Medical model of disability
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The medical model of disability is a sociopolitical model by which illness or disability, being the result of a physical condition intrinsic to the individual (it is part of that individual’s own body), may reduce the individual's quality of life, and cause clear disadvantages to the individual.
The medical model tends to believe that curing or at least managing illness or disability mostly or completely revolves around identifying the illness or disability from an in-depth clinical perspective (in the sense of the scientific understanding undertaken by trained healthcare providers), understanding it, and learning to control and/or alter its course. By extension, the medical model also believes that a "compassionate" or just society invests resources in health care and related services in an attempt to cure disabilities medically, 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.
Historical development of model
Original WHO definition for disability
In 1980 the WHO introduced a framework for working with disability, publishing the "International Classification of Impairments, Disabilities and Handicaps". The framework they proposed approached disability 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 their age, sex and social and cultural factors
The International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. 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. This 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; further, resources are seen as excessively misdirected towards an almost-exclusively medical focus when those same resources could 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. Often, a medical model of disability is used to justify large investment in these procedures, technologies and research, when adaptation of the disabled person's environment might ultimately be more beneficial to the society at large, as well as financially cheaper and physically more attainable.
Further, some disability rights groups see the medical model of disability as a civil rights issue, and criticise charitable 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"). Various sociologists (Zola, Parsons) studied the socio-cultural aspects of "normalcy" and the pressure it exerts on individuals to conform.
The recent World Health Organization ICF Classification (International Classification of Functioning, Disability and Health) takes into account the social aspects of disability and does not see disability only as a 'medical' or 'biological' dysfunction.
- WHO, International Classification of Impairments, Disabilities and Handicaps,1980
- WHO, Fact sheet N°352, June 2011. Accessed at http://www.who.int/mediacentre/factsheets/fs352/en/index.html 20 July 2012
- "International Classification of Functioning, Disability and Health". WHO. Retrieved 15 November 2011.