Thursday, 5 November 2009

The Analogy with the Social Model of Disability

Ok, I've stated my premise, now I need to go about developing the argument!

First of all let me direct you to the post that started me thinking about all of this earnest: Why I think I am a patient and not a consumer. Even more important than the post are the comments it has generated. In fact, I would like to invite Anne Marie and everybody who has commented on the post to become co-authors of this blog! In time I will try to synthesise the comments into the model.

My Bona Fides

I gained a Biochemistry degree in 1969 from Sussex University. Later that year I wrote my first computer program and three years later I become a programmer with ICL, developing the VME operating system. After 13 years at that I joined a UK bank and eventually became an Information Architect. I beleive that the biochemistry background and a continuing interest in the biological sciences and the analysis skills required to be an Information Architect give me the skills to look back over my own experience as a cancer patient and to create a general model from that and my analysis of other people's stories.

I have also had first hand teaching about the Social Model of Disability by Alison John. Ally is a remarkable woman who lives with Cerebral Palsy and runs her own training and consultancy business, Alison John and Associates. Alison was one of the disabled[1} young people who contributed to the development of the Social Model during the UN's International Year of the Disabled in 1981. I've worked with her as her Personal Assistant several times and she made sure I understand, and can apply, the Social Model.

It's going to be difficult to be entirely objective about this but so long as I am aware of the danger I should be able to address it.

Despite the emphasis on "me" and "I" in the foregoing this is meant to be a collaborative process, which is why I have started this blog. Please comment on the entries. I am also open to requests to become co-authors of the blog and hence the model. Either leave a comment on the blog making the request and include URL's of your blog or whatever so I can get an idea of what your contribution might be. Somebody who disagrees might be useful.

As an aside, I would be interested in using Google Wave for this process. I have requested an invitation but it will probable be a long time coming.

The Analogy

The Social Model of Disability was developed an antidote to the Medical Model of Disability. In order to spare the feelings of medical professionals the emerging preferred term for the Medical Model of Disability is the Traditional Model of Disability[2}

In essence the Traditional Model of Disability said "You are disabled because there is a problem with you. We need to fix the problem to fix you". In other words, attempts were made to alter the disabled person in order to make them fit better into society. However the Social Model of Disability says: "You have an impairment. Because of the way society is organised it has erected various barriers that prevent you reaching your full potential. Let's try to fix society." This has given rise to legislation to try to reduce those barriers. An obvious example being the provision of ramps or lifts to enable access to buildings for people who can't manage steps for whatever reason.

In my view the Traditional Model of Disability is only a subset of the still prevailing and traditional view of Medicine in general. This model is authoritarian, cabalistic (has information only made available to insiders), hierarchic, paternalistic and even abusive[3].

This model is currently being challenged and the proponents of change wish for an open, equal and informed relationship between the person who is managing their own health and the health professionals who are enabling them to adress any issues that arise.

[1}For American Readers: Where I use the word disabled of any word derived from it, you should substitute handicapped but be aware that in the UK the H-word is regarded by disabled people in the same way as the N-word by black people.
[2] Personal communication from Lynne, Disability Equality Trainer, 2009-10-28.
[3] Consider the use of the "chemical cosh" to restrain difficult people or even the routine dispensing of strong sleeping pills to patients to ensure that the night staff have an easy time of it.


  1. Hello Keith,

    I can see this is going to be an interesting discussion! So would a social model of medicine say that we shouldn't bother to try and treat disease? Instead we should accommodate people who have illness and make their lives as comfortable as possible.

    I guess I get a little confused about the social model of disability. If I had broke my wrist 100 years ago I wouldn't have had the surgery that helped minimise deformity as it healed and so is encouraging a return to normal function. If I had been left with impaired function in my wrist then I would have a disability and could have been handicapped by this. Yes, efforts could be made to reduce this by adapting my car or getting me software so that I could voice dictate rather than type. I might have moved in to an area of medicine that didn't involve physical contact with patient.

    All of that would have reduced the impact of my disability on my life. But the medical model has meant that I haven't had to endure that.

    To me it seems obvious that the two models are not opposed to each other but can live easily together. Medically we do what is sensible and what the patient agrees to, whilst still helping them to live socially as best they can with whatever impairment or disability is retained.

    I wonder if I have made things even more confusing!

  2. This is why I want Google Wave! I want to keep the issues easily visible. If we use comments to continue the debate then we will get nested really deep. You've raised an interesting point so I will raise it a post and respond to it there.