The medical model regards disability as an impairment that needs to be treated, cured, fixed or at least rehabilitated. Disability is seen as a deviation from the normal health status. Exclusion of disabled persons from society is regarded as an individual problem and the reasons for exclusion are seen in the impairment.
Disability Models
What is “Disability”?
Models of disability are analytic tools in disability studies used to articulate different ways disability is conceptualized by individuals and society broadly.
The most common known are the following:
- Medical Model
- Social Model
- Human Rights Model
Impairment vs. Disability
To understand the different models, it is important to distinguish between “impairment” and “disability” (which both translate to “障がい” (shōgai) in the Japanese language).
“Impairment” refers to a physical or mental condition that is independent of the environment, such as not being able to move one’s legs or being blind.
On the other hand, “disability” refers to a barrier in social life, such as the inability to move around because facilities or public transportation are not barrier-free, regardless of the degree of functional impairment.
In other words, “impairment” is fixed unless a revolutionary treatment is discovered, while “disability” is something that can be eliminated by changing social systems and structures.
The different Disability Models
In 2014 Theresia Degener wrote the following in “A human rights model of disability”.
A translation into Japanese can be found here.
The Medical Model
Disability according to the medical model remains the exclusive realm of helping and medical disciplines: doctors, nurses, special education teachers, rehabilitation experts.
Another feature of the medical model of disability is that it is based on two assumptions that have a dangerous impact on human rights:
(1) Disabled persons need to have shelter and welfare and
(2) impairment can foreclose legal capacity.
The first assumption legitimizes segregated facilities for disabled persons, such as special schools, living institutions or, sheltered workshops.
The second assumption has led to the creation of mental health and guardianship laws that take an incapacity approach to disability.
During the negotiations of the CRPD, the medical model served as a determent. While there was often no consensus among stakeholders which way to go in terms of drafting the text of the convention, there was overall agreement that the medical model of disability definitely was not the right path.
Rather the social model of disability was supposed to be the philosophical basis for the treaty.
But the social model does not seek to provide moral principles or values as a foundation of disability policy. The CRPD, however, seeks exactly that.
Theresia Degener - 2014 - A human rights model of disability
The Social Model
The social model of disability explains disability as a social construct through discrimination and oppression. Its focus is on society rather than on the individual.
The social model differentiates between impairment and disability.
While the first relates to a condition of the body or the mind, the second is the result of the way environment and society respond to that impairment.
The social model of disability was created as one explanation of exclusion of disabled people from society. It has been developed as a powerful tool to analyse discriminatory and oppressive structures of society.
Theresia Degener - 2014 - A human rights model of disability
The Human Rights Model
If there is one single phrase which summarizes the success story of the CRPD, it is that it manifests the paradigm shift from the medical to the social model has often been stated as the main achievement of the CRPD.
However, while it is true that the social model of disability has been the prevalent reference paradigm during the negotiation process, my understanding of the CRPD is that it goes beyond the social model of disability and codifies the human rights model of disability.
My thesis is that the human rights model is an improvement of the social model of disability and that it is a tool to implement the CRPD.
However, most states parties to the CRPD are far from comprehending this new model of disability and are still stuck with the medical model of disability.
Now, what is the difference between the social and the human rights model of disability and why is the CRPD a manifestation of the latter?
(1) Impairment does not hinder human rights capacity
(2) The human rights model includes first and second generation human rights
(3) The human rights model values impairment as part of human diversity
(4) The human rights model acknowledges identity issues
(5) The human rights model allows for assessment of prevention policy
(6) The human rights model strives for social justice
Apparently, most states parties have a problem to understand the model of disability which has been adopted with the CRPD. Several states parties reports reveal an understanding of disability which follows the traditional medical model of disability.
Theresia Degener - 2014 - A human rights model of disability