Medical model of disability

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The medical model of disability, or medical model, is based in a biomedical perception of disability. This model links a disability diagnosis to an individual's physical body. The model supposes that a disability may reduce the individual's quality of life and aims to correct or diminish the disability with medical intervention. [1] It is often contrasted with the social model of disability.

Contents

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 or improve functioning, and to allow disabled people to lead a more "normal" life. The medical profession's responsibility and potential in this area is seen as central.

History

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. [2] This could particularly be illustrated with aristocratic doctors treating the elite during the 17th and 18th century. [3]

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. [4]

Components and usage

Pathology tends to classify physiological or mental states to "Normal", "More", and "Less". This creates an illusion of one "Normal" size fits all. But there will be people who are outliers in this schema, and "their normal" isn't everyone's normal. Trying to bending back to the accepted normal may actually harm them, for example DSPD (Delayed sleep phase disorder). One size fits all - how pathology tend to classify conditions.png
Pathology tends to classify physiological or mental states to "Normal", "More", and "Less". This creates an illusion of one "Normal" size fits all. But there will be people who are outliers in this schema, and "their normal" isn't everyone's normal. Trying to bending back to the accepted normal may actually harm them, for example DSPD (Delayed sleep phase disorder).

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. [1] 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. [1] [2] Medical professionals now define what is "normal" and what is "abnormal" in terms of biology and disability. [3]

In some countries, the medical model of disability has influenced legislation and policy pertaining to persons with disabilities on a national level. [5] [6]

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). [7]

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. [8]

Criticism

The medical model focuses on individual intervention and treatment as the proper approach to disability. Emphasis is placed on the biological expression of disability rather than on the systems and structures that can inhibit the lives of people with disabilities. Under the medical model, disabled bodies are defined as something to be corrected, changed, or cured. Terminology used can perpetuate negative labels such as deviant, pathological, and defective, thus, best understood in medical terms. The history and future of disability are severely constricted, focusing solely on medical implications and can overlook social constructions contributing to the experience of disability. Alternatively, the social model presents disability less as an objective fact of the body and mind, and positions it in terms of social relations and barriers that an individual may face in social settings. [9]

The medical model of disability can influence the factors within the creation of medical or disability aides, such as creating aides reminiscent of hospital settings and institutions which can be traumatic to some who have spent and extended period of time there, or which solely reflect the function of hospital aides but not necessarily the function of an aide outside of these contexts. [10]

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 (otherwise known as ableism). [11] 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. [12] This includes the monetary and 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 criticize 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").

See also

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References

  1. 1 2 3 Fisher, Pamela; Goodley, Dan (January 2007). "The linear medical model of disability: mothers of disabled babies resist with counter-narratives". Sociology of Health & Illness. 29 (1): 66–81. doi: 10.1111/j.1467-9566.2007.00518.x . PMID   17286706.
  2. 1 2 Bury, Mike (2001). "Illness narratives: Fact or fiction?". Sociology of Health & Illness. 23 (3): 263. doi: 10.1111/1467-9566.00252 .
  3. 1 2 Lawrence, Christopher (1994). Medicine in the making of modern Britain : 1700-1920 (Digital Printing ed.). London [u.a.]: Routledge. ISBN   9780415091688.
  4. ↑ WHO, International Classification of Impairments, Disabilities and Handicaps,1980
  5. ↑ Kanter, Arlene S. (2014-11-27). The Development of Disability Rights Under International Law: From Charity to Human Rights. Routledge. ISBN   9781134444663. Archived from the original on 2023-07-19. Retrieved 2020-11-01.
  6. ↑ Mendes, Errol; Srighanthan, Sakunthala (2009-04-18). Confronting Discrimination and Inequality in China: Chinese and Canadian Perspectives. University of Ottawa Press. ISBN   9780776617800. Archived from the original on 2023-07-19. Retrieved 2020-11-01.
  7. ↑ "International Classification of Functioning, Disability and Health". WHO. Archived from the original on 23 April 2019. Retrieved 15 November 2011.
  8. ↑ dos Santos, Adriana Neves; Pavão, Sílvia Leticia; de Campos, Ana Carolina; Rocha, Nelci Adriana Cicuto Ferreira (1 June 2012). "International classification of functioning, disability and health in children with cerebral palsy". Disability and Rehabilitation. 34 (12): 1053–1058. doi:10.3109/09638288.2011.631678. ISSN   0963-8288. PMID   22107334. S2CID   207500685. Archived from the original on 21 April 2022. Retrieved 7 May 2022.
  9. ↑ Kafer, Alison (2013). Feminist, queer, crip. Indiana University Press. ISBN   978-0253009340.
  10. ↑ Barton, Len (1996), "Sociology and disability: some emerging issues", Disability and Society, Routledge, doi:10.4324/9781315841984-2, ISBN   978-1-315-84198-4 , retrieved 2024-04-11
  11. ↑ Dirth, Thomas P.; Branscombe, Nyla R. (June 2017). "Disability Models Affect Disability Policy Support through Awareness of Structural Discrimination: Models of Disability". Journal of Social Issues. 73 (2): 413–442. doi:10.1111/josi.12224.
  12. ↑ Goering, Sara (June 2015). "Rethinking disability: the social model of disability and chronic disease". Current Reviews in Musculoskeletal Medicine. 8 (2): 134–138. doi:10.1007/s12178-015-9273-z. PMC   4596173 . PMID   25862485.
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