Between Diversity and Exclusion: Bioethics Reflections on the Vulnerabilities of Neurodivergent People
DOI:
https://doi.org/10.14422/rib.i31.y2026.004Keywords:
bioethics, neurodevelopmental disorders, health vulnerability, autism spectrum disorder, attention deficit disorder with hyperactivity, dyslexiaAbstract
This article presents a narrative literature review on the vulnerabilities experienced by neurodivergent people, considering ethical, biomedical, legal and social dimensions. Neurodivergence, which includes conditions such as autism spectrum disorder, attention deficit hyperactivity disorder and dyslexia, challenges the traditional biomedical model by proposing the appreciation of neurological diversity as part of the human condition. The analysis highlights tensions between the biomedical and neurodiversity paradigms, pointing out their respective limits and contributions. The discussion focuses on topics such as structural ableism, stigma, informed consent, school inclusion, workplace equity and relational autonomy. National and international legal frameworks that guarantee rights, although still anchored in pathologizing language, are also examined. It concludes that overcoming vulnerabilities requires clinical practices and public policies that combine empathy, restorative justice and the recognition of the plurality of ways of being, thus promoting inclusion that is both effective and equal.
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References
Armstrong, T. (2011). The power of neurodiversity: unleashing the advantages of your differently wired brain. Da Capo Press.
Brasil. (2008, 17 de setembro). Decreto nº 6.571, de 17 de setembro de 2008. Dispõe sobre o atendimento educacional especializado. Diário Oficial da União. http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2008/decreto/d6571.htm
Brasil. (2009, 25 de agosto). Decreto nº 6.949, de 25 de agosto de 2009. Promulga a Convenção sobre os Direitos das Pessoas com Deficiência. Diário Oficial da União. http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2009/decreto/d6949.htm
Brasil. (2012, 27 de dezembro). Lei nº 12.764, de 27 de dezembro de 2012. Institui a Política Nacional de Proteção dos Direitos da Pessoa com Transtorno do Espectro Autista. Diário Oficial da União. http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2012/lei/l12764.htm
Brasil. (2020, 8 de janeiro). Lei nº 13.977, de 8 de janeiro de 2020. Institui a Carteira de Identificação da Pessoa com Transtorno do Espectro Autista (CIPTEA). Diário Oficial da União. http://www.planalto.gov.br/ccivil_03/_ato2019-2022/2020/lei/L13977.htm
Brasil. (2021, 30 de novembro). Lei nº 14.254, de 30 de novembro de 2021. Dispõe sobre o acompanhamento integral para educandos com dislexia, TDAH e outros transtornos de aprendizagem. Diário Oficial da União. http://www.planalto.gov.br/ccivil_03/_ato2019-2022/2021/lei/L14254.htm
Burrow, A. (2020). Relational autonomy and support for autonomy: A commentary on “Relational Autonomy as a Theoretical Lens for Qualitative Health Research” by Jennifer A. H. Bell. IJFAB: International Journal of Feminist Approaches to Bioethics, 13(2), 11–17. https://doi.org/10.3138/ijfab.13.2.11
Gawande, A. (2010). Complicações: medicina e as imperfeições humanas. Companhia das Letras.
Gorbea, M. S. (2025). Beyond binary models: a bioethical inquiry into neurodiversity and the medical framework in mental health. AJOB Neuroscience, 16(1), 51-54. https://doi.org/10.1080/21507740.2024.2438024
Kapp, S. K. (ed.). (2020). Autistic community and the neurodiversity movement: stories from the frontline. Palgrave Macmillan. https://doi.org/10.1007/978-981-13-8437-0
Knopes, J. (2025). Mental health conditions between neuro-diversity and the medical model. AJOB Neuroscience, 16(1), 20-31. https://doi.org/10.1080/21507740.2024.2412549
Knopes, J. (2025). Rethinking neuroethics: between acceptance and intervention. Neuroethics Journal.
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. https://doi.org/10.1016/j.jaac.2017.03.013
Rose, N. (2013). The human sciences in a biological age. Theory, Culture & Society, 30(1), 3-34. https://doi.org/10.1177/0263276412456569
Schmidt, R. B. (2025). The power of a patient's story: a practice in cultural humility. Frontiers in Global Women's Health, 6, 1498385. https://doi.org/10.3389/fgwh.2025.1498385
Shore, L. M., Cleveland, J. N., & Sanchez, D. (2018). Inclusive workplaces: a review and model. Human Resource Management Review, 28(2), 176-189. https://doi.org/10.1016/j.hrmr.2017.07.003
Singer, J. (1999). Why can’t you be normal for once in your life? From a “problem with no name” to a new category of disability. In M. Corker & S. French (eds.), Disability discourse (pp. 59-67). Open University Press.
Singer, J. (2016). Neurodiversity: the birth of an idea. Amazon.
Singer, J. (2020, agosto). Taster: explaining neurodiversity [blog]. Reflections on Neurodiversity. https://neurodiversity2.blogspot.com/2020/08/neurodiversity-what-it-is-and-isnt.html
Singer, J. (2021, 20 de fevereiro). Neurodiversity: it’s politics, not science! ...or... It’s the name of a social justice movement, not a diagnosis [blog]. Reflections on Neurodiversity. https://neurodiversity2.blogspot.com/2021/02/neurodiversity-its-political-not.html
Snowling, M. J. y Hulme, C. (2012). Annual research review: the nature and classification of reading disorders—a commentary on proposals for DSM-5. Journal of Child Psychology and Psychiatry, 53(5), 593-607. https://doi.org/10.1111/j.1469-7610.2011.02495.x
Stevens, B., & Kirby, E. (2025) Neuroqueer in/and social work: A scoping review of theory and practice. The British Journal of Social Work, 55(5), 2519-2540. https://doi.org/10.1093/bjsw/bcaf059
Thapar, A. y Cooper, M. (2016). Attention deficit hyperactivity disorder. The Lancet, 387(10024), 1240-1250. https://doi.org/10.1016/S0140-6736(15)00238-X
United States. (1990). Americans with Disabilities Act of 1990 (ADA). Public Law 101-336. U.S. Department of Justice Civil Rights Division. https://www.ada.gov/
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Copyright (c) 2026 Fernanda Boos-Lima, Bernardo Fumian Silva, Guilherme Vaz de Melo Trindade, Julianne Belchior da Silva, Nicollas Campos Martuchelli, Paula Ludmila Rocha Ferreira, Rafaela de Brito Ribeiro, Maria Isabel Villalobos
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