Disability is really a term trusted for the social condition recognised as resulting from any sort of physical or mental impairment mainly identified through medical procedures. Some are present at birth while other impairments occur at various stages of an individual's life either as manifestations of genetic conditions or as the consequence of conflicts (e.g. war), and accidents. Examples are varying examples of blindness, deafness, speech impairments (dumbness) and lack of limbs. Chronic illnesses too should be added to this list. Usually prosthetic devices such as magnifying glasses, Braille, hearing aids, sign language, crutches, wheelchairs along with other similar aids have already been made to ameliorate handicaps in living, experienced by disabled people.
Constitution of Disabled Peoples' International (1981) defines Impairment as 'the loss or limitation of physical, mental or sensory function on a long-term or permanent basis', with Disablement thought as 'the loss or limitation of opportunities to be a part of the standard life of the city on the same level with others due to physical and social barriers'
Since all serious impairments giving rise to disability appear to stem from a recognised medical condition, historically, disability studies relied on a medical model centred almost solely on the average person. Following the medical model the disabled were segregated from 'normal' people and viewed as deficient, without self-efficacy, needing care. The disabled were defined by their deficiencies, in what they might not do, rather than by what they might do. Society at large made no try to adjust to the requirements of the disabled, to integrate them, instead maintaining isolate them in institutions or at home. Impairment was seen as the problem, and the disabled were limited to being passive receivers of medication, care, and targeted assistance through state intervention or charity. Right now, as befitting the medical model, disabled people are regarded as requiring rehabilitation. They're at the mercy of negative stereotyping and prejudice by the rest of society. Further, the ubiquitous built environment imposes restrictions on their mobility, usage of employment and recreation.
Mike Oliver (1996), an academic with first-hand connection with disability and what it entails, calls the medical model an 'individual model' creating a binary distinction between it and the social models which followed the Disabled People's Movement in the 1970s. Vic Finkelstein, another academic and Paul Hunt, an activist, were also involved in helping to form the Union of the Physically Impaired against Segregation (UPIAS). Oliver struggled the 'medicalisation' of disability denying that there never was a 'medical model' of disability. Oliver believed that problems attendant on disability should not be regarded exclusively because the responsibility of the medical profession and other similar 'experts' who, from the position of power, start to see the problem as entirely located within the individual. For Oliver and others working in the disability field around the 1970s disability was a social state rather than a medical condition. These pioneers were influenced by Marxist rhetoric much in evidence at the time.
The individual discourse on disability is allied to World Health Organisation pronouncements, for example, by the International Classification of Functioning, Disability and Health. It owed its existence to advances in science and medicine which placed disabled individuals into medical categories for the capability of medical practitioners and other medical researchers. This, though eminently practical and appropriate at that time, was later experienced by the disabled population as an oppressive situation. They felt themselves labelled, manipulated, and powerless vis-a-vis their own bodies and personhood.
There's inherently nothing wrong with impairments being initially identified and treated as a medical condition. Indeed, this can be a necessary first step, particularly when individuals require continuing, lifetime health care. It really is when such treatment excludes or disregards the social environment, which to a large extent defines the parameters within that your disabled are expected to function, that problems arise. It inevitably invites social exclusion and disadvantage, segregation and stigmatisation, which is the fundamental criticism against the narrow medical model.
Still, there are apologists for the medical style of disability. They regard as questionable Mike Oliver's denial that impairment has any causal correlation with the societal notion of disability. For them this is an 'oversocialized' and overly politicized view. Although he accepts that disability is both biologically and socially caused, he places 'more significant causal weight' on the former. They recognise the sociological need for your body, but complain hat the social model is suffering from 'somatophobia' because of an over-emphasis on the social context. Other researchers are keen to emphaise that there surely is social oppression at play in neuro-scientific disability.
Shakespeare and Watson (2002) stress that 'embodied states are relevant to being disabled'. They believe that social model advocates 'over-egg the pudding' by stating that disability is entirely a creation of society instead of accepting that 'disability is a complex dialectic of biological, psychological, cultural and socio-political factors, which cannot be extricated' to any great extent. However, Ethereal Paradox (2004) is critical of anyone not recognising the importance of disabilism in their discussion of disability. She thinks they confine themselves to a 'commonplace meaning of disability' ignoring the much larger significance allied to similar concepts like racism, sexism and homophobia.
Vic Finkelstein, a pioneering academic and activist in neuro-scientific disability, himself disabled, was a refugee from apartheid South Africa where he previously been in prison for five years. Having been mixed up in civil and human rights movement in South Africa, he was immediately sensitised to the ghetto-like connection with the disabled in the UK. He saw that they were denied participation in the mainstream social and political life of the united states. One of Finkelstein's collaborators Paul Hunt, had been living in residential institutions (Cheshire Homes) from childhood and campaigned with other residents for a job in the management of such Homes. Following a medical model Cheshire Homes believed it had provided compensatory measures to meet the requirements of the disabled, but disabled activists like Finkelstein and Hunt saw it as oppression of a minority by society most importantly.
These activists saw the medical model because the default position of the disability 'industry' staffed by care managers, social workers, physiotherapists, occupational therapists, clinical psychologists and doctors. Disabled persons' powerless and socially inferior position was reinforced in such circumstances, however sympathetic and dedicated these professionals were in undertaking their duties. It was only following the establishment of UPIAS that the political landscape changed. UPIAS (1976) concluded that '... it is society which disables physically impaired people. Disability is something imposed along with our impairments incidentally we have been unnecessarily isolated and exclude from full participation in society. Disabled folks are therefore an oppressed group in society'.
Apart from the horrors of the Holocaust which enabled doctors to experiment on disabled victims, there's at least one documented case of clinical abuse of disabled children in the USA. Referred to as the Willowbrook Experiment, in 1956 disabled children were deliberately infected with viral hepatitis to monitor progress of the disease over a lengthy period of 14 years. Parents had been under pressure to accede to it. It was also approved by the brand new York STATE DEPT. of Mental Hygiene. To a big extent such extreme measures are no more evident, but one can see how disability had been a custodial discourse.
Among a drastic change in the medical model is that no more than four decades ago, the universally acclaimed and used Diagnostic and Statistical Manual of Mental Disorders (DSM) listed homosexuality as a mental illness. resolving DOT physical concerns and clinical psychologists practised aversion therapy (among others) to 'cure' these 'unfortunates'. Regardless of objections from the few extreme right politicians and religious fanatics, it is now accepted as a standard and positive variation of human sexuality. Indeed equal opportunity and human rights legislation have recognised the 'gay' community as a minority group. Some states even allow civil union and also marriage between same sex couples.
The way the society's views and treatment of the disabled have changed over the years is demonstrated by the exemplory case of Lord Nelson and President Roosevelt. With an arm amputated and blind in a single eye, 'the statue of Horatio Nelson defies modern infatuation with physical perfection by flouting his impairments.' He contrasts Admiral Nelson with the wheel-chair using wartime US president Franklin Delano Roosevelt. Unlike Nelson, he was born right into a modern culture where having an 'impairment' was likely to directly 'disable' an individual. Therefore, a 'public statue of Roosevelt sitting in a wheel chair was unthinkable' So now we are presented with a statue to a major USA public figure that takes care to hide any proof his impairment. There is probably not a call to erect a statue to a far more modern celebrity like Prof. Stephen Hawking, but one must grant that minus the medical advances that recognise his impairments allowing for him to receive the proper treatment and continue living and working as he does, there wouldn't normally be a social or academic role for him to fill with such distinction.
In Australia, a variation of the social model was known as the rights-based model of disability. As in the united kingdom, disabled people as a group there sought a political voice. Such activism and advocacy has brought gains, but they admit that there are also limitations. Although as a political strategy it helped to effect a result of needed changes through legislation, it locks people into an identity defined as being members of a minority community. This way the conceptual barrier between 'normal' and 'abnormal' is maintained. There are also new challenges when the latest genetic and reproductive technologies add a larger proportion of the population as carriers of 'bad' genes and unwittingly put into the disabled category inviting discrimination and avoidance.
Four decades after the Cheshire Homes incident, we've the spectre of Remploy Ltd. a government owned factory network across the UK established in 1945 offering both employment, and employment placement services, to the disabled, being dismantled. Remploy have been producing or assembling a vast selection of products in its 54 factories spread in the united states. Towards the end of the final century it even moved into service sector work. In 2009/10 Remploy placed 10,500 disabled people in jobs in a variety of sectors. This year the Coalition government has made a decision to close 36 Remploy factories making 1700 workers redundant (press reports). It is unlikely that UPIAS would accuse Remploy to be available of segregating the disabled, but at some early point in a disabled person's life that kind of provision was always likely to have been necessary.
On doctrinaire grounds alone neither the medical model nor the social model would be privileged in explaining changes in circumstances such as those occurring now in the UK as exemplified by the fate of Remploy Ltd.
Others in the field take somewhat of a middle ground. For them disability is really a 'post-modern concept, since it is indeed complex, so variable, so contingent, so situated. It is at the intersection of biology and of agency and structure. Disability can't be reduced to a singular identity: this can be a multiplicity a plurality.' They assert that any social theory must include 'all the dimensions of disabled people's experiences: bodily, psychological, cultural, social, political, rather than claiming disability is either medical or social'. They found people unwilling to recognize themselves as disabled. They wanted to see themselves as normal though different. Many people with learning difficulties won't be known as disabled.
People have many different identities. Those who do not accept being labelled disabled may own up to various other identities as more salient. For instance, gender, ethnicity, sexuality, class or marital status. The social model developed in the 1970s is not any longer useful or valid. There must be a paradigm shift.
Today's academics argue against a 'crude determinism' towards a more sophisticated method of disability. For them, disability is not just a condition. Neither should it be reduced to being the consequence of social oppression, 'overlaid with negative cultural meanings'. The disability literature has been plagued with overgeneralisations in fact it is now time and energy to admit that it cannot speak for over six million people who have impairments in Britain alone, and over half of a billion across the planet. Alternatively, researchers in the field have accepted the idea that all humans are impaired in one way or another. Disability may be the normal condition of most humanity; it is not limited to a little minority of people.
The refusal to acknowledge that disablement or impairment is not only limited to those very obviously disabled but is a 'normal condition of all humanity' is clearly the reason behind the historical oppression and exclusion of ostensibly impaired people by the majority of so-called normal people. That is said to be due to a need for denial of their own vulnerability, frailty and mortality, projecting them to others less in a position to defend themselves. The far-reaching insight that we are impaired should alert us to the truth that simplistic models may serve their purpose, however in a time-limited and contingent manner.
The above is a wide ranging exploration of academic discourse comparing and contrasting the concepts of the medical model and the social style of disability. Exploration of advantages and disadvantages of either model as situated in historical context gave rise to the idea of disability as a universal human condition that neither model could explain comprehensively. Researchers and commentators today need to acknowledge that no-one model could comprehensively encompass such a continually shifting paradigm.