Wednesday, August 10, 2022

What Is The Medical Model Of Disability

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Epistemic And Moral Authority

What is the Medical Model of Disability

The first-hand experience of stigmatization may confer two sorts ofauthority on people with disabilities. The first is epistemic. Thereshould be nothing about us without us because anydiscussion of, or research into, disability not informed by thatexperience would likely be inaccurate and misguided. For example,discussions of well-being that do not take into account theperspective of disabled people may assume that their level ofhappiness or satisfaction is much lower than it in fact is, or that itis lower mainly because of difficulties directly attributable toimpairments rather than to attitudes and social barriers. This is butone application of the more general issue of first-person authority:the extent to which people have special or privileged knowledge oftheir own mental states and experiences . Although this is a subject of greatcontroversy in the philosophy of mind, there is widespread agreementthat, at minimum, first-person ascriptions of mental states carry adefeasible presumption of correctness.

At the same time, there are several dangers associated with placingtoo much emphasis on the moral privilege of victims of stigmatization.First, there is the danger of defining people by their oppression. Thevictims may not want to be spokespeople or witnesses, or not for verylong; they may want to move on. It is important to recognize both themoral authority of victims to testify and their prerogative to declinethat role.

My Childhood Issues With The Terms Deaf And Hard Of Hearing

It is curious that as a young child I had difficulties with the terms “deaf” and “hard of hearing,” yet the reality was clear. I couldnt hear very well, and I had no solutions for those terms. Then the term “hearing impaired” came along. However, this too, suggested that a problem existed. Thus, I was to continue being an outsider no matter what term eased my sore nerves on the topic. I could not escape the medical distinction: my hearing was subpar.

My Issues With Wearing Hearing Aids

Wearing hearing aids was a bigger issue for me because, for many years, I struggled with thoughts that I am doing so just to fit into society, for societys sake, and not necessarily for my own benefit. My argument here is that hearing aids tend to bring in excessive ambient noises confusing a user, overwhelming a user, and in a lot of environments, making it even more difficult for communication. This, of course, doesnt even begin to discuss the range of fear, stress, and frustration for all involved. All too often, Ive felt as if I was wearing hearing aids to appease a society which is impatient, lacking in empathy, and very judgmental. This is evident by the numerous examples when I have asked a person who has known me for some time to repeat themselves. Then, in exasperation, that person asks if Im wearing my hearing aids as if the hearing aid is the all-encompassing “fix” for any difficulties I might be having. Imagine their surprise when they find out that I am wearing hearing aids. The solution might be a different environment, improvement in their speech technique, or even different choices of words aid in our conversations.

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Models Of Disability: Types And Definitions

Synopsis: Lists the scholarly defined different models of disability and also provides explanations on each of the various current models in society today. The spectrum model refers to the range of visibility, audibility and sensibility under which mankind functions. The model asserts that disability does not necessarily mean reduced spectrum of operations. Disability rights movements, activists, scholars, and practitioners construct debates around the two main models, social and medical, of understanding of disabilities.

The Models Of Disability

The Social Model of Disability

Biomedical Model of Health

The biomedical model of health is the most dominant in the western world and focuses on health purely in terms of biological factors. Contained within the biomedical model of health is a medical model of disability. In a similar vein, this focuses on disability purely in terms of the impairment that it gives the individual. The biomedical model is often contrasted with the biop-sychosocial model.

Clipart image of an empty wheelchair in the foreground with colored silhouettes of people to the left and right of the wheelchair. A world map is featured in the background.

Medical Model of Disability

The medical model of disability is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition which therefore requires sustained medical care provided in the form of individual treatment by professionals.

  • In the medical model, management of the disability is aimed at a “cure,” or the individual’s adjustment and behavioral change that would lead to an “almost-cure” or effective cure.
  • In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming health-care policy.

Identity Model

Disability as an identity model is closely related to the social model of disability – yet with a fundamental difference in emphasis – is the identity model of disability.

Social Model of Disability

Minority Model of Disability

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Evolution Of Models Of Disability

The prevailing wisdom about the causes of disability has changed in the last several decades. In the 1950s, impairment of a given severity was viewed as sufficient to result in disability in all circumstances; in contrast, the absence of impairment of that severity was thought to be sufficient grounds to deny disability benefits. Thus, the American Medical Association’s Committee on Medical Rating of Physical Impairments stated that “competent evaluation of permanent impairment requires adequate and complete medical examination, accurate objective measure of function, and avoidance of subjective impressions and nonmedical factors such as the patient’s age, sex and occupation” .

Suggested Citation:Enabling America: Assessing the Role of Rehabilitation Science and Engineering

among medical conditions, impairments, functional limitations, and the effects of the interaction of the person with the environment although each uses different nomenclatures for the components.

Although the Nagi model included the environment, it was limited in how it conceived of the environment. In his model, the environment impinges on individuals only when activity limitation interacts with the demands placed on those individuals; the process that gives rise to disability is still inherently a function of the characteristics of medical conditions and attendant impairments.

Suggested Citation:Enabling America: Assessing the Role of Rehabilitation Science and Engineering

Social And Medical Models Of Disability: Paradigm Change

Disability is a human reality that has been perceived differently by diverse cultures and historical periods.; For most of the 20th century, disability was defined according to a medical model that defines a disability as the result of a physical condition within an individual.; In 2001 the World Health Organization established a new definition of disability based on human rights or social models.

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The Social Model Vs The Medical Model Of Disability

Social model of disability

The social model of disability says that disability is caused by the way society is organised, rather than by a persons impairment or difference. It looks at ways of removing barriers that restrict life choices for disabled people. When barriers are removed, disabled people can be independent and equal in society, with choice and control over their own lives.

Disabled people developed the social model of disability because the traditional medical model did not explain their personal experience of disability or help to develop more inclusive ways of living.

Changing attitudes to disabled people

Barriers are not just physical. Attitudes found in society, based on prejudice or stereotype , also disable people from having equal opportunities to be part of society.

Medical model of disability

The social model of disability says that disability is caused by the way society is organised. The medical model of disability says people are disabled by their impairments or differences.

Under the medical model, these impairments or differences should be fixed or changed by medical and other treatments, even when the impairment or difference does not cause pain or illness.

The medical model looks at what is wrong with the person and not what the person needs. It creates low expectations and leads to people losing independence, choice and control in their own lives.

Social model of disability: some examples

Convention On The Rights Of People With Disabilities

What is the social model of disability? – Scope video

Entered into force on 3 May 2008, the United Nations Convention on the Rights of People with Disabilities represents the first international convention on the rights of PWDs. As of June 2011, 101 countries have ratified and 149 countries have signed the Convention. Negotiation of the Convention involved a wide range of delegates from government, non-government, human rights and international organisations. It was the first time that non-government organisations had actively participated in the formation of a human rights instrument. Influence of the social model can be seen in the CRPD definition of PWDs:

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 .

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What Does The Medical Model Focus On

The biological approach of the medical model focuses on genetics, neurotransmitters, neurophysiology, neuroanatomy, and so on. Psychopathology says that disorders have an organic or physical cause. The approach suggests that mental conditions are related to the brain’s physical structure and functioning.

Examples Of The Social Model In Action

  • You are a disabled person who cant use stairs and wants to get into a building with a step at the entrance. The social model recognises that this is a problem with the building, not the person, and would suggest adding a ramp to the entrance.
  • You are a teenager with a learning difficulty who wants to live independently in your own home, but you dont know how to pay the rent. The social model recognises that with the right support on how to pay your rent, you can live the life you choose. The medical model might assume that the barriers to independent living are insurmountable, and you might be expected to live in a care home.

An illustration of the social model of disability in practice would be a town designed with wheelchairs in mind, with no stairs or escalators. If we designed our environment this way, wheelchair users would be able to be as independent as everyone else. It is society which puts these barriers on people by not making our environments accessible to everyone.

The problem isnt that I cant get into a lecture theatre, the problem is that the lecture theatre isnt accessible to me.. Professor Mike Oliver

Professor Michael Oliver; was a British academic, author, and disability rights activist. He was Emeritus Professor of Disability Studies at the University of Greenwich. Much of his work centered on advocating the social model of disability.

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Medical And Social Models Of Disability

Leaders in the disability rights movement have constructed two distinct models of how society views disabilities: the Medical Model and the Social Model. These models provide a framework for how people perceive those of us with disabilities. While the Medical Model is a helpful way of understanding illness and loss of function, people in the disability community have largely rejected it in favor of the Social Model. The Social Model promotes the idea that adapting social and physical environments to accommodate people with a range of functional abilities improves quality of life and opportunity for people with and without impairments.

Medical Model In Practice

The Medical Model of Disability

This leads us onto the ways that the medical model exists in attitudes as well as practice.

Societies and individuals recreate the construct of non-disabled as normal in latent and blatant ways regularly.

Language is one way that cultural ideas are practiced in unintentional ways.

A key word from the medical model lexicon was handicapped. There are various accounts of the etymology of the phrase, but simply it means that someone has a physical limitation.

Other Medical Model language includes phrases like the handicapped or the blind to refer to disabled or blind people as whole subsections of society, homogenous and other.

In response to this, many disabled people started to advocate for people first language where they would be seen as a person, where before they were seen as their impairment.

In that way they might be a person with a disability or a person with a visual impairment.

The phrase able-bodied is, although commonly used today, also derived from the Medical Model. In identifying people who arent disabled as able-bodied, we understand the opposite of disabled to be abled.

This both infers that disabled people arent able and also that disability is located in a persons body, that disability is physical and that disability is visible.

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Critique Of The Social Model

I do not believe that the social model has really engaged with the real issues facing the vast majority of disabled people, and, despite its rhetoric and undoubted attractions for some, it has not produced a cogent approach which can serve the real practical needs of disabled people, or indeed the research community.

The social model has been criticised for failing to address impairment, argued as integral to the experience of disability . The implication of this criticism is that the model does not fully account for the lived experience of PWDs. While some PWDs position their lives fully within the social model, others do not . Disregard of impairment has likely contributed to the limited research into the lives of PWDs and, in turn, has limited the development of disability-specific policy. There exists little robust research into the living standards of PWDs, particularly in developing countries, and little attention has been given to disability in national poverty reduction strategies . A more comprehensive and inclusive social theory of disability is called for .

My Struggle With The Medical Model Of Disability In My Youth

Labeled disabled as a young child, Ive fallen into the medical model of disability and have struggled my entire life as an outcast/outsider. Because the medical model assigns predominantly medical significance and meaning to certain types of human variation, I certainly understand the significance of the medical model and the difficulties that come with such a label.

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Social And Human Rights Models

Based on a human rights paradigm, these models emphasize that disability-related problems stem from an inaccessible social structure, as opposed to the disability itself. These models focus on environmental and attitudinal barriers that prevent people with disabilities from having equal opportunities in their societies. Many disability rights activists today embrace social and/or human rights models to inform their work.

What it looks like: A person with a disability is able to attend a school, go to work, participate in community activities alongside non-disabled people, perhaps using disability-related accommodations or modifications that make the environment more accessible to them.

Diagram of Social Model of Disability adapted from www.salto-youth.net

Examples Of The Social Model Of Disability In Action

Ruben Carol, explaining the difference between the Medical Model of Disability and the Social Model
  • A wheelchair user wants to get into a building with steps at the entrance. In a social model solution, a ramp would be added to the entrance so that the wheelchair user is free to go into the building immediately.
  • A teenager with a learning difficulty wants to work towards living independently in their own home but is unsure how to pay the rent. In a social model the person would be supported so that they are enabled to pay rent and live in their own home.
  • A person with a visual impairment wants to read the latest best-selling book to chat about with their sighted friends. In a social model the publishing group ensures full text audio recordings are available when the book is first published. This means all students and those with a love of literature with visual impairments can join in with cultural activities on an equal basis with everyone else.
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    Social And Medical Models Of Disability And Mental Health: Evolution And Renewal

    Over the last 6 decades, many published commentaries, from both within and outside the medical community, have criticized medicines characterization and management of mental illness and disability. These critiques have often referenced the medical model, a term that has multiple meanings but has almost always been used pejoratively. Prominent critics have included disability scholars and self-advocates, who attacked the so-called medical model and espoused an alternative social model, which characterizes disability as the product of an unaccommodating and oppressive society, rather than an individual and medical problem.

    The terms social model and medical model have frequently been used to highlight opposing views of disability, but there has been little historical examination of their origins and evolving meanings. As a result, clinicians have had limited access to information about what these concepts mean to patients, making it difficult to respond adequately to the concerns they raise. For physicians, fully embracing social-model views would require political engagement and a greater focus on societal, rather than individual, problems. Even if most physicians do not adopt these roles, increased awareness of disability perspectives and familiarity with critiques of the medical model may help them to identify new ways of improving care for their patients, while also enhancing opportunities and support for clinical trainees and colleagues with disabilities.

    Models Decisions And Policies

    The medical and social models suggest different views about the impact of disability on well-being, anddifferent views about how disability is relevant to reproductivedecisions, medical interventions, and social policy. Those who accepta social model of disability regard the association between disabilityand well-being as highly contingent, mediated by a variety ofenvironmental and social factors. They question conceptions ofwell-being that give a central role to the possession or exercise ofthe standard array of physical and mental functions, as thoseconceptions imply, or are often taken to imply, that well-being isprecluded or diminished merely by the absence or limitation of thosefunctions. As a result, theygenerally see the disadvantages of disability not only as externallycaused, but as less formidable than they appear to people who viewdisability in largely biomedical terms. These differences arereflected in the conflicting assessments of life with disabilitiesfound in the bioethics and public policy literature on the one hand,and disability scholarship on the other .

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