Medical Model of Disability

The medical model of disability has been dominant since the 19th century (Goodley, 2011; 2017). Disability in this model is defined as “an individual’s defect lodged in the person, a defect that must be cured or eliminated if the person is to achieve full capacity as a human being” (Siebers, 2008, p. 3). This defect is meant to be located in the body or mind of a person labelled disabled (Oliver, 1990; Linton, 1998; Goodley, 2001, 2014). As Reindal (1995), Shakespeare (2006) and Goodley (1997; 2011; 2017) point out, the common

understanding of disability within the medical model is a lack of, or limitations in an individual’s mind and body.

This means that disability is pathological (Goodley, 2011; 2017) because it is conceptualised as a defect of the mind or body within-person instead of within-society (Shakespeare, 2006). This understanding mixes disability and impairment as a personal tragedy (Oliver, 1990; Thomas, 2002; Goodley, 2011, 2017) that has nothing to do with social construction or discrimination and oppression of disabled people (Oliver, 1990). Advocates of this model assume that disability can be fixed and resolved through the power of medicine and the paramedical professions (Reindal, 1995; Linton, 1998; Kauffman, 2007; Goodley, 2011; Grue, 2015). They claim that only through this route can disabled people be enabled to function ‘normally’ in life (Oliver, 1990; Reindal, 1995; Shakespeare, 2006; Kelmen & Vanhala, 2010; Goodley, 2011, 2017; Grue, 2015).

However, the efficacy of this model in resolving the problems of disability has been questioned since the 1970s (Thomas, 2002; Keleman &Vanhala, 2010), and its conception of disability as an individual tragedy and of the problems of disability as located solely within- individual has been highly criticised since the 1960s (see for example, Goffman, 1968; Illiich, 1977; Oliver, 1990; Linton, 1998; Shakespeare, 2006; Goodley 2011, 2017).

Keleman and Vanhala (2010) point out that the medical model fails to promote a more inclusive society or to eliminate or, at least reduce, the various forms of prejudice and discrimination that disabled people face in society and in educational institutions in particular. This model, however, leads to and encourages the exclusion of disabled students into special schools and classrooms within mainstream schools, and disabled children being

taught by ‘special’ educators who claim to have a unique knowledge and expertise to cater to disabled children’s different requirements (Slee, 2011; Goodley, 2011). As Biklen (1992, p. 83) states:

“Special educators usually describe their work as clinical. They treat individuals. If their work is with groups, they nevertheless usually attempt to individualize their ‘interventions.’ They are presumed to possess current expert knowledge. And they are expected to exercise professional judgment in each case they handle. They recommend and sometimes have the power to require a particular treatment”.

This clearly shows how the medical model affects disabled children’s experiences in schools by assigning psychologists and ‘special’ educators to diagnose and examine disabled children’s minds and bodies using biased tools, leading them to be labelled and thus excluded. As Thomas (2002) argues, the medical model assumes that disability limits disabled people’s activities and participation, thus they should be excluded in order to receive ‘special’ care and treatment from ‘special’ professionals. Goodley (2017) supports this when he states that the medical model benefits paramedical professions such as psychology and special education and, as Shakespeare (2006) puts it, stands for the dominant production of special professionals such as psychologists and special educators.

The impact of this model on disabled people and children does not stop there, extending to include perceiving disabled people as either childlike and dependent or overcomers and ‘supercrips’ (Shapiro, 1994), which in either case promotes stereotypes and represents disabled people as in need of pity and charity (Oliver, 1990, 2013; Shapiro, 1994). Cyndi Jones, an American disabled activist, explains this by saying:

“‘pity oppresses’… [it] says it’s not okay to be disabled… [charity] plays on fear. It says this could happen to you, your child, or your grandchild. But it says, if you just donate some money, the disabled children will go away” (cited in Shapiro, 1994, p. 12 & 14).

The original connection between disability and the medical model goes back many years to charity advertising (Mason, 1992) when disabled people were used as poster children for charity organisations (Shapiro, 1994). As Drake (1996) puts it, the representation of disabled people as meriting pity and charity is a direct consequence of viewing disability as a personal tragedy via the medical model of disability. Although this might have successfully raised money, it also created walls of fear between disabled and non-disabled people and significantly contributed to the spread of disabling attitudes towards and the exclusion of disabled people (Shapiro, 1994). This is because it reinforces the sad and negative image of disability (Mason, 1992) and shows disabled children as the problem. In other words, it is their responsibility to fit into the world as it is. As Tremblay, Campbell and Hudson (2005, p. 112) put it, medical model proponents believe that disabled “individuals need to adapt to existing environments and that wheelchairs were obstacles to participation, not steps and curbs”. They also postulate that normalisation or curing interventions are the only things disabled people could do to help them ‘normally’ participate in society’s activities (Drake, 1996; Goodley, 2011, 2017; Grue, 2015), otherwise they should be excluded to special education institutions/schools or in self-contained classrooms within mainstream schools if medical and normalisation interventions fail to remediate the individual’s mind or body.

Moreover, the shortcomings of this model also lead to the measuring of children’s intelligence against what is considered ‘normal’ and comparing their physical performance and bodily appearance against what is considered ‘normal’ in the society where they live (Davis, 1995; 2013). It focuses on what children cannot do instead of what they can do. Thus, it empowers and privileges people considered ‘normal’ or ‘able’ at the expense of people labelled disabled because it sees people so-labelled as unproductive and less human (Davis, 1995, 2013; Goodley, 2014). This not only affects how disabled people view themselves

(Oliver, 1990) but also where they live, where they receive their education, the support they receive, their relationships with others and their job opportunities (Slee, 2011).

The conclusion is that the medical model creates major problems in the lives of disabled people and their families and allies through standing for and supporting the creation and perpetuation of different forms of dis/ablist discourses and practices (Goodley, 2014), including but not limited to labelling and appreciation based on ability, oppressive language, inaccessibility of spaces, discrimination in education and employment, charity, pity, diagnosis, labelling and exclusion (Bogdan & Biklen, 1993; Thomas, 2002; Scullion, 2010). The social model, which will be discussed in the next section, originates as a reaction to expose, problematise and challenge the dominant structured and non-structured social oppression, inequality and exclusion of disabled people in the society where they live (Drake, 1996; Thomas, 2004; Goodley, 2011, 2014, 2017).