 In their influential book From Chance to Choice, Buchanan et al. (2000) repeat the assertion that there would be excessive social costs in reconstructing society to permit the full participation of people with significant cognitive impairments. They compare the reconstruction of society for greater inclusion with a family decision to play only the card games that a young child can understand. They contend that just as adults will tire of a constant game of Go Fish, the society will be “dumbed down” if it refashions itself to fully include people with cognitive impairments.