Narratives around disability and disabled people often influence how disabled people are understood and treated. These narratives can be used to both promote and challenge eugenic practices and they often form what can be thought of as models of disability. Models function to provide insight into the nature and function of phenomena. Broadly speaking, there are two main models that have been used to describe disability: medical models and social models.
The medical model of disability
Within medical models, disability is used interchangeably with terms such as impairment, disease, illness, chronic disease, and defect. Disability is a kind of defect or problem inherent to an individual, one that involves deviation from species-typical norms. It is defect directly caused by disease, trauma, or other medical health conditions. The primary objective of medical models is to treat or cure disabilities. This can involve things like managing the disability of a person or person-to-be, prevention of birth, deselection at the embryo level, or normative adaptation. According to the medical approach, care, prevention (in the case of the fetus/embryo), and rehabilitation are viewed as the primary endpoints; while at the political level, the purpose is to make curative and preventive medicine more efficient (Wolbring, 2005). In short, medical models perceive people as disabled by their bodies such that they require ‘fixing’ in one form or another. Other models that take a similar stance include the expert or professional model, the tragedy and/or charity model, the moral model and the economic model (Disabled World Definitions of The Models of Disability, 2013; National Black Disability Coalition Models of Disability, 2013).
The social model of disability
In contrast, according to social models, disability emerges from attitudinal and environmental barriers. The origin of disablement lies in how society views and reacts to subspecies-typical bodies and minds. Instead of focusing on fixing the body, social models focus on changing the physical environment and societal climate to accommodate the biological reality of people with disabilities. Disability is not an attribute or defect of an individual but, rather, a societal reaction (Wolbring, 2005). In this way, disability is seen mainly as a socially created problem, one that requires fully integrating individuals with different biological realities and abilities. The focus is less on origins and more on environmental and social intervention. Other models with a similar stand include the empowering model, the social adapted model, the market model, the Spectrum Model, and the rights based model (Disabled World Definitions of The Models of Disability, 2013; National Black Disability Coalition Models of Disability, 2013). One counter-narrative to the general approach of the social model comes from Deaf culture (Mirus, 2007; Paul & Moores, 2010; Blume, 2010).
International views of Disability
The UN Convention on the rights of persons with disabilities adopts a mixed approach to understanding disability. It holds that disability has both a biological and social component. “Disability results from the interaction between persons with impairments (sub species-typical functioning) and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others” (United Nations Convention on the Rights of Persons with Disabilities, 2006). Similarly, the International Classification of Functioning (ICF), a WHO framework for measuring health and disability at both individual and population levels, also recognizes the mixed origins of disability. “The outcome or result of a complex relationship between an individual’s health condition and personal factors, and of the external factors that represent the circumstances in which the individual lives”. International Classification on Functioning, Disability and Health, 2006).
Beyond the species-typical (enhancement models)
Historically, what was considered “normal” or “species-typical” body determined the meaning of impairment or disability. However, increasingly scientific and technological advancements provide a way for people to “go beyond” species-typicality, and thus rethink disability. Through procedures such as somatic and germline genetic interventions, synthetic biology and mechanical add-ons to the body (cyborgization), people are beginning to have the option to escape the “confines of their bodies”. This has given rise to enhancement models of disabiilty. Because advancements allow genomic and morphological freedom, they are sometimes seen as offering an escape from disability altogether (Ball & Wolbring, 2012). Instead of being confined to the species-typical, enhancement models look to liberate the disabled body through modification. This kind of model has a direct link to eugenics. Eugenics has a long history of looking to ‘enhance’ people—for example, through selected breading. Known as positive eugenics, the attempt to ‘make better people’ by adding or enhancing their abilities or bodies is strongly related to the idea that some kinds of traits are more desirable of continuation than others, and that one goal of a eugenic science is to further desirable traits.
Conclusion
Different models of disability produce different understandings of what disability is and how it originates. More importantly, though, models of disability influence what kinds of solutions and interventions are seen as necessary when dealing with disability. When the medical narrative is used, problems of disability come with ‘medical’ solutions. When the social model is used, problems of disability come with solutions of societal intervention.
-Gregor Wolbring
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