Justice, Disability, and Law: A Neurological and Ethical Assessment of Multiple Sclerosis in Turkey.

backgroundThis study analyzes Supreme Court decisions involving parties diagnosed with Multiple Sclerosis (MS) between 2008 and 2024, focusing on disability justice and the normative evaluation of judicial practice. MS is a chronic neurological disease with potential physical and neurocognitive consequences that may affect legal capacity, employment, and social participation. The study is grounded in the United Nations Convention on the Rights of Persons with Disabilities (CRPD), Daniels’ principle of Fair Equality of Opportunity, and Fricker’s concept of epistemic injustice.

methodsA qualitative document analysis was conducted on 85 Supreme Court decisions in which at least one party had an MS diagnosis. Decisions were classified according to civil or criminal chambers and type of legal dispute. The analysis examined reliance on institutional medical reports, requests for individualized neurological or neurocognitive assessments, and the compatibility of judicial reasoning with normative disability justice standards.

resultsOf the 85 decisions, 63 belonged to civil chambers and 18 to criminal chambers (HGK: 3, CGK: 1). In civil law, divorce cases were most frequent (24/63; 38.1%), followed by disability or social security disputes (10/63), labor law cases (7/63; 11.1%), and work accident or workforce loss cases (6/63). In disability or workforce loss cases (n = 16), Social Security Institution reports were considered decisive in 14 cases (87.5%), while independent neurological evaluations were requested in only three cases. In criminal cases (n = 19), individuals with MS were victims in 12 cases and defendants in 7; forensic medical reports were obtained in 5 of the defendant cases, with partial criminal capacity reduction applied in only one case. No explicit reference to standardized neurocognitive testing (e.g., MoCA, MMSE, ACE-R) was identified in the publicly accessible decision texts.

conclusionsThe frequent prioritization of institutional reports over individualized neurological assessments, together with the limited consideration of neurocognitive vulnerability, may be in tension with Articles 12 and 27 of the CRPD and may contribute to structural inequality. To promote disability justice, we propose adopting personalized neurological assessment as a procedural minimum standard, ensuring independent expertise in administrative–clinical report conflicts, clarifying reasonable accommodation obligations in labor law, introducing aggravating circumstances in crimes against disabled victims, and incorporating standardized neurocognitive tests into criminal capacity evaluations.