We are always taught to define key concepts at the beginning of any investigation, so let’s try and do that. What is meant by the term ‘disability’?
Disability was defined by the World Health Organisation (WHO) in 2008 as:
“Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives”.
The WHO have since withdrawn this definition, and it is interesting to note that the WHO website no longer has a separate section for ‘disability’. What this 2008 definition did highlight was the distinction between ‘impairment’ and ‘disability’, with the point being that whilst the former is a physical fact which can possibly be objectively verified and measured, the latter is a product of society, influenced by factors like participation, or more often by limitation or exclusion.
To use slightly blunter language, disability can be seen as a convenient label for social discrimination: a social phenomenon rather than something directly arising from each individual’s impairment. It also means that society can deliberately ignore the individual and the individual impairment, preferring to label, and thereafter collectively deal with, individuals as a part of a group defined by their disability, rather than by their individual attributes.
Doesn’t say much for society, does it?
Some would even go further and argue that government policies with regard to those with disabilities are simply an exercise in economies of scale: lump them together, treat them the same, and keep costs down by financing a one size fits all budget.
This sort of approach has far more than just financial or economic consequences, however. It is also an exercise in removing the humanity from the disability, thereby turning the disability into a commodity that is subject to budgets and balance sheets like everything else that must be paid for. It is far more politically expedient (and a lot cheaper) to talk about “those on the spectrum” than attempt to tailor services to individual needs. Try teaching an autistic child and an Asperger’s child and a Down’s child the same lesson in the same classroom and you will understand what I mean – and yet this is exactly what is happening.
Two theories of disability
The dominant and most common theory of disability is the medical model, often (ironically) called the ‘individual’ model of disability. According to the medical/individual model of disability the problems disabled people face in their daily life are mainly caused by their impairment, either physical or mental, and these impairments prevent the disabled person from fully participating in society. A good example is the so-called employment discrimination law. The statute or its regulations provide a list of the conditions or definitions of impairments which will allow a person to claim the protection of that legislation. In other words, the emphasis is on the individual and/or his/her impairment, rather than looking at their skills, which is how ‘normal’ people are selected for employment.
With the emphasis that the whole capitalist system places on the need for the employee to turn up for work every day and do a ‘full-day’s work’, it is little wonder that governments have seen it necessary to create a marginalised group of ‘people with disabilities’ or the cuter sounding ‘people with special needs’.
Before the advent of our highly industrialised and automated society, it might have been possible to find a place in the workforce for somebody with an intellectual disability, and even somebody with a moderate physical disability. The rural production process, and the extended nature of the feudal family, allowed many to make a genuine contribution to daily economic life. Families living and working as large groups were able to provide networks of care for children and the elderly, and in turn children and the elderly had a specific and important contribution to play in the process and the family which changed depending on age and capabilities.
In a industrialized and highly specialized society, if you are not able to work in a factory or operate a machine in the manufacturing process, you are useless to the capitalist economy and accordingly are marginalised as ‘disabled’. In other words, useless, surplus to requirements.
This raises interesting questions in our modern, highly automated, computer-driven society. Could it be argued that there should be more space for at least the physically impaired given the relative physical ease with which the instruments of production can now be controlled? It can certainly be argued that there has been some movement to re-admitting the physically impaired person back into the workplace, by the gradual transformation of that workplace to allow greater ease of access (wheelchair ramps, lifts, etc.). Whilst this can be seen as progress, the more cynical would argue it allows the capitalist owner of that facility to extract a full day’s work from that person, which was not possible before.
Whilst such an economic analysis (favoured by the Marxists) is undoubtedly important, and perhaps self-evident, it is not the only reason for the marginalisation of people with disabilities. At the same time the church and religion was a very dominant force (and this was especially true in Ireland, where the Roman Catholic Church had a hugely influential role in all things government and traditionally dominated any political discourse until as late as the eighties.) Again, it was only relatively recently that the church stopped regarding the disability as a mark of good or evil (depending on the disability) which usually culminated in people with disabilities being institutionalised and hidden from public view.
Hopefully this model of disability is on the way out, to be replaced by what is commonly known as the social model of disability.
This model recognizes that disability is a social construct because it is the wider community (i.e. me and you) that erects and places societal and environmental barriers such as attitudes, policies and the physical environment, and that these barriers function to exclude or marginalize individuals with disabilities.
The social model of disability aims to integrate individuals with disabilities into the broader society by recognizing that changes are required by society as opposed to the individual concerned, for example by setting out the rights of individuals with disabilities to participate in the labour market, measured by their potential contribution, rather than by their impairment.
The social model of disability underpins the UN Convention on the Rights of Persons with Disabilities (UNCRPD) and this should allow for an expansive definition of disability to develop.
Disability is defined in Article 1 of the CRPD:
“Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”
What is interesting about this definition is that it is not a definition at all. It rather confirms that disability is a social construction which places barriers to prevent the full and equal participation of the person with a physical or intellectual impairment.
This approach reflects a social and human rights model of disability by highlighting that is society’s failure to accommodate the needs of people with disabilities which give rise to their impairment, rather than as a direct consequence of their physical or intellectual condition.
Therefore, what we as a society need to be asking is how can we change our attitudes and approaches to people with disability, so as to include them in everything we do, rather than holding them at arm’s length like some alien race?