The British Social Model of Disability and its drawbacks

“I’m not a ‘person with a disablity’, I’m a disabled person” (from xojane by Lisa Egan)

Recently I’ve noticed that a number of blogs by disabled people in the UK insist on referring to themselves, and similarly affected people, as “disabled people” rather than “people with disabilities”, the internationally recognised term which was commonly used in the UK until fairly recently, and that this term has become common (though not used consistently) in organisations such as government departments and student unions. The theory behind this is that the former term reflects a “social model” in which disability is the product of social barriers rather than a person’s physical impairments — the latter being termed the “medical model” in which disability is a medical problem to be cured, if possible. I see several problems with this use of language: it puts the British disability community out of step with those abroad, it regularly causes misunderstandings and misrepresentations, it is not inclusive, and is a false dichotomy in which an ideal model is presented in opposition to a composite of the worst disablist attitudes. (More: Emma’s Hope Book.)

British social-modellers present the social and medical models as an “either-or”: according to the medical model, they say, disability is inherent and the social and physical barriers just have to be accepted. The British activist Lisa Egan, who wrote the piece linked at the top of this article, called it a right-wing, “tough shit” attitude (here in the comments), while the British charity Scope (for people with cerebral palsy) offers this example:

A teenager with a learning difficulty wants to work towards living independently in their own home but is unsure how to pay the rent. Under the social model, the person would be supported so that they are enabled to pay rent and live in their own home. Under a medical model, the young person might be expected to live in a communal home.

Black and white picture of Lois Curtis, a Black American womanThis is quite a big leap of logic, and not one that is accepted by the disability community overseas. In other countries, there has been a focus on rights, rather than definition of disability, and the right to live in as unrestrictive a situation as possible is considered a right by disability campaigners in other countries such as the USA, where there have been legal rulings (such as Olmstead v EW & LC) that people should receive care in the least restrictive setting (in that particular case, the two named litigants, Elaine Wilson and Lois Curtis (right), had been held unnecessarily in a mental hospital for most of their lives since adolescence). Such restrictive care is not opposed because it is the source of their disability, or is disability itself, but because it is a denial of civil rights and a kind of oppression. At the moment, the Washington, DC-based Quality Trust for Individuals with Disabilities is fighting to get Jenny Hatch out of a group home in which she is being held against her will. The habit of calling an impairment “a disability”, or the impaired person a “person with a disability” does not equate to “it’s your problem” or “stay where you are” to them, clearly.

I have heard some people with chronic illnesses say that the medical model is in fact valid for their conditions while the social model is valid for physical impairments. They will say that for them it is not the lack of lifts, ramps, voice-activated or talking computers or support to live independently that is disabling (indeed, some can walk and do not even need adaptations), but chronic pain, persistent vomiting and repeated infections and hospitalisations that are disabling. There is some validity to this: the social model was invented by those with physical impairments and (partly) reflects their experience, and has been criticised by Tom Shakespeare for ignoring the experiences of women (although the enthusiasm of disabled women for the model perhaps is enough to dismiss the gender critique) and people with learning difficulties, and for downplaying the relevance of the body in public while its advocates “talk about aches and pains and urinary tract infections” in private. Many physical impairments also bring various health complications which cannot be overcome with technology or adaptations and which significantly impinge on someone’s ability to lead a full, independent life. However, it is a mistake for chronically ill people to embrace the “medical model” because this is a straw man invented by the same people who invented the social model; it is a peg to hang hostile ideas on.

A screenshot from the website of the UK's Daily Telegraph, with an image showing a man in a yellow tracksuit with crutches. The headline reads "The fake disabled are crippling our economy" and the author is James DelingpoleThat it has connotations with physically impairment makes it advantageous to that section of the disability community, and allows one of them to say “I am disabled”, such that a layperson will believe that the physical condition is being referred to, while an “in-person” will know that they are referring to the social model and being “disabled by society”. The term ‘disabled’ makes any lay-person think of someone with an obvious impairment, such as a physical condition that requires the use of a wheelchair, which is perhaps a legacy of the time when such people were the most prominent disability activists, as they were the most able to get out and about while those with mental illnesses and learning difficulties were still trapped in long-stay hospitals and the chronically ill were more isolated than they are now because nobody had Internet access. The term “people with disabilities”, still common parlance internationally, is inclusive: people learned that a disability might be something they could not see, but might not be so accepting of the idea that someone with Asperger’s syndrome, for example, who can walk, talk, see, hear and speak coherently if a little oddly, is “disabled”, and at a time in which the press are on the lookout for people to expose as “fake disabled”, and pouring scorn on the idea that “10% of the population is disabled”, using misleading terminology (particularly at an official level) puts people in danger.

A further complication with the social model is that anyone with a learning difficulty which presents partly with behavioural problems will often have been accused of blaming other people for their problems, even when they are under significant pressure from bullies and unreasonable teachers and other adults in authority. Any attempt by them or their parents or carers to claim that their disability comes from society and not from themselves will be met with derision. The nature of these impairments means that dealing with normal social situations is made more difficult or stressful, although they can be made easier by such measures as getting rid of unreasonable demands or stupid rules. As with so many other impairments, the exclusion that results is a mixture of individual and societal factors.

A recent article on Disability Now criticised a new textbook for claiming that the social model was outdated and that it posited a “false dichotomy” between the disabled and the able-bodied. In my opinion the real false dichotomy is between the “social model”, and a doctrinaire version of it which makes ideologically-loaded jargon of everyday English words, and a “medical model” which calls disability “tough shit” and denies the necessity of any support or adaptation. Not everyone who does not adopt this version of the social model wholesale adopts the so-called medical model or the ideas attributed to it, and it is insulting to disability activists in other parts of the world, where barriers to acceptance are often higher than they are here, to suggest that they do.

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