Deaf Living Post #4: The Medical Model of Disability
There are various schools of thought, frameworks, or models of thought used to guide discussions- and research- on a topic. This includes models of mental health, physical health, business, economics, politics, and religion. Models have elements that explain the origin of the topic, the definition or purpose of the topic, and the impact of the topic on society and its relevant population.
The medical model of disability is one such model that paints a specific picture, and expectation, of the disabled and the larger community they exist within.
The Medical Model of Disability
The medical model, in brief, ascribes physical health interventions and medical aid to resolve the problem- which is within the client that is disabled. For example, if, for genetic and/or developmental reasons, my lower body is weak and I cannot walk for long periods of time, I will be eligible for wheelchair use, and can self-label as disabled.
The medical model would recommend exploring surgical and occupational therapy interventions, when applicable, so I am cured and then “able bodied,” or a person without defects or challenges. So the problem would start with me and end with me.
As Zosia Zaks put it in their 2022 paper on this model: “The fundamental assumption of the medical model is that the bodies and brains of disabled people are tragically abnormal and that disabled individuals are responsible for any consequences of their presumed or actual incapacity…. At great detriment to disabled people, disability policies, laws, research, education, and medical care under the medical model have focused on normalizing bodies and brains of those deemed disabled, eradicating disability traits, and segregating the disabled from non-disabled people”.
Model Benefits
Contributes to understanding illness: both medical and psychological
Contributes to understanding what the loss, or lack, of well-being presents as, its causes, and its effects
Encourages use of curative and supportive medical and technological interventions
Model Losses
Pathologizes normal human experiences and conditions
Lacks interventions beyond medications and other forms of medical treatments; hence social advocacy and minimizing poverty and negative social attitudes and stigma are not considered in interventions
Leads to segregation of the disabled and the able-bodied in society
Resolutions of losses:
There are other models that were born, like the social model of disability, and the biopsychosocial model, to allow for a more holistic perspective of disability, and avoid the disadvantages of the classic medical model. I will talk about those models in the future and only briefly list some of them and how they try to resolve loopholes of the medical model.
The Social Model of Disability: Disability is a social construct. That is, a person is disabled because society is not accessible for them in their natural state. It isn't their fault, hence the solution isn't only with them.
The Human Rights Model of Disability: Every disabled person has the right to equal human dignity and access to society. The definition of “normality” is avoided and the full promise of inclusivity is the core focus of this model unlike the medical model which explicitly categorizes humans as innately different in a negative light (or deviant).
The Affirmative Model of Disability: Focuses on redefining perceptions of disability to a place of normalizing disability as a part of the human experience. It doesn’t ignore the challenges and distress caused by disability and pays attention to the benefits brought by the diversity of the disabled experience. Meanwhile, the medical model looks at majority rule; what is common is norm. Everything else is a problem and should be re-directed to the statistical norm of functioning, health, socialization, language, etc.
Anecdotes
This isn’t to say there’s a Holy Model of Disability that covers everything- medical, sociocultural, legal, political, and the spiritual aspects of the disabled experience in their larger social context. Each of these models have major flaws in them- as we’ll see in future posts.
I wish there was such an ideal model! That would be great!!
It would standardize legal and political structures in society and how every disabled person can expect to be treated in whatever country they travel to. Sounds like a dream!
As things stand now, medical, or healing, approaches have a history of being strictly curative and dehumanizing in their perception and relations with disability. It’s changing, but, do note, the social model of disability only came around in the latter half of the 1900s…. That wasn’t long ago. So there’s ways to go within healing professions and in the general social dialogue around disability and diversity.
I will take this line to acknowledge variations in healing practices around the world- from Western medicine to indigenous knowledge bases- which no doubt also has variations in how they see and treat the diverse.
Personally, I was raised hearing so I was blind to my oppressed identity as a deaf person- or the potential of being oppressed. It was only when I was in a mainstream Elementary School with other DHH kids, and a Special Education program, that I was informed that I wasn’t “hearing impaired” or “hearing challenged ''- medical terms of impairment/brokenness.
These were neutral terms describing a physical deviance from the norm, and they understood that. However, I was empowered with other languages that weren’t based on defects but a cultural identity- a normalized and affirmative form of reality.
I could say I was “deaf” and it wasn’t a bad thing. I could say I was “hard of hearing,” if it was relevant for me (it wasn’t since I was profoundly deaf). And I can say “deaf/hard of hearing”.
Conclusions and Reminders
The change in language seems slight but it was a shift in worlds entirely. Even while it was subconscious and something I dismissed with rational thoughts of being loved by my family and, truly, blessed and supported in my lifetime, I was carrying quiet narratives of darker tones.
I did feel like a burden and I had evidence of influencing my entire family’s trajectory because I was their one disabled child.
I did feel like a replaceable human being- at times, even sub-human- because I had no unique traits or anything to contribute to society (I was a child, why did I expect to do something amazing???).
And I did identify as broken because that was the larger medical and societal model that was given to be to explain what happend to me at the age of 7. Of course, I trusted these smarter adults. But I’m more grateful for my Elementaty teachers and interpreters and peers.
Because I had a doorway revealed to me, through language, to identity as not a problem and a defect of a human being and just…me.
Sources: Hogan AJ. Social and medical models of disability and mental health: evolution and renewal. CMAJ. 2019 Jan 7;191(1):E16-E18. doi: 10.1503/cmaj.181008. PMID: 31009368; PMCID: PMC6312522.
Zaks, Z. (2023). Changing the medical model of disability to the normalization model of disability: clarifying the past to create a new future direction. Disability & Society, 1–28. https://doi.org/10.1080/09687599.2023.2255926.
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