Medical model of disability
The medical model of disability, or medical model, arose from the biomedical perception of disability. This model links a disability diagnosis to an individual's physical body. The model supposes that this disability may reduce the individual's quality of life and the aim is, with medical intervention, this disability will be diminished or corrected.
The medical model focuses on curing or managing illness or disability. By extension, the medical model supposes a "compassionate" or just society invests resources in health care and related services in an attempt to cure or manage disabilities medically. This is in an aim to expand functionality and/or improve functioning, and to allow disabled persons a more "normal" life. The medical profession's responsibility and potential in this area is seen as central.
Before the introduction of the biomedical model, patients relaying their narratives to the doctors was paramount. Through these narratives and developing an intimate relationship with the patients, the doctors would develop treatment plans in a time when diagnostic and treatment options were limited. This could particularly be illustrated with aristocratic doctors treating the elite during the 17th and 18th century.
The reliance of doctors on the narratives of patients diminished with the growth of bio-medicine.
In 1980, the World Health Organization (WHO) introduced a framework for working with disability, publishing the "International Classification of Impairments, Disabilities and Handicaps." The framework proposed to approach disability by using the terms Impairment, Handicap and Disability.
- Impairment = a loss or abnormality of physical bodily structure or function, of logic-psychic origin, or physiological or anatomical origin
- Disability = any limitation or function loss deriving from impairment that prevents the performance of an activity in the time lapse considered normal for a human being
- Handicap = the disadvantaged condition deriving from impairment or disability limiting a person performing a role considered normal in respect of age, sex and social and cultural factors
Components and usage
While personal narrative is present in interpersonal interactions, and particularly dominant in Western Culture, personal narrative during interactions with medical personnel is reduced to relaying information about specific symptoms of the disability to medical professionals. The medical professionals then interpret the information provided about the disability by the patient to determine a diagnosis, which likely will be linked to biological causes. Medical professionals now define what is "normal" and what is "abnormal" in terms of biology and disability.
The International Classification of Functioning, Disability and Health (ICF), published in 2001, defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (such as cerebral palsy, Down syndrome and depression) and personal and environmental factors (such as negative attitudes, inaccessible transportation and public buildings, and limited social supports).
The altered language and words used show a marked change in emphasis from talking in terms of disease or impairment to talking in terms of levels of health and functioning. It takes into account the social aspects of disability and does not see disability only as a 'medical' or 'biological' dysfunction. That change is consistent with widespread acceptance of the social model of disability.
The medical model of disability focuses on the individual's limitations and ways to reduce those impairments or using adaptive technology to adapt them to society. Current definitions of disability accept biomedical assistance but focus more on factors causing environmental and social exclusion. Uncritical reliance on the medical model produces unwanted consequences.
Among advocates of disability rights, who tend to subscribe to the social model instead, the medical model of disability is often cited as the basis of an unintended social degradation of disabled people; Resources are seen as excessively misdirected towards an almost-exclusively medical focus when those same resources could potentially be used towards things like universal design and societal inclusionary practices. This includes the monetary and the societal costs and benefits of various interventions, be they medical, surgical, social or occupational, from prosthetics, drug-based and other "cures", and medical tests such as genetic screening or preimplantation genetic diagnosis. According to disability rights advocates, the medical model of disability is used to justify large investment in these procedures, technologies and research, when adaptation of the disabled person's environment could potentially be more beneficial to the society at large, as well as financially cheaper and physically more attainable.
Also, some disability rights groups see the medical model of disability as a civil rights issue and criticise charitable organizations or medical initiatives that use it in their portrayal of disabled people, because it promotes a pitiable, essentially negative, largely disempowered image of people with disabilities rather than casting disability as a political, social and environmental problem (see also the political slogan "Piss On Pity").
- Fisher, Pamela; Goodley, Dan (January 2007). "The linear medical model of disability: mothers of disabled babies resist with counter-narratives". Sociology of Health & Illnness. 29 (1): 66–81. doi:10.1111/j.1467-9566.2007.00518.x. PMID 17286706.
- Bury, Mike (2001). "Illness narratives: fact or fiction?". Illness Narratives: Fact or Fiction?. 23 (3): 263. doi:10.1111/1467-9566.00252.
- Lawrence, Christopher (1994). Medicine in the making of modern Britain : 1700-1920 (Digital Printing ed.). London [u.a.]: Routledge. ISBN 9780415091688.
- Jewson, N (1976). "The disappearance of the sick man from medical cosmology". Sociology. 10 (2): 225. doi:10.1177/003803857601000202.
- WHO, International Classification of Impairments, Disabilities and Handicaps,1980
- Kanter, Arlene S. (2014-11-27). The Development of Disability Rights Under International Law: From Charity to Human Rights. Routledge. ISBN 9781134444663.
- Mendes, Errol; Srighanthan, Sakunthala (2009-04-18). Confronting Discrimination and Inequality in China: Chinese and Canadian Perspectives. University of Ottawa Press. ISBN 9780776617800.
- "International Classification of Functioning, Disability and Health". WHO. Retrieved 15 November 2011.