The last century has seen a rise in philosophical and bioethical interest in disability, and namely the way in which we comprehend it. Models of disability provide a framework through which we can gain an understanding of the way people with impairments experience disability, providing also a reference for society in regard to laws, regulations and structures that are developed that impact the lives of disabled people. Social and medical models of disability suggest altering views on the impact of disability on well-being, and the relevance of disability to medical intervention and social policy. Vernacular regarding discussions of disability are of high importance, as they have implications on society, namely, the influence they hold over societies’ expectations and perceptions. This essay will compare and contrast firstly the origins and varying definitions of disability, then will go onto the goals of intervention of the respective models and the way in which the models seek to integrate people with impairments into society.
Defining disability is highly contentious for numerous reasons. Namely, because the expression “disability” has only been used to refer to a distinct class of people in the last century, and because it has, historically, been employed as a substitute for “inability” or as a reference to lawfully enforce restrictions on rights and powers. Both models seek to define ‘disability’ and provide a framework for understanding, however achieve this in divergent ways. The medical model of disability emerged after the mid 1800s, where the religious model was superseded due to significant progressions in the field of medical science. Brittain (2004) suggests that the emergence of the model was due to the medical field’s ability to explain illnesses and parts of the body as well as heal injuries and treat diseases. Disability is referred to, in the medical model, as a medical problem that inhabits the individual which is a flaw or failure of the bodily system and subsequently, is fundamentally atypical and pathological (Olkin, 1999). It is a defect which is caused by disease, trauma, or other health conditions, and involves a deviation from species-typical norms. It is discussed fundamentally adversely and is considered a pitiable circumstance. The emerging language of literature and discourse assuming the medical model is highly negative, including the words, ‘invalid’, ‘cripple’, ‘spastic’ and ‘handicapped’ (Creamer 2009, as cited by Retief & Letsosa, 2018). It is referred to, also, as ‘personal tragedy for both the individual and her family, something to be prevented and if possible, cured’ (Carlson 2010, as cited by Retief & Letsosa, 2018), and has been held accountable for personalising and pathologising the experiences of disabled people (Thomas, 2007).
On the other hand, the social model emerges through the activism of the British movement in the 1960s-1970s which developed as a result of limitations in the medical model of disability (D’Alessio, 2011). It sees disability as a condition which is caused by social, attitudinal or environmental conditions, requiring for its elimination (Barnes, 2013). Fundamental to the model is the notion that disability is an ultimately socially constructed phenomenon, rather than a problem of the individual. It is referred also as the minority model, and emphasises the fact that society disables people with these impairments or defects, rather than the impairment being the disability as suggested in the medical model. The social model focuses primarily on the terms of ‘impairment’ and ‘disability’, where impairment is the ‘lacking part of or all of limb, having defective limb or mechanism of the body’ and disability is the disadvantage or restriction of activity that is caused by contemporary social disorganisation which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities (Lowe 2010;Anastasiou & Kauffman, 2013)
Another notable comparison between the two models is their desire to integrate people with disabilities into society, however, this integration is achieved through vastly different means in the two models. The disability model is referred to as the ‘personal tragedy model’ as it discusses disability in an essentially negative way (Thomas & Woods, 2003). The goals of intervention in the medical model with these bodily defects and abnormalities are to find a cure and to return to normality (Haegele & Hodge, 2016). This model supports the correction of the biological condition whether that be through a form of compensation or the correction of the biological condition, as well as prevention of such impairments. This can involve the prevention of birth, deselection at embryo level or normative adaption. According to the medical approach, care, prevention (in case of foetus and embryo) and rehabilitation are primary endpoints (Wolbring, 2005). In short, the medical model perceives disabled people as disabled by their bodies such that they require ‘fixing’ in one form or another. People who are affected by these defects are expected to seek medical intervention, assuming the role as patient and being aided by trained medical professionals. Assume for example, in a real life condition, a scenario in which someone who must use a wheelchair due to bodily impairments wants to enter a building with a set of stairs at the entrance. Under the medical model, the wheelchair user would be excluded from entry to the building, as they cannot climb the stairs.
According to the social model, a solution must be derived from societal change rather than individual adjustment and rehabilitation, and the agent of remedy can be the individual, an advocate, or anyone who detects this error in the arrangement of society and seeks to affect this and cause a social change (Gill, 1987). Instead of focusing on the body, social models focus on changing the physical environment and societal climate to accommodate the biological reality of people with disabilities, as disability is not an attribute or a defect of an individual but rather, a societal reaction, such that the societal reaction needs ‘fixing’ rather than the individual (Wolbring, 2005). In this way, disability is a socially created problem which requires fully integrating individuals with different biological realities and abilities. It is focused less on the origins and more on environmental and social intervention. With reference to the wheelchair example, the concern is not of whether the individual suffers with an impairment which requires them to have a wheelchair, the concern is with the disabling of the individual and their exclusion to participate in essential and leisurely activities. The medical model, thus, would call for a ramp, so that the wheelchair user is free to enter the building and lead life freely.
This essay has sought to compare and contrast the social and medical models of disability, providing also scenarios to represent the implications of these models on society and disabled people. This essay, firstly, presented the way in which both models seek to define disability, however, convey this definition in vastly different ways with altering meanings. It finally, sought to represent the way in which both models seek to intervene in the lives of disabled peoples in order to integrate them into society. The models, however, have different methods of intervention, where the medical model seeks to intervene medically in order to ‘fix’ the ‘problem’ that is inherent to the individual in order to return them to normality and species-typical functioning. The social model, however, seeks to integrate the individuals into society by altering attitudinal, societal and environmental barriers which are responsible for disabling people with impairments, as disability is ultimately a socially derived phenomenon. This essay thus compared and contrasted the medical models of disability and related them to real life examples to show the implications of the models on society.