to Pay for Sex? - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Brian D. Earp Introduction Is prostitution harmful? And if it is harmful, should it be illegal to buy (or sell) sexual services? And if so, should there ever be any exceptions? 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