Transcript Medical-model-of-Disability

THE MEDICAL MODEL OF DISABILITY
(The Individual Model of Disability)
The society we live in tends to consider disability to be a tragedy for the individual
and a burden for the family and society.
This is based on the ‘individual’ or ‘medical’ model of disability. This model focuses on
the lack of physical or mental functioning and uses a clinical way of describing an
individual’s disability.
This model leads to a dehumanising view, where only the nature and severity of the
impairment is important, together with the extent to which the difference can be put
right. It casts the individual as victim.
When people such as policy makers think about disability in this individual way, they
tend to concentrate their efforts on ‘compensating’ people with impairments for what
is ‘wrong’ with their bodies by targeting ‘special’ welfare benefits at them and
providing segregated ‘special’ services for them and so on.
It can also affect the way disabled people think about themselves. Many disabled
people internalise the negative message that all their problems stem from not having
‘normal’ bodies/minds, and can be led to believe that their impairments automatically
prevent them from participating in society.
The medical model of disability sees the
person as the problem, and the solution as
making the person ‘normal’. The medical
model leads to the provision of special
schools, special transport, sheltered jobs,
physiotherapy and speech therapy, charities
and benefits. It also leads to eugenics –
getting rid of disabled babies by stopping
disabled people and others having them.
Simon Aspis
`The messages we
receive are very
strong and clear and
we have little access
to different values
which may place a
more positive value
on our bodies,
ourselves and our
lives. Our self image
is thus dominated by
the non-disabled
world's reaction to
us'
Jenny Morris
The Social Model of Disability
Disability as expression of human diversity and not as something
in need of ‘cure’ or ‘correction’
People are disabled by their environment, the attitudes of others,
and the policies, practices and procedures of organisations
Learning disabled people have fewer opportunities and a lower
quality of life than non-disabled people.
We believe that it is not their impairments that prevent them
from enjoying full citizenship but the way society is organised
and its attitude to difference.
The social model of disability makes the important distinction
between 'impairment' and 'disability'. and is the response of the
disabled people's civil rights movement to the oppression of
disabled people. Disability is caused by 'barriers' or elements of
social organisation that take no or little account of people who
have impairments. It follows that if disabled people are to be able
to join in mainstream society, which is their human right, the way
society is organised must be changed. Removing the barriers
which exclude (disable) people who have impairments will bring
about this change.
This was the explanation I had sought for years. Suddenly what I had always known, deep
down, was confirmed. It wasn't my body and mind that was responsible for all my difficulties, it
was external factors, the barriers constructed by the society in which I live. -Liz Crow
Examples of what disables people …
“I can’t speak; I am disabled by the fact that you won’t take the time and trouble to learn how to
communicate with me.”
“I have a learning disability. I am disabled by the fact that you don’t produce your leaflets in easyto-read language and symbols, so that I can find out about the services you offer.”
Medical model
Social model
Rehabilitate Disabled Persons
Charity, Medical treatment
Rehabilitate Society
Adjustment to the norm
Acceptance of differences
Exclusion
Little consultation
From
Disability is an individual problem
Differences in abilities are inadequacies
Seeing deficits
Patient
Special service provision
Society choosing for ‘them’
Institution orientated
Us and them: exclusion - tolerance
Medical model of disability
- control or cure
Rights
Inclusion, participation, citizenship
‘Nothing about us without us’
To
► Disability is a problem in society
► Differences in abilities are assets
► Seeing strengths
► Citizen
► Accessible mainstream services
► Disabled people choosing for themselves
► Community orientated
► All of us: inclusion – valuing
► Social model of disability
- change environment and attitudes
Disability Discrimination-MYTH
Disability is something an individual
“suffers” from.
Disability Discrimination-FACT
Disability is the product of an
interaction between the person and the
environment.
Challenging Prejudice –
Medical Model Thinking
Challenging Prejudice –
Social Model Thinking
􀂄 Individual is faulty
􀂄 Diagnosis
􀂄 Labeling
􀂄 Impairment becomes focus of attention
􀂄 Assessment, monitoring, therapy imposed
􀂄 Society remains unchanged
􀂄 Individual is valued
􀂄 Strengths and needs defined by self and others
􀂄 Identify barriers and develop solutions
􀂄 Resources are available for ordinary services
􀂄 Relationships nurtured
􀂄 Diversity welcomed, individual is included
Coming out of the shadows
Disabled people, health and social inclusion
Why is a social model of disability needed?
The standard way of thinking about disability in the past was the so-called
medical model. That remains fine for doctors, but it is less useful for
others. The medical model, naturally enough, concentrates on disease
and impairments. It puts what is wrong with someone in the foreground. It
is concerned with causes of disease. It defines and categorises conditions,
distinguishes different forms and assesses severities.
All these are important in diagnosis, prognosis, devising treatment
programmes and in prevention. But they are not very relevant to the way
that someone with a disability lives their day-to-day life. If you have
epilepsy, you know what your seizures are like. It isn't necessary to know
whether doctors regard them as mild, moderate or severe. It may be
interesting for someone to know that the Latin name for their movement
disorder is hemiplegia. But the chances are they are concentrating on
more practical things.
What is unhelpful about
the medical model?
It is likely to inspire pity, or even fear. Pity is not a useful commodity.
Many people are scared of impairments, sometimes irrationally so.
The model risks objectifying people, lumping them together because of
their condition, not because of who they are.
It is not nice to be told you are a typical case of something or other –
and even worse to be viewed like that.
Perhaps the most important consequence of the medical model is that
bringing the impairment into the foreground risks pushing the person
into the background. They become less of a person, and more a
collection of symptoms.
What is more, it doesn't have very much to say about people's lives
and how they live them.
How is the social model of disability different?
Instead of emphasising the disability, the social model puts
the person at the forefront. It emphasises dignity,
independence, choice and privacy.
A key concept of the social model is that society disables
people. Another way of saying this is that disability is a social
construct. How we organise things in our culture limits and
restricts what some of its members can do.
That takes some understanding, so first it is worth clarifying
some terminology……
Words are important, not because of the need to use the fashionably
correct terms, but because the terminology reveals the thinking
behind them. Here are some definitions of two key words:
Impairment. Having an impairment means there is something not working
properly with part of the body, mind or senses. Someone who has had a
leg amputated has an impairment. So does someone whose learning
disability makes it difficult for them to remember things. So does someone
is partially blind, or deaf, or who has epileptic seizures, or who has
unwanted muscular spasms, or any number of things that don't work
properly.
Disability occurs when a person is excluded, because of their impairment,
from something that other people in society take for granted. That might be
the chance to attend an event, access some service or get involved in an
activity. It might be to live independently, to earn a living, to be kept
informed, or just to make choices for themselves.
You might assume that the impairment causes the
disability. Wrong. It is the choices society makes that
causes someone to be disabled.
Organise things differently, and they are suddenly enabled,
though the impairment hasn't changed.
An obvious example might be a deaf person wanting to
attend a conference. If no sign language interpreter is
there, or no loop for a hearing aid, there is not much point
in going. The person is excluded – disabled. But with a
signer operating alongside the speakers, or a loop, the
person can take part just the same as anyone else. They
still have the same hearing impairment. But they are not
disabled.
So the impairments themselves don't matter?
Obviously, they still matter. Not being able to see, hear,
walk, has an important effect on people. But generally
speaking people find ways to cope – they get used to living
with the impairment.
And in any case what someone with an impairment cannot
do is always much less than what they can do – if they are
given the chance. The idea of the social model of disability is
to give them a chance, remove the barrier that society
places.
So impairment does not have to lead to disability?
That is right. Think about people who are have poor vision – short sight
or astigmatism. Without spectacles or contact lenses very many would
have a much reduced quality of life. They could not join in many events
and activities, and may even be a danger to themselves and others in
certain circumstances.
But society provides an ophthalmologist on every high street, and a
system of getting affordable corrective lenses. As a result, people with
bad eyesight don't have to be excluded from anything.
If we ordered life differently, the same could be true of people with
learning disabilities, epilepsy, spina bifida, deafness, arthritis and all the
other conditions we think of as "disabilities". People with these
impairments could live the lives they wanted, getting involved with
others and making informed choices about what they do.
Isn't using aids and adaptations for everyday life still a
disability?
No. Or if it is, we are all disabled. We all rely on aids and
adaptations of some sort in our daily lives.
We use motor vehicles for transport, electronic aids for
entertainment and accessing information. We rely on flushing
toilets and water on tap for comfort and hygiene. We need
electrical gadgets for cooking and washing clothes. Our
society would disable everyone if these were not so readily
available.
How disabled would you be if you had to find a private space
and dig a hole every time you wanted to use the toilet?
What does the social model mean for disabled people?
The logic is that only disabled people – as individuals or
groups – know how their ability to participate in society in
the way that they want to is affected.
It is not something you can easily identify from outside. So,
to find out what needs to be different, disabled people need
to be listened to.
That puts them at the centre of things, replacing the
paternalistic "we know what's best" approaches of the past
Models of disability
• Individual: Disability is located in the individual
with an emphasis on individual coping and
acceptance
• Medical: Disability defined in reference to the
person’s functional status or condition with an
emphasis on cure/reduction of functional deficits
– Disability associated with loss (e.g. loss of function,
impairment, deficits)
The Social Model of Disability
– Disability is a function of the interaction of
individuals and the social and physical
environments
– Focus on barriers, disabling and enabling
factors in the physical environment and
society
– Concept of “functional limitations” as
influenced by social roles, as opposed to
medical quantifiers (e.g., ability to care for a
child vs. how many lbs. can be lifted)
The Social Model of Disability, cont.
• Disability as expression of human diversity
and not as something in need of ‘cure’ or
‘correction’
• More ‘in tune’ with the views and
experiences of people with disabilities
• Emphasizes social and economic
participation over medical orientation
Disability, according to the social model, is all the
things that impose restrictions on disabled
people; ranging from individual prejudice to
institutional discrimination, from inaccessible
buildings to unusable transport systems, from
segregated education to excluding work
arrangements, and so on. Further, the
consequences of this failure do not simply and
randomly fall on individuals but systematically
upon disabled people as a group who
experience this failure as discrimination
institutionalized through society. (Oliver, 1996)
Impairment vs. Disability
• Impairment
– biological, functional, cognitive
Disability
– reduced participation due to society’s failure
to accommodate the needs of individuals
Subjective interpretations of ‘disability’:
Which of the following statements reflects
the medical vs. the social model?
• “My doctor’s office is not accessible since
it has no wheelchair access. This keeps
me from seeing my doctor for check-ups.”
• “I have a spinal cord injury and use a
wheelchair, so I can’t see the doctor
because of this.”
Key Points to Remember
• The individual/medical model identifies
‘disability’ as a problem located in the individual
and emphasizes the biological differences
compared to the general population.
• Most people with disabilities think about their
lives in terms of the social model of disability.
• The social model looks beyond the individual
and focuses on the barriers that are imposed on
individuals by society and environment.
Exercise
Think about a person with a disability you
may have met. Use the different models,
the individual/medical and social model,
to describe this person.
Now imagine some problems they have,
based on your 2 descriptions.
What support would you suggest based
on the needs resulting from the
individual/medical model and the social
model description?