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5 Jul 07, 8:10 AM - Social vs. Medical Disability Model

Posted by Zephyr

I don't believe wholeheartedly in the Social Model of Disability. Or rather, I don't think it's the only answer. There, I said it.

I believe that for a lot of disabled folk, the only thing that makes them disabled is the barriers put up by society. If society would just put up ramps and tear down prejudice, a lot of people wouldn't be disabled anymore. But you know what? I still would be. I have a chronic pain disorder. No amount of social and civil justice is going to change that. It would help me a great deal, but at the end of it all, I would still be stuck with a debilitating condition I don't want.

Nope, I wholeheartedly embrace the Medical Model of Disability as well. I don't see why the two models can't be complementary. Granted, I don't think the Medical Model is always applicable to certain disabilities or people. I know there are people with conditions like Cerebral Palsy or Autism who don't want to be cured, who want to live and thrive with their respective conditions. I support that. But I think if you were to take a poll of people with conditions like mine, you'd find that most or all are gung ho for a cure. I don't think anyone wants to live with degenerating pain.

The problem with the medical establishment is that they paint all diseases with the same brush. It never occurs to them that some people don't want to be cured.

But anyway, I hope no one thinks I'm a traitor to the Disability Rights Movement. I see no reason why I can't support both points of view.

• Visit Arthritic Young Thing
*May contain adult content*

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At 10:40 AM on 05 Jul 2007, The Goldfish wrote:

I'm afraid you've misunderstood what the Social Model and Medical Models are about. You're right to say that the difficulties you face in life have a combination of medical and social causes, to be dealt in different ways, but is this what makes you disabled?

After all, what do you or I have in common with other disabled people? Not medical diagnoses? Not physical or cognitive symptoms? The only thing we all have in common is our status as defined by society's treatment.

You can subscribe to the Social Model and still do everything you can to reduce distressing symptoms or even hope for a cure. However, as a community, the only part of our problem that we can work together to change is the social one. There will probably always been illness, injury and impairment; there need not always be disability.

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At 10:41 AM on 05 Jul 2007, Nicola wrote:

rejecting the social model on the grounds that it ignores your medical experience, the things that can't be address by social change, pain, fatigue, the things people want cured, is bad logic.

its like complaining that your microwave can't make ice cubes.

its not about rejection of medical cures its primarily a societal explanation of our inequality, second class citizenship.

all the medical model does is explain that inequality in terms of individual defects - 'people with disabilities'. That means so long as you are disabled you can never be equal. So no, they can't work side by side . That's my take on it.

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At 10:44 AM on 05 Jul 2007, Alison Fox wrote:

Tear down prejudice and negative thinking about disability .
The one thing I hate is people assuming my impairment is a negative thing . However , because I can't do some things I have become more proficient at others and am probably a better person .
I really hate this idea that we all want to be cured.
I know that some people need the medical model as well as they are in pain or have conditions that severely limit them ; but they will still benefit from tackling prejudice as this will hopefully improve the way doctors interract with them as people and mean that treatment will be delivered in the way they want it to be . After all even a cure still has to be given to the person by doctors , and this cure has to be explained to the person so that they can make an informed decision . The decision is far more likely to be informed if the doctor has the right attitude towards the person and sees them as a person on equal terms rather than as a (for example) spinal injury in bed 4

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At 11:30 AM on 05 Jul 2007, Sully wrote:

Hi Zephyr, thanks for saying that, you expressed a lot of what I feel myself and it's a difficult thing to say.

The other comments are interesting too though, I hadn't realised that the social model isn't about rejecting medical cures - probably because I've heard it (mistakenly, it would seem) pushed as that in the past.

"Social changes will solve everything" just isn't true, for the reasons you expressed above.

But of course "Medicine will fix everything" isn't true either.

Are these two "opposing" models outdated now? Or just widely misinterpreted?

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At 11:52 AM on 05 Jul 2007, Nicola wrote:

"Social changes will solve everything" just isn't true"

No its not and the Social Model never set out to claim that. the only people who claim that are the people criticising it.

" I hadn't realised that the social model isn't about rejecting medical cures - probably because I've heard it (mistakenly, it would seem) pushed as that in the past."

i think we should distinguish between difference of opinion/interpretation and just 'being wrong' but i'd actually go far as to say that cure or treatment rejection is a damaging myth and is indeed just wrong.

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At 02:38 PM on 05 Jul 2007, Peter Farrington wrote:

Readers may find reading the recent discussion we had on the “Talk” message board helpful.

“Disability is Part of Me”:

http://www.bbc.co.uk/dna/mbouch/F2322273?thread=4196500

The thread began with the following comment by Sarah to start the debate:

“Many here say that they don't want to be cured even if it were possible because if they were they wouldn't be who they are.

Lots of others say they have adapted, that they live quite happily or as much as possible as they are but would take a cure if it came along.

Others, especially (those) who have become disabled, seem to put their lives on hold for a cure.”

My own original contribution sums up my own take on the reasons for three such groups and the part the social/medical models may well play in this:

“The part that disability plays in our own individual and collective “identity” is clearly an important topic for us all, along with our reactions to what we perceive as other’s perception of that identity especially when the “others” in question are not themselves disabled.

The key distinction between having been born with a disability and “acquiring” it later in life, this thread has identified, is clearly an important factor in predicting the likely membership of your two main groups, albeit that some from each group would be the exceptions that prove the rule as it were.

I suspect it also explains why many in the first group will find the “social” model better fits their own experience. For them their initial “world” would tend to have been adapted to their needs and it is therefore the reality of the outside world that for them is the “change” from their earlier experience.

For those in the second group, of course, the reverse applies and the world they knew will have remained the same but it is they themselves that will have effectively changed to some degree.

The explanation for the existence of a third sub group, and the fact it tends to only be populated by members of the second group, is I suspect largely down to the influence of the normal grieving process that tends to accompany any “loss” but which of course generally does not apply directly to those in the first group as “loss” in that way is not a factor.”

I hope others will find this debate interesting and informative as I said in one of my later posts:

“I think more than anything else what this thread, and how it later developed to explore other aspects of how we each view our own, (and other's) individual relationship with disability, has served to give all of us a far deeper understanding not only of our own thoughts and feelings about the part disability plays in our lives but importantly also for others, and this can only be to the good.

What is clear is that there are no universal answers and individual points of view are just that, but gaining a better insight into how others have arrived at where they are now might just enable all of us to be a little more sensitive and accepting to both the existence and validity of those alternative views.”

Peter aka “Sociable”

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At 03:00 PM on 05 Jul 2007, Lady Bracknell's Editor wrote:

In haste - because I'm off out very soon for an acupuncture treatment - this and
this from my own blog may be helpful/interesting.

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At 05:06 PM on 05 Jul 2007, The Goldfish wrote:

I have to disagree with Peter's assessment. We're not talking about a way in which a person can frame their own psychological relationship with impairment - that's important and personal and a subject worthy of discussion, but absolutely nothing to do with the validity of the Social Model. This isn't about a feeling; all feelings may be valid, of course. Sociopolitical models, however, are often mutually exclusive.

Peter's comments do, however, offer a clue to why this is so often misunderstood.

I have a debilitating chronic illness, pain, fatigue, cognitive and immune dysfunction, can't work, long spells in bed, blah blah blah. I can't not work because of discrimination; I couldn't stay awake long enough. And yeah, that sucks.

However, I also face all manner of physical, social and psychological barriers which, unlike my medical condition, are actually things we can change.

Only one of these things can be described as disability. Only one of them is the only thing I have in common with other disabled people with different sorts of impairments. And only one of them are we able to address as a group, and as a society.

If we use the same word for both, we get in a real mess. And every time you can't access a building, you have to ask the question, is the problem with my body because it's unable to walk or is the problem with a building with a enormous step up to the door?

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At 05:34 PM on 05 Jul 2007, Peter Farrington wrote:

I hear where you are comming from Goldfish but......

The problem is a significant proportion (and maybe even a majority) of disabled people let alone society as a whole use a different deffinition of "disability" than the one you are using based only on the social model.

We had another interesting discussion of this back in April following a post by Mathew aka “frogbucket”:

http://www.bbc.co.uk/dna/mbouch/F2322273?thread=4081569&skip=0&show=20

This was my contribution to that debate which perhaps explains my stance on the various models better than anything else could.

“I like the way Mathew is exploring his thoughts and feelings about his “disability”, not just from his own personal perspective but also in terms of how his own and other’s experience and observations of the world at large, might serve to inform the overall debate about the nature of “disability” and the impact this has on his own and other’s interaction with society as a whole.

He quite rightly, in my opinion, identifies there are serious shortcomings in the current theories and explanations for “disability”, not just with the various “medical” models but, interestingly, also with the alternative “social” model so fiercely advocated by large sections of the more politically active disabled community as a whole.

I make this distinction, about the more politically active section of the disabled community, partly because I think it helps to explain the perhaps inevitable paradox Mathew has identified surrounding the part “pride” plays not least in squaring his own experience of “disability” with that provided by the “Social” model.

The real paradox in this, for me at least, is that “pride” is clearly at the very heart and soul of the “social” model of “disability” and has been since its early beginnings back in the 1960’s and the later refinement of the model in the early 1980’s when the term “social model” first became adopted by activists.

My own take on this is that the one major flaw in the “social” model has always been the assumption “pride” is only possible if one passes ownership and responsibility for disability” to others, rather than the disabled person actually taking full ownership of that disability for themselves regardless of who is seen by them, or others, to be to blame for its existence.

It is ownership of ones own disability that allows one to be in control of how it then impacts of our own self image and how we decide to move forward in being ourselves in our dealings with the wider world.

For me the answer was both extremely simple and extremely complex at the same time but, in the end, came down to the simple realisation that I can own my disability without it owning me.

I have various illnesses and disabilities, they do not have me.

Above all I am not my disability and my disability is not me and never will be and more than that has little or nothing to do with any feelings of pride I may have in either myself or my achievements.

As for the notion that we need a new way to understand, explain and explore the essential nature of disability, in order that we can collectively as a society help to reduce and ultimately remove the inequalities it leads too, I agree 100% with Mathew we do need a better and broader “model” to work with in order to achieve this.

Both he and Simon appear to be concentrating mostly on the part the existence of an emerging “disabled community” might play in the equation.

I, however, would go far further than either he or Simon seem to be suggesting we need to try to develop a model that actually seeks to explore the way both individuals with disabilities and the broader disabled community as a whole functions within society and vice versa.

This will inevitably need to build on existing theories and understanding, not least of all the “social” model itself, but also include the part other factors such as psychology, economics, politics and the simple practical realities of life always play in the overall scheme of things.

Perhaps if we all can, for now at least, call a short truce on how to define "disability" for long enough we might just collectively be able to work together to achieve this goal.

If not I will just carry on working on my own theory for now and come back to the topic when I have been able to put together my own thoughts more clearly in the hope I can build in a degree of consensus that might avoid the current squabbles discussion of such things always seems to provoke right now.”

Peter aka “Sociable”.

"Go placidly..be gentle with yourself..strive to be happy"

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At 05:48 PM on 05 Jul 2007, Bob Williams-Findlay wrote:

How can these two models be compatiable?

Many people are confusing the issue of 'medical intervention' and the spectrum from pain relief through to removing an illness or impairment with the meaning of "cure" within the medical model.

The medical model is about getting rid of abnormality, assisting society avoid paying out on adjustments - make them walk, put them in an institution - no need for ramps then.

Those of you who embrace the medical model do you really think you're freaks, inferior or probably better of dead?

The bottom line: it's a paradox, but I believe it's the medical model that holds back progress on the type of medical interventions you would like to see.

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At 07:05 PM on 05 Jul 2007, Nicola wrote:

i don't think the people here want the medical model, actually.

People want treatment and cure, people experience pain, people are ill, fine, people think its not all political when you suffer -but that ain't the medical model. its lots of very emotive, subjective, things, but it ain't that.

like bob said the medical model is about purging abnormality. in that case we are abnormal, socially inferior until medicine comes to our rescue.

Never mind do you think WE are freaks, why would you ever want that for yourself?

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At 07:38 PM on 05 Jul 2007, Peter Farrington wrote:

How on earth does saying the social model has some limitations mean one must therefore fully accept a completely medical model instead, particularly in the extreme form the last few posters have implied is how the medical model works?

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At 09:07 PM on 05 Jul 2007, DavidGillon wrote:

There seems to be almost a horrified reaction that some of us don't consider the social model to be the complete solution to all ills, with claims that the social model does address things like chronically limiting illnesses. Well not (in my experience) as it's normally portrayed it doesn't. The understanding of the social model I see repeated endlessly is that we need to change society so that it no longer disables us. I agree wholeheartedly, but you can have a perfectly physically and procedurally adapted society, and my participation will still be limited by pain and pain control measures in comparison to the norm. I will, in fact, still be disabled, just not by society.

There's an assumption in some of the replies that to criticise the social model means you must reject it and support the medical model. Far from it, but the social model needs to admit its limitations.

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At 09:44 PM on 05 Jul 2007, Zephyr wrote:

Goldfish - Even if the world were completely accessible, my pain and immobility would still keep me from a lot of jobs and recreational activities. My condition would still be disabling.

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At 09:47 PM on 05 Jul 2007, Zephyr wrote:

Nicola - I'm not rejecting the Social Model! I think it's valid and needed. I just want medicine to keep working on treatments and cures as well, especially for painful diseases.

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At 11:02 PM on 05 Jul 2007, DavidGillon wrote:

There seems to be almost a horrified reaction that some of us don't consider the social model to be the complete solution to all ills, with claims that the social model does address things like chronically limiting illnesses. Well not (in my experience) as it's normally portrayed it doesn't. The understanding of the social model I see repeated endlessly is that we need to change society so that it no longer disables us. I agree wholeheartedly, but you can have a perfectly physically and procedurally adapted society, and my participation will still be limited by pain and pain control measures in comparison to the norm. I will, in fact, still be disabled, just not by society.

There's an assumption in some of the replies that to criticise the social model means you must reject it and support the medical model. Far from it, but the social model needs to admit its limitations.

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At 12:27 AM on 06 Jul 2007, NORMA BELL wrote:

I AM 60 YEARS YOUNG.FEMALE LIVE IN A NURSING-HOME.THIS YEAR I STARTED A BATCHELOR OF COMMUNICATION.SO WHAT I HEAR YOU ASK.LAST MONTH I HAD MY THYROID GLAND REMOVED.10 YEARS AGO I UNDERWENT SURGERY FOR THE REMOVAL OF A TUMOR ON MY LEFT BREAST.ALL MY BALANCE,CO-ORDINATION AND MOST OF MY FINE-MOTOR SKILLS ARE GONE.MY DIAGNOSIS IS PARA NEO PLASTIC CEREBELLAR DEGENERATION.SO DON'T SPEAK OF MEDICAL VERSUS SOCIAL.YOU JUST HAVE TO GET ON AND DO YOUR OWNN THING.VERY FEW PEOPLE HAVE ANY TIME FOR PEOPLE IN WHEELCHAIRS,WE DON'T FIT INTO THEIR IDEA OF DISABLED IF WE WANT AN EDUCATION.BY THE WAY,I LIVE IN AUSTRALIA

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At 09:56 AM on 06 Jul 2007, Bob Williams-Findlay wrote:

May I respond to David Gillon's post?

Anyone who thinks the social model is the answer to all of our ills, not only fails to grasp what it was supposed to, they are using it in a dogmatic and unhelpful way.

In a nutshell, the social model shifts the focus away from the idea that the root cause of both biological limitation and social disadvantage is solely the absence of 'functional loss' or presence of "normality", to looking at how negative social interactions between impaired individuals and their social environments occur.

Both the nature and degree of the impairment as well as the social environnment determines the disabling experience.

Therefore, David, in some cases the dominant 'disabling' factor could well be the person's impairment. The social model doesn't deny this, it merely challenges the idea that it is 'a given fact'.

Has the model limitations? Depends on what you mean. Was the ballpoint pen designed to clean out ears? The fact that some use a pen in this way unsatisfactorily, doesn't mean the pen was designed wrong!

Neither is the social model wholly responsible for the fact that society has produced a series ideologies/models that give different meanings to certain words.

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At 11:14 AM on 06 Jul 2007, Marmiteboy wrote:

The Medical Model has nothing to do with receiving treatment. It is about society viewing disabled people in a certain way and saying that it is the impairment (although the word would not be used under the medical model) that is the 'problem'.

The Social model is not trying to deny treatment to anyone. It is stating that if there were procedures/environmental changes in place a disabled person would be far more able to live a life of equality.

The Social model is empowering and the medical model is the opposite. It gives the power to someone other than the disabled person by saying that in order to obtain equality they will have to be non-disabled (not an option open to everyone I'll think you'll agree).

I am a strong advocate of the social model, however that does not stop me seeking treatment for my levels of pain. What I will not countenance however, is societies view that I am a lesser person because of my impairment and that in order to gain access to certain goods, services or employment I would have to be 'cured'of my 'disability'.

As I can't be cured of my 'disability' the Social Model is there to advocate that society provides the tools for me to be treated equally.

I would never wish to impose my views on others (people can believe what they like) but I do fail to understand why any disabled person would want to be patronised and treated like a second class citizen as the Medical Model does.

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At 12:09 PM on 06 Jul 2007, Lady Bracknell's Editor wrote:

David,

It isn't the purpose of the social model to do anything. It's not a solution. To anything. It's a way of looking at things.

It distinguishes between the problems we experience which are inherent to our impairments*, and those which are the result of environmental, organisational and attitudinal barriers to our full participation in society. That's all.

And, although that may not sound like very much, it was a completely new and innovative approach when it was first introduced.

Prior to that, we were seen as faulty and inferior and in need of being "brought up" to "the norm". If we couldn't be made to approximate to that norm, we were either locked away in an institution or treated as tragic cripples. In neither case were we regarded as being equal to everybody else.

It is very unfortunate that a few extreme and vocal apologists have interpreted the social model as meaning that any crip who seeks a cure is weak and a "traitor to the cause". That isn't what the model says.

*At no point does the social model deny that our impairments can be very difficult - if not impossible - to live with. It never says that I won't experience chronic pain any more if only people would have the decency to give up their seat for me on the bus.

As a sociological model, it highlights the resolvable problems which society itself (often unwittingly) imposes on its disabled members.

Society can't resolve my back injury.

Medicine may, ultimately, be able to. (I don't actually think it will be able to, but that's not the point. I'm pretty damn' keen that it carries on researching more efficient, less damaging pain killers, that's for sure.)

Without medical assistance, I'd have been dead a long time ago. But my need of, and appreciation for, the medical establishment doesn't mean for a moment that I accept the medical model of disability in which, because I have impairments, I am deemed to be less valuable and less valid than a non-disabled person.

As I have said many times before, it's the name of the medical model which causes much of the confusion in this never-ending debate. Medicine may ultimately provide cures for many very unpleasant conditions. Medicine can relieve unspeakable suffering. Medicine is not the enemy.

But the medical model regards me as being socially inferior because I am not medically perfect. And that I will not accept.

People see the word "medical" in "medical model" and assume it's about receiving medical treatment for your problems. If that were all it was about, then only the extremist few would have any problem with it. Unfortunately, that's not all that it's about. Not even close.

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At 12:59 PM on 06 Jul 2007, Peter Farrington wrote:

The danger with the blind adherance only to the social model many have when looking at "solutions" though is that unfortunately those for whom the model fits less well tend to often get thrown out with the bathwater.

Two examples I would use to demonstrate this are the recent welfare reforms, based on the notion all should be able to work regardless of how inappropriate that might be in many cases.

The second is the attitude even the DRC had to the Remploy workers.

These days I often actually feel more "opressed" by those that insist I use words in the way they define them, rather than the way I and the majority understand them,than by the various physical and social barriers I find society has placed in my way.

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At 02:06 PM on 06 Jul 2007, Marmiteboy wrote:

Peter,

I'm not sure that either of your examples are the fault of the Social Model. The recent welfare reforms are made by a government who, in my opiniion, care little for disabled people or other minority groups they purport to support. By their actions, it is apparent that they aren't keen on the medical model either. If they did we'd have accessible transport, better drugs etc, etc.

As for the Remploy workers. I am appalled at the way these workers have been treated. Not just the recent closure of the factory and the resultant job losses but the terms and conditions they have had to put up with for years. It is not the fault of the Social model that has caused this either. It is caused by an employer who thinks it can treat workers poorly becuase they are disabled. More adherent to the medical model I'd have thought, seeing as they have been so poorly paid. The message that I get from companies such as Remploy is that the disabled people they employ(ed) are lucky to have a job and should stop moaning. A totally medical model response. If they were non-disabled then hey would no dobt have received equal pay and conditions.

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At 02:41 PM on 06 Jul 2007, Peter Farrington wrote:

The reason I used those two examples Marmiteboy is that in each case the social model was used to justify the DRC's and other's particular stance on the issues concerned in a way that worked against many disabled people.

I would agree it was probably a misuse of the social model in each case, but it does illustrate the many dangers inherant in trying to apply social model theory to each and every aspect of policy and practice regardless of the possible negative impact it might have.

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At 05:56 PM on 06 Jul 2007, Glenda Lee wrote:

Medical model + Social model + living in Australia - Charity model + whatever good ideas we come up with in the future = a bloody good start to a normal life.

cheers
Glee

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At 03:01 PM on 12 Jul 2007, Sarah wrote:

Hi... I am studying Disability and how people with disabilities face barriers when they wish to access sport and lesiure. I recently wrote an article about disability and it was based on this quote " I am not disabled, society disables me" and i think this is true. I people helped other more in society today and made things more accessable for everyone! then i think that issues such as this would not be a problem.... however the issue of hidden barriers will still be an issue but with the intergration in main stream schools now... prejudice is decreasing because from an early age people are now introduced to the impairements that people have and they now understand them which eliminates the fear of lack of knowledge.

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