This paper explores the relationship between disability and quality of life and some of its implications for bioethics and healthcare. It focuses on the neglected perfectionist approach that ties well-being to the flourishing of human nature, which provides the strongest support for the common view of disability as a harm. After critiquing the traditional Aristotelian version of perfectionism, which excludes the disabled from flourishing by prioritizing rationalistic goods, I defend a new version that prioritizes the social capacities of human nature and the goods of personal relationship. This relationship-centered perfectionism is able to accommodate and explain disabled thriving. I also show how these issues have important implications for specific bioethical debates and clinical practices, using a cluster of issues related to Down syndrome as timely illustrations. My goal is to sketch a perfectionist theory that gives a more plausible account of the relationship between disability and well-being and that provides better practical guidance in cases involving judgments about the quality of disabled lives.

中文翻译：

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生活质量不受限制：残疾，人性，福祉和人际关系。

本文探讨了残疾与生活质量之间的关系及其对生物伦理​​学和医疗保健的影响。它侧重于将幸福与人性的繁荣联系在一起的被忽略的完美主义方法，该方法为将残疾视为伤害的普遍观点提供了最有力的支持。在对传统的亚里斯多德式的完美主义进行批判之后，我通过优先考虑理性主义的商品来使残疾人无法蓬勃发展，之后，我捍卫了一个新版本，该版本优先考虑了人性的社会能力和人际关系的商品。这种以关系为中心的完美主义能够容纳并解释残疾人的蓬勃发展。我还将展示这些问题如何对特定的生物伦理学辩论和临床实践产生重要影响，使用与唐氏综合症有关的一系列问题作为例证。我的目标是勾勒出一种完美主义理论，该理论更加合理地说明了残疾与幸福之间的关系，并且在涉及对残疾人生活质量的判断的案例中提供了更好的实践指导。