One of the best days of my life—and one of the scariest—was the day my twin daughters were born. My wife went into labor 13 weeks prematurely, and the girls were born by a traumatic emergency C-section. Sophia was born first, and as they carried her away to a small exam table, a nurse whispered in my ear that I should come see her because they didn’t know how long she’d be with us. She was no bigger than my hand, and I had never seen a human being who looked more frail or vulnerable. Olivia was born two minutes later.

Their premature births were the beginning of our family’s unexpected journey into the world of disabilities. By the time Sophia and Olivia were two, both girls had been diagnosed with autism, a rare seizure disorder and white matter disease. Olivia was eventually diagnosed with an intellectual disability, too. Thanks be to God, both girls have lived to become young adults. They have made me a better person, helped my wife to become an amazing mother and shaped their sister—our oldest daughter, Grace—into one of the most loving and compassionate people I know. 

Don’t get me wrong: They have their moments. But they have truly been blessings to our family, the world and the church.

I shudder to think that if Sophia and Olivia had been born 30 years earlier, we would most likely have been told to put them in an institution and forget about them. And now, if the Trump administration has its way, they might still end up in an institution.

The integration mandate

What has made it possible for Sophia and Olivia to thrive at home and in our community is the protections afforded by the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973 and the Supreme Court’s decision in Olmstead v. L.C. in 1999. These legal actions, along with the federal government’s policies for implementing them, gave rise to the “integration mandate,” which requires that services be provided to people with disabilities in the most integrated setting appropriate to the individual’s needs—often their homes or local community. 

For the last 30 years or so, this mandate has empowered countless people with disabilities to live on their own, with their families or in other places of their choosing rather than being coerced to live in institutions. If you know anything about the history of those institutions, you’ll understand how important the integration mandate is for people with disabilities to be able to live lives that honor their innate human dignity. 

If you don’t know that history, it might be helpful to watch the 1972 exposé about the Willowbrook State School, where people with intellectual disabilities were subjected to filthy, overcrowded conditions, abuse and even unethical medical experiments (including being deliberately infected with hepatitis). I warn you, though: What you will see in the footage taken from that institution will make you sick.

This is why many in the disability community have been so alarmed by a recent barrage of attacks on the integration mandate. They’re afraid it portends a return to the days of coerced institutionalization. 

The legal assault began with a lawsuit commonly referred to as Texas v. Kennedy. The suit was originally filed in 2024 and used a scattergun approach to attack Biden-era Health and Human Services regulations for implementing Section 504 of the Rehabilitation Act, which prohibits disability-based discrimination in programs and activities that receive federal financial assistance. As the case evolved, it became more focused on removing the integration mandate from these regulations. 

In June of 2026, the Department of Justice issued a “slip opinion” in which it argued, contrary to some 30 years of established jurisprudence, that the Americans With Disabilities Act and Section 504 do not actually contain an integration mandate and that executive branch agencies do not have the authority to impose one. 

In July, the D.O.J. issued a clarification in which it stated that federal regulations containing an integration mandate are not legally enforceable. 

In August, the D.O.J. asked a federal court to vacate its decision in United States v. Florida, a case in which the federal government had already prevailed in its efforts to require Florida to provide home and community-based services to medically fragile children rather than forcing them to live in nursing homes if they want to receive life-saving care. The D.O.J. stated that it does not make sense for the court to require injunctive relief from Florida—in other words, to require the state to provide services that would allow these children to live at home with their families—because the government no longer espouses the legal principle that had undergirded its own case—that is, the integration mandate. 

On Sept. 1, the D.O.J. filed a joint motion with Texas and its co-plaintiffs to settle Texas v. Kennedy. In this motion, the government agreed to strike a number of provisions related to the integration mandate from federal regulations, including the fundamental requirement for services to be provided in the most integrated environment appropriate to the individual. And on Sept. 23, a federal judge accepted the motion, removing community integration requirements from Department of Health and Human Services regulations.

If there was any doubt about the federal government’s intentions regarding a return to the days of institutionalization, the D.O.J.’s actions should remove it. The Trump administration is clearly signaling that the federal government will no longer hold states accountable for providing home- and community-based services to people with disabilities if the states choose to fund only institutional services. Several deep red states are already pushing that agenda, leaving people with disabilities in those states in a particularly precarious position.

Catholic concerns

Catholics should be especially troubled by this situation. The “Pastoral Statement of U.S. Catholic Bishops on Persons With Disabilities” tells us:

The central meaning of Jesus’ ministry is bound up with the fact that He sought the company of people who, for one reason or another, were forced to live on the fringe of society. (cf. Mk. 7:37) These He made the special object of His attention, declaring that the last would be first and that the humble would be exalted in His Father’s kingdom. (cf. Mt. 20:16, 23:12) The Church finds its true identity when it fully integrates itself with these marginal people, including those who suffer from physical and psychological disabilities.

In keeping with Jesus’ own care for people with disabilities during his earthly ministry, the church is called to accompany, empower and advocate for those who have disabilities today. What does this call demand of us in the present moment? From my perspective as a Catholic philosopher of disability, the answer seems clear. It demands that we speak up against what is happening in the courts and at the Department of Justice. Every relevant principle of Catholic social teaching cries out against unnecessary institutionalization for people with disabilities. 

All human beings possess the same inherent and inalienable dignity, and this includes people with disabilities. Taking away the opportunity to live and receive services in the most integrated environment from people with disabilities and their families is an affront to their dignity. It deprives them of autonomy. It prevents them from making contributions to society through their work and other activities. And it severs bonds of friendship and family. 

A life of forced institutionalization is also inconsistent with the most fundamental aspects of Catholic anthropology, which teaches that every human being has free will, that we are social beings whose primary social unit is the family, that we all share the same natural capacities (even if our abilities to use these capacities differ) and that each of us has gifts to contribute to the world.

Unfortunately, the way we have chosen to organize society has made people with disabilities disproportionately poor and marginalized. Because of this, the Catholic commitment to the preferential option for the poor and vulnerable places a special demand on us to take action when these brothers and sisters are subjected to injustice.

Subsidiarity and solidarity

Taking control of where they live away from people who have disabilities and, when appropriate, their families is also contrary to the principle of subsidiarity, which demands that higher-level authorities not supplant the legitimate roles of individuals and families in making decisions about matters that affect them directly. 

As Pope Leo XIV has recently written in “Magnifica Humanitas,” “If every woman and man is called to take ownership of his or her own life and to contribute to the formation of society, then social institutions must also respect and support this responsibility.” This statement draws a clear connection between subsidiarity, with its focus on the individual, and the principle of solidarity, which requires that we arrange our social institutions, including government programs and the economy, in a manner that ensures the dignity and full participation of all members of society. Forcing people who have disabilities to live in institutions in order to receive services they need is the very antithesis of true solidarity.

Proponents of this kind of intervention might argue that organizing services for disabled people so that they are administered through institutions rather than through home- and community-based providers will be more financially efficient. Most of the existing evidence suggests that this is not true. It is significantly more expensive to provide services to a person in an institution than in a home- or community-based setting. More important for Catholics, though, while we understand the need to be good stewards of society’s financial resources, it is human dignity, not market efficiency, that must be the guiding principle from which we form a society that is truly just and free for all of its members. People have a fundamental value that is greater than money. 

A pro-life church and world

Mindful of the value of human life—all human life—we should also ask how a return to the days of forced institutionalization comports with the church’s pro-life teaching. Can we really say that we are a pro-life people if we are unwilling to provide the conditions for disabled people to live lives that are commensurate with their full human dignity? Worse yet, in a world where parents who receive a difficult prenatal diagnosis already feel pressured to terminate their pregnancies, the writing is on the wall about what will happen if we return to the days in which parents were told to put children like my daughters in an institution and forget about them: More and more of those children will be aborted. 

With a growing number of countries now treating disability as grounds for “granting access” to euthanasia and assisted suicide, it is also not hard to imagine that there will be a slippery slope from institutionalization to an increase in those practices—especially under the leadership of a president who is reported to have told his nephew, whose son lives with profound disabilities: “He doesn’t recognize you. Maybe you should just let him die and move to Florida.”

As a father, I often worry about what will happen to my daughters when my wife and I can no longer take care of them. Many parents of children with disabilities say that this is their greatest fear: that there will be no one to care for their loved ones when they’re gone. The specter of unnecessary—and even forced—institutionalization gives rise to new fears, though: fears of a world in which children like my daughters would never be born in the first place; or, once born, would be sentenced to the sub-human institutional life disabled people suffered in my parents’ generation; or, worse yet, would be cast into a system that believes killing them is an appropriate response to their disabilities.

Catholics should be deeply troubled by what’s happening in the Department of Justice and in the courts, and by the future these events portend. We should raise our voices—and the church should use its considerable influence—to stop these growing threats. We cannot allow coerced institutionalization to be the future for our brothers and sisters who have disabilities.

Michael M. Waddell is the McMahon Aquinas Professor of Philosophy and founding director of the graduate program in Autism Studies at Saint Mary's College in Notre Dame, Ind. He writes and teaches on issues at the intersection of disability and philosophy, with a special interest in autism.