Societies have long sought to explain disability. Historically, the two most prevalent viewpoints-that disability is either a moral condition (special or frightening) or a medical condition (a malady to be cured by experts) have had a profound and mostly negative impact on the lives of people with disabilities. Only recently has a third view of disability emerged-that people with disabilities are regular people, a minority group with the same civil rights as others.
In this second of a three-part series, we look at the medical/professional view of disability: where it comes from, how it affects the lives of people with disabilities today, and what we can do about it.
We start with the premise that the medical/professional viewpoint undermines the basic values of dignity, inclusion, and self-determination.
Understanding the Medical/Professional View of Disability
Everywhere you turn, a wave of experts are doing what they can to fix disability, to help people overcome the “problem” of having a disability. This wave is powered by an attitude we call the “Medical/Professional” view of disability. It’s the false idea that people with disabilities are broken and need to be fixed by experts. Disability is stereotyped as simply a “medical condition”, a physical “problem” located in the body. This harmful attitude gives experts all the power: they supposedly know what’s best and make the call on how best to fix the patient, or client. If you look around, you’ll find this viewpoint everywhere: at the clinic, at school, at work, at home. Because of its prevalence and power, this viewpoint deserves closer attention.
Where Did It Come From?
The medical view of disability may have started during the European Renaissance (1200 B 1500 CE). During that period, a “rebirth” of learning was taking place. As a part of this growing curiosity, scholars began studying the anatomy of people with disabilities, hoping to find a cause and a cure. Before this time, the most common stereotype had been that disability was a punishment for sin. Now people with disabilities became stereotyped in a different way-as objects of study. Over the next 700 years, this scientific approach the medical/professional viewpoint-has expanded in three directions.
One thrust has been to find the causes and “cures” of disability. For instance, curious “doctors” in the 16th century drilled holes in the heads of people with disabilities (with no anesthetic) hoping to find the nonexistent “fool’s stone”, which they would often pretend to remove. In the 19th century, Dr. Benjamin Rush dreamed up brutal “treatments” such as spinning people at high speeds in special contraptions-a damaging “cure” called “shaking out the madness.” Modern medicine is full of behavior modification plans and drugs to get people to behave more “normally.”
A second direction has been research to improve the lives of people with disabilities. At first, Phillip Pinel (1790, France) sought to “treat” and “cure” people through humane living situations and compassionate care, rather than the chains and beatings widely used in his time. Then, Samuel Gridley Howe (1850, America) used new methods of education to give his students the skills to live in the community. Lastly, Alfred Binet (1900, France) developed the IQ test to identify children who might need extra help in school.
Some professionals have sought to “improve” society by getting rid of people with disabilities, who were seen as a burden to society. Social scientists in Europe and America addressed the “problem” by containing people in asylums, poor houses and large institutions, many of which became places of abuse. In the 1800s, “mental defectives’ were scapegoated as the source of crime in society. Respectable scientists and professionals called for their imprisonment, deportation and elimination to make society safe. In the early 1900s, many states had laws that enforced sterilization and prohibited marriage of people with disabilities. There were even calls for elimination of these “deviants”. Notice how in all these examples, disability is a problem to be fixed and experts are in charge.
Isn’t It a Good Thing?
At first glance, the medical/professional viewpoint has fostered research and services that appear to improve the lives of people with disabilities. Of course, many of these advances came at the cost of treating people as objects of study. The “objects of study” were not asked whether or not the costs were worth it. It’s also important to remember that research and progress can happen within a disability rights framework. Many professionals are now realizing that progress can also only come when people’s dignity is respected, when people retain the power of self-determination, when the people themselves decide what is needed and use experts as resources to pursue these self-determined goals.
But the problems go deeper than individual attitudes and individual behavior. There is a lot of money at stake in continuing the patient/client stereotype and the imbalance of power. Before you receive any funded services, you have to have a diagnosis. Your provider is strong-armed by medical rules and regulations to be treating you, rehabilitating you, behavior modifying you, making you loose weight, improving you, changing you, making you different in some way. The entire service system is set up to define you as a patient in need of fixing by a paid expert. This viewpoint is so widespread that people tend to think it’s just “reality.”
The sad part is that many people with disabilities have also accepted the medical/professional view as “reality” and go along with their role as the object of professional efforts to change them. Here is what one woman reports, “They give me Skittles for taking my shower in the morning. I don’t know why they started it. It was a staff idea and we just keep doing it. I know it is weird, but it’s what they want to do. The staff and residents are all so used to it that they don’t think twice about how weird it is.”
What Can I Do?
The medical/professional viewpoint undermines the basic values of dignity, inclusion, and self-determination. We need to expose it, to build the skills to recognize it, and to invite allies and peers to oppose this negative, disempowering attitude at all levels. Only by educating ourselves and acting together can we begin to challenge and overcome the negative power of the medical/professional view of disability.
Groups interested in training materials on the medical/professional view of disability may contact Advocating Change Together at 651-641-0297 and ask about the workshop “The Patient Needs Fixing: Understanding the Medical/Professional View of Disability.” or visit their web site at www.selfadvocacy.org