Transcript Different Ways of Thinking About Disability.

Different Ways of Thinking About
Disability.
Richard Olsen
Nuffield Community Care Studies
Unit
University of Leicester
18/2/03
Aims
• To subject conventional classification of
disability to critical scrutiny
• To introduce differences between medical
and social models of disability
• To illustrate the implications of different
models of disability for research and
practice
Background
• 14.2% of the adult population described as
disabled (OPCS, 1988). – 6.5 million people
• Disability Discrimination Act 1995 and
Disability Rights Commission
http://www.drc.org.uk
• A more accessible environment
• Radical changes in the way in which
assistance is provided (eg. Direct payments)
Conventional classification of
disability
• Impairment: an impairment is any loss or
abnormality of psychological, physiological
or anatomical structure or function
• Disability: a disability is a restriction or
lack (resulting from an impairment) of
ability to perform an activity in a manner or
within the range considered normal for a
human being
Conventional classification of
disability
• Handicap: a handicap is a disadvantage for
a given individual, resulting from an
impairment or a disability, that limits or
prevents the fulfilment of a role that is
normal (depending on age, sex and social
and cultural factors) for that individual
• Source: International Classification of
Impairments, Disabilities and Handicaps
(Scambler, 1997, p.80)
Important points
• Being disabled is the result of flaws in the
body
• The answer lies in medical terms - hence,
the ‘medical model of disability’
• This model is commonly accepted as the
way in which disability should be
categorised
Alternative classification of
disability:
• Impairment: lacking part of or all of a limb, or
having a defective limb, organism or mechanism
of the body
• Disability: the disadvantage or restriction of
activity caused by a contemporary social
organisation which takes no or little account of
people who have physical impairments and thus
excludes them from the mainstream of social
activities
• Source: Oliver, 1990, The Politics of Disablement,
p.11
Important points
• Disability is a result of social organisation
• The answer lies in identifying and removing
‘barriers’ in the way society is organised –
hence, the ‘social model of disability’
Why are the differences between medical and
social models of disability important for
sociology?
• Sociologists instrumental in developing the
ICIDH
• Sociological interest in chronic illness
• The origin of the ‘social model of disability’
in the disability movement itself
Important points for research
• Different terminology/different focus
• Research informed by different models will
ask different questions
• Research funding often tied to a ‘social
model’ approach
• Implications for collaborative work
A core criterion in judging all proposals is the extent
to which those whom projects are intending to
benefit (or research) are involved in identifying
the issues to be addressed, and in planning and
carrying out the project…We also expect
proposals to be located within - or to draw on - the
social model of disability and related social
models.
Joseph Rowntree Foundation webpage
http:www//jrf.org.uk
Implications for practice
• Alternative solutions to ‘the problem’
• Not everyone will see impairments as ‘bad’
• Examples: cochlear implants, conductive
education, genetic screening and
counselling
(1) Cochlear implants in
childhood:
‘There is little reason to condemn anyone to be a
prisoner of deafness...it is not only to the
advantage of the child and his or her family to
eliminate hearing loss, but also to society, which
will see increased benefits from these productive
individuals.’
Pulec, J. (1994) ‘The benefits of the Cochlear
Implant’, Ear, Nose and Throat Journal, 3:137.
‘The deaf child no less than the hearing child
has all the requisite skills that will enable
her to achieve a different, but no less
human, expressive potential.’
Crouch, 1997, ‘Letting the deaf be deaf reconsidering the use of cochlear implants in
prelingually deaf children’, Hastings Center
Report, Vol.27, No.4, pp.14-21.
(2) Conductive education:
Conductive education philosophy is imbued with the concept
of orthofunction. After graduation from a conductive
education program, graduates should be able to function
as normally as possible....neuro-motor-disabled
individuals should be able to approach normal function
and lead age-appropriate lives while making choices of a
lifestyle that can include maximal independence
(Spivack, 1995, ‘Conductive education perspectives’, Infants
and Young Children, Vol.8, No.1:75, added emphasis)
Attitudes towards disabled people are tainted by
obsessive concern with ‘normative’ goals…The
extraordinary intensity and time spent in trying to
make disabled children ‘normal’ must, surely,
inculcate idealised images of the able-bodied form
and lifestyle.
Finkelstein, V. (1990) Conductive Education: A Tale
of Two Cities, at http://www.leeds.ac.uk/disabilitystudies/archiveuk/finkelstein/A%20Tale%20of%2
0Two%20Cities.pdf
(3) Genetic screening and
counselling:
Human genetics poses a threat to us because while cures…are
promised, what is actually being offered are genetic tests
for characteristics perceived as undesirable. This is about
eliminating or manipulating foetuses which may not be
acceptable for a variety of reasons. These technologies
are…opening the door to a new eugenics which directly
threatens our human rights
Disabled Peoples International Position Statement
http://www.dpieurope.org/htm/bioethics/dpsngfullreport.htm
Also, The disability rights critique of prenatal genetic testing
http://www.thehastingscenter.org/oldsite/pdf/supseptoct_99.pdf
Concluding points
• SMOD very influential but not without critics
• Ambiguous place of medicine and PAM
• Conflict between medical and social models of
disability have real implications
• Particularly because so many differences focus on
the appropriate way to ‘treat’ disabled children
• About awareness and not identification