What is disability?
The question is more difficult than it seems. Perhaps the age-old adage of “I know it when I see it” is appropriate here. It was first used by Supreme Court Justice Potter Stewart who, acknowledging that he couldn’t define obscene material, chose to make his verdict based on an intuitive definition. Is disability the same in this sense? Well, two models have been hypothesized as ways to define disability. The medical model and the social model.
The medical model of disability describes disability as a physical deficit that disrupts a person’s functioning. This seems to be obvious. After all, most people would consider being forced to use a wheelchair as functional impairment. Depression, too, limits a person’s ability to participate in activities. There are countless examples of how disability leads to functional impairment, and countless examples of it resulting from physical issues. One hypothesis, for example, posits that the positive symptoms of Schizophrenia, like psychosis, are caused by dysregulation in how the brain processes dopamine.
The social model of disability describes disability as a consequence of a society that isn’t built for the disabled, where impairment only exists because the world around us makes it so. This immediately seems like a stretch, but are there examples which could support it? Well, ADHD and its precursors are modern conditions, and it isn’t just that the label is new; similar symptoms to what we would now consider ADHD simply don’t appear anywhere near the frequency that they have in the last few decades. Given this short timeframe and how ADHD has become so prevalent across many cultures, it doesn’t seem like there’s a physical cause. What some suggest is that labor, especially white-collar labor, is just more boring than anything that we’ve ever experienced. It isn’t, then, that people have a biological dopamine deficiency but rather that society has alienated us from our labor and increased the amount of time that a person spends on it to the extent that many people simply can’t engage without medication, which, instead of treating an individual problem, merely serves as an individual solution to a societal issue.
The implications of the question from earlier are wide-reaching. When we attempt to reduce the prevalence of disability in society, we must choose to engage in one of these two models. What we often don’t realize, though, is how the medical model has become the basis of most treatments. Emphasis is placed on changing a person’s physical body rather than altering their context, and popular conceptions of “cure” suggest, regardless of whether a person’s social conditions have entirely eliminated the impairment of their physical difference, that a person remains disabled until their body is permanently altered to match a normative state.
Look to the push to “cure” blindness by surgically altering the eyes or using new technology to bypass physiological barriers to normative sight. Giving eyes to the blind can almost be considered a trope with how ingrained it is in the popular consciousness. Yet, these solutions—these “cures”—fail to address a key problem: that being able to see doesn’t make one actually able to perceive through vision in the same way that another person might. After we stop using a sense, we become unable to do so—often permanently. Even if it were possible to cure the blind with years of retraining one’s vision, would it be worth it? Why not just make accommodations that improve a person’s quality of life and reduce the impact of their disability on their functioning instead of jumping through flaming hoops for years only to end up with an inevitably useless solution?
Questions like these can be applied to other types of disabilities as well. Perhaps a paradigm shift is necessary. Perhaps we need to come to the understanding that disability only exists so long as our world makes it exist. Perhaps we can apply that understanding to make the world a better place for the disabled instead of demanding that they suffer any amount of pain or pay any sum to modify their bodies or rewire their brains.
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