Dahl has remarked on how democratic theorists largely avoid directly confronting the question of who has a rightful claim to be included in the demos. Anderson places emphasis on the communicative dimension of participation, envisaging democracy as 'collective self-determination by means of open discussion among equals'. The suggestion is that people with People with profound and multiple learning difficulties (PMLD) cannot exercise the right to vote because they lack the requisite competence. Someone with PMLD can choose whether or not to accept the food offered to him, without exercising any intellectual ability – or, at least, any intellectual ability of the kind required to choose between political alternatives. If people with PMLD are not entitled to participate in the political process then they are 'disqualified form the most essential forms of citizenship. They do not count. Their interests are not weighed in the balance'.