The Medical and Social Models of Disability

In order to develop an understanding of the influence that models have upon society, it is necessary to explain their purpose, give their meaning and describe their characteristics.

At first glance models can be seen as tools, which offer representations of reality, provide the basis for the expansion of rights and entitlement for disabled people, and offer insights into attitudes. Such models can provide a useful framework, in which one may gain an understanding of the perspective held by those operating and applying such models. It is important to remember that;

“…models do not explain anything. They should not be confused with theories or hypotheses, which do reveal the inner or hidden laws governing the nature of things and relationships.”

(Finkelstein, 1996:1, in Johnstone, 1998, p.16).

The Medical Model of Disability

The medical model views disability as being caused by medical symptoms, the disabled person as subject for treatment and cure. It focuses on the individual and their impairment, and relies on the notion that such individuals can be made ‘normal’ as a result of medical intervention. Hardly surprising if one considers the WHO definitions, (which, for point of reference, are formulated in the main part by the medical profession):

Impairment: any loss or abnormality of psychological or anatomical structure or function.

Disability: any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being.

(WHO, 1976, International Classification Document. A29/INF.DOC/1, in Johnstone, 1998, p.10)

Such definitions lend themselves to the opinion that, it is the individual’s impairment which prevents them from fully participating in society, suggesting disability to be an abnormality. The reference to impairment as being something negative, a condition which must be eradicated, perpetuates the ‘normalisation’ approach adopted by the medical, educational and caring ...

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Impairment: any loss or abnormality of psychological or anatomical structure or function.

Disability: any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being.

(WHO, 1976, International Classification Document. A29/INF.DOC/1, in Johnstone, 1998, p.10)

This obsession with a ‘return to wholeness’, which invariably fails as impairment is not an illness which can be cured, has led to the prejudice, oppression and discrimination of disabled people.

The Social Model of Disability

In contrast, the social model views disability not as something which belongs to the individual, but rather as a consequence of environmental, social and attitudinal barriers, that prevent maximum participation in society. It focuses on removing these barriers, not on ‘normalisation’, cure or care.

A fundamental difference, when one considers that models are devised by people about other people, is that, the social model was formulated by disabled scholars and activists (such as Mike Oliver, Paul Abberley, Vic Finkelstein and Paul Hunt),(Marks, 1999).

The Union of the Physically Impaired against Segregation (UPIAS) advanced the definitions of disability:

Impairment: lacking part or all of a limb, or having a defective limb, organ or mechanism of the body.

Disability: the disadvantage or restriction of activity caused by a con-temporary social organisation which takes no or little account of people who have physical impairments and thus excludes them from the mainstream of social activities.

(UPIAS, 1976, p.14)

This redefining of terms has led to a shift of onus, away from the individual person to society as a whole. It has led to transference of empowerment, away from the professionals towards disabled people themselves, though there is still a long way to go (Johnstone, 1998).

Conclusions

The medical model places the ‘problem’ of disability within the individual, suggesting that it is a medical condition which can be cured, (medicalisation of disability). On the contrary, the social model locates disability within society, focusing on its failure to adequately address the needs of disabled people in its organisation (Oliver, 1990).

The importance of self-representation is recognised as being an essential factor in creating a change in social thinking.

There is a danger of becoming preoccupied with semantic discussions, which could result in concealment of the real issues of oppression and exclusion.

The ‘problems’ surrounding disability are incredibly complex, adopting any one model as a tool for resolving these issues would be inappropriate, … “problems can only be resolved by groups or collectivities working together on them; effective solutions cannot be imposed from outside or from above” (Oliver, 1990, p.5)

References:

JOHNSTONE, D. (1998) An Introduction to Disability Studies. 2nd ed., London: David Fulton.

MARKS, D. (1999) Disability. London: Routledge.

OLIVER, M. (1990) The Individual and Social Models of Disability. [online]. 1990. [accessed 23 October 2003]. Available from:< http://www.leeds.ac.uk/disability-studies/archiveuk/Oliver/in%20soc%20dis.pdf>.

UPIAS. (1976) Fundamental Principles of Disability. London: Union of the Physically Impaired Against Segregation.