This chapter continues the theme of Part Two, tracing how we got to where we are today. In this chapter we examine changing assumptions about intellectual disability and their implications for a good life. In particular we explore how intellectual disability has been variously constructed as a problem and how ‘solutions’ to it have changed over time. We argue that despite dramatic changes in the way intellectual disability has been constructed since the early 20th century, there are continuities also, in the form of the creation of a binary – us and them – and a wish to diminish or minimise the costs associated with supporting adults who are rarely able to be financially self-supporting, and that ‘they’ constitute a perceived problem for which a solution has to be found. As a result of this, we argue that it is hardly surprising that a good life for people with intellectual disabilities has not been at the forefront of society's planning and practice in relation to them.

Chapter Four provided an account of how policy has evolved to the point where a ‘better life’ is equated with individualism, and, as Burton and Kagan put it, ‘significant impairments and the personal histories that produce human damage are not so much denied as glossed over’ (2006, p 305). There is a paradox here. As we have shown in Part One, contemporary views of a good life, in part, have been premised on values of autonomy, equality and participation. The fact that some adults require care underpins their exclusion from conventional conceptualisations of a good life. And yet, in spite of a failure to systematically define a good life, current policy across the English-speaking world now asserts the relevance of these values to the lives of people with intellectual disabilities.

In this chapter we argue that over the past 50 years, roughly the second half of the 20th century, ideas about people with intellectual disabilities shifted dramatically. From being a burden on society, they have become in rhetoric people to whom society owes a duty to provide at least some of the current values of a ‘good life’.