Chestnuts roasting on an open fire

BADD is good and BADD is necessary, but it don't half expose some hoary old chestnuts. I'm pinning this one on Jack, because his was one of the first posts published this year, but I'm quite prepared to believe that others have fallen into exactly the same trap - I just haven't worked my way through to the offending posts yet.

Here's what Jack says:-

“Of course, the social model of disability tells us that they are disabled by society: that while they might have very poor hearing, for example, this would not represent a problem, were it not for the fact society does not generally adapt enough to their needs. The medical model of disability would say that the people are disabled by the fact that they have very poor hearing. My personal belief is that both models are appropriate, depending upon the circumstances: for example, the social model deals most effectively with disability discrimination (and preventing it); the medical model is better used by the medical profession when looking at the condition in question…”


I've tried not to react to this. I really have. But it's been eating away at me since Friday morning, and I can't leave it alone any longer. So, Jack, much as I love you, here goes nuffin'...



Let’s start with the basics. Models of disability are sociological models. In other words, they are models of the position those of us who have impairments hold within society. That is both what they are and all they are. They’re not designed to do anything. With the exception of the social model, they are reflections of existing attitudes. Also, with the exception of the social model, sociologists didn’t sit down and devise them. The medical, tragedy and charity models weren’t called the medical, tragedy or charity models until after the social model was drawn up, at which point terms were needed to define pre-existing responses to disability.


To say that the social model view of very poor hearing is that it wouldn’t represent a problem were it not for the fact that society doesn’t adapt to the needs of people with very poor hearing is, I’m afraid, a misunderstanding of the social model. The social model distinguishes between impairment (the very poor hearing) and disability (society’s failure to adapt to the needs of those with very poor hearing), certainly. What it doesn’t do is to say that having very poor hearing isn’t inherently a problem.


Hearing is probably the worst of all possible choices of example, as it happens, because many Deaf people are firmly of the belief that an inability to hear simply isn’t an inherent impediment to quality of life. So let’s use diabetes instead.


Does my diabetes present a problem? Hell, yes. And lots of them. Would it continue to present problems if society treated those of us with diabetes as true equals, and encouraged us to eat whenever we need to, even if doing so interrupted a meeting/appointment/social event? Absolutely, it would. Diabetes is a constant, tyrannical presence in my life which robs me of what little spontaneity my chronic pain might have left me with. Ignore the demands of my diabetes, and I die. No amount of societal commitment to full disability equality will alter that hard fact.


The social model of disability recognizes both the existence of impairments and the depth and breadth and extent of their impact on the individual. But it doesn’t dwell on that aspect of being a disabled person because that’s not what it was designed to illustrate. Instead, it differentiates between impairment (a lack of, or difference in, function – the stuff that can’t be changed) and the oppressive and exclusive nature of disability (society’s failure to treat people who have impairments as equals – the stuff that can be changed.)


By implication, because it demands equality of participation in society, the social model treats each and every impairment as morally-neutral. (This is comparable to the fight for genuine race equality, in which it is the reaction to differences in skin colour which causes exclusion, not the differences in skin colour themselves.) Morally-neutral or not – and that moral neutrality is a huge step forward in comparison with the belief that having an impairment is punishment for ill behaviour in a previous life – the impairment isn’t going anywhere. And neither are the problems it brings with it. But what we can eliminate – in theory, at least – are all the additional problems created by a society which treats people with impairments as abnormal and lesser beings. In other words, we can’t get rid of impairment, but we can and should eradicate disability. Just as we should eradicate racism, homophobia and sexism.


The phrase “abnormal and lesser beings” brings me neatly back to the medical model. I know I’ve said this before, but the medical model has been perilously-badly named. As it stands, it sounds as though it’s about providing medical care to people with impairments. Nuh-uh. It is nothing of the kind. If we could rename it the “Dear God, you can’t expect me to live next door to that!” model, then people like Jack would be far less likely to conclude that the two models can happily exist together in tandem.


Under the medical model of disability, you “have a disability” if there is something fairly seriously medically “wrong with” you. Having something “wrong with” you diminishes your position in society. It reduces your rights. Under the medical model, there is no obligation on society to adapt the general environment so that it’s accessible to you. Such obligation as there is lies with the medical profession – hence, “medical model”. Their job is to normalise you; to change and improve you until you fit in. Can’t be done in your particular situation? Oh, shame. Well, in that case, you get to be hidden away, either in your own home or in an institution, so that normal people – the ones with rights – aren’t exposed to your hideous deformities and distressing tics.


So, no, actually, I don’t think “the medical model is better used by the medical profession”. In fact, if I believed for even a fraction of a moment that my osteopath, acupuncturist, GP or diabetes nurse regarded me as an aberration who needs to be changed to fit in with normal society, I would be out of that treatment room as fast as my stick could carry me. There is an incalculably-huge difference between providing necessary medical treatment to someone with impairments and believing that, unless and until that treatment can make them look and behave like a normal person, they are inherently inferior.

The irritatingly-pedantic Editor