Disability vs. Illness
Updated: Aug 26, 2020
Modern movements for the rights of individuals with disabilities have been diligent in separating disability from illness in an attempt to reframe how disabled people have been seen under the dominant medical model construct. Under this construct, a disabled person is medically assessed, diagnosed, and treated most often in isolation (Laing, 1971). Their disabling condition is seen as an illness in need of curing or healing, when in fact, not all disabled people are sick.
Most disabled people are relatively physically stable and do not need continual medical intervention, yet they are continued to be “treated” as ill. Under the purview of the medical model, a disability is located solely within the person and needs to be ameliorated or eradicated to successfully function in society and they are often alienated as a result (Wendall, 2013). Conversely, the social construct approach to disability locates the issues to be that of society’s neglect of differing abilities which leads to total exclusion and subsequent oppression.
The disabling factor is not a problem located in the person, but an environmental problem because it does not offer flexibility or adaptation. However, this model mostly takes into account those with physical or sensory impairments which can be easier to accommodate through physical adaptation (Shakespeare, 2006). Learning disabilities, and other disabilities such as autism, can pose very different challenges that cannot necessarity be cured or physically adapted to, which is why an approach located somewhere in between these models needs to be considered.
The World Health Organization revised the classification of functioning and disability in recognition of the importance of the full participation of persons with disabilities and in recognition that the terms used in classifying such people can be stigmatizing (WHO, 2007).
But what does participation mean and how is this facilitated successfully?
In a study by Hammel, J., et.al (2008), this question was posed to a group of diversely disabled people to ascertain what participation meant to them in order to characterize it and to identify the barriers and supports that they required to experience it. The result of the study yielded that there was no ‘gold standard’ for participation. The participants reported needing to be free to pursue participation on their own terms and in their own way based on their personal experiences and the experiences that they had in their different communities.
Participation was seen as a relational right and a responsibility between the disabled person and her environment, and it was based on individual experience.*
Hammel, J., Magasi, S., Heinemann, A., Whiteneck, G., Bogner, J., & Rodriguez, E. (2008). What does participation mean? An insider perspective from people with disabilities. Disability and rehabilitation, 30(19), 1445-1460.
Laing, R. D. (1971). The politics of the family, and other essays (Vol. 5). Psychology Press.
Shakespeare, T. (2006). The social model of disability. The disability studies reader, 2, 197-204.
Wendell, S. (2013). Unhealthy Disabled: Treating Chronic Illnesses as Disabilities. The Disability Studies Reader, 161
World Health Organization. (2007). International Classification of Functioning, Disability, and Health: Children & Youth Version: ICF-CY. World Health Organization.
* Excerpt from: Fabbo, L. R. (2017). EDUCATING MARTA. The Social Work and K-12 Schools Casebook: Phenomenological Perspectives, 9.