6.1.1 The four models
In the international discussion, attitudes, assumptions and the perception of disability are generally grouped into four models. DPOs worldwide have sought to promote two of these, the social model and the rights-based model.
The Charity Model
The Charity Model sees people with disabilities as victims of their impairment. Depending on the disability, the disabled persons cannot walk, talk, see, learn, or work. Disability is seen as a deficit. Persons with disabilities are not able to help themselves and to lead an independent life. Their situation is tragic, and they are suffering. Consequently, they need special services, special institutions, such as special schools or homes because they are different. People with disabilities are to be pitied and need our help, sympathy, charity, welfare in order to be looked after. Sometimes people with disabilities themselves adopt this concept, in which case they usually feel “unable” and have a low sense of self-esteem.
The Medical Model
The Medical (or Individual) Model considers people with disabilities as persons with physical problems which need to be cured. This pushes people with disabilities into the passive role of patients. The aim of a medical approach is to make people with disabilities “normal” – which of course implies that people with disabilities are in some way abnormal. The issue of disability is limited to the individual in question: in case of disability, the disabled person has to be changed, not society or the surrounding environment.
According to the Medical Model, persons with disabilities need special services, such as special transport systems and welfare social services. For this purpose, special institutions exist, for example hospitals, special schools or sheltered employment places where professionals such as social workers, medical professionals, therapists, special education teachers decide about and provide special treatment, education and occupations.
The Social Model
The Social Model regards disability to be a result of the way society is organised. Shortcomings in the way society is organised mean that people with disabilities face the following types of discrimination and barriers to participation (see figure):
- Attitudinal: This is expressed in fear, ignorance and low expectations (influenced by culture and religion);
- Environmental: This results in physical inaccessibility affecting all aspects of life (market and shops, public buildings, places of worship, transport, etc.); and
- Institutional: This means legal discrimination. Persons with disabilities are excluded from certain rights (e.g. by not being allowed to marry or to have children), or from school, etc.
These three types of barriers make people with disabilities unable to take control of their own lives. According to the Social Model, a disability not only depends on the individual but also on the environment, which can be disabling or enabling in various ways. Is a person in a wheelchair still disabled if s/he can drive a car or motorbike and if her/his home, workplace and other buildings are accessible?
The Rights-based Model
This model is closely related to the Social Model. It focuses on the fulfilment of human rights, for example the right to equal opportunities and participation in society. Consequently, society has to change to ensure that all people – including people with disabilities – have equal possibilities for participation. It is a fact that persons with disabilities often face a denial of their basic human rights, for example the right to health (physical and psychological) or the right to education and employment. Laws and policies therefore need to ensure that these barriers created by society are removed. The Rights-based Model states that support in these areas is not a question of humanity or charity, but instead a basic human right that any person can claim. The two main elements of the rights-based approach are empowerment and accountability. Empowerment refers to the participation of people with disabilities as active stakeholders, while accountability relates to the duty of public institutions and structures to implement these rights and to justify the quality and quantity of their implementation.
Application of the models
The four models listed above simply categorise four ways in which people classify "disability" and how they see people with disabilities. Everybody uses one of the models or a mixture of them – consciously or unconsciously. These models influence our thinking, our way of talking and our behaviour.
The following chart provides some examples of how people with disabilities tend to be seen by other persons and what consequences this could have.
Young women using a wheelchair
"What a pity, this beautiful woman is bound to a wheelchair, she'll never be able to marry, have children and care for her family."
"Oh, this poor woman, she should go to a doctor and discuss with him if there is a therapy which could enable her to walk again, like everybody else."
"The community really should build ramps in front of public buildings, so that persons like her can participate in social life."
"When she gets a job, her employer will have to build accessible rooms. This is her right!"
Man with an intellectual disability
"Look at this poor confused man; he seems to be mentally retarded, it would be better for him to live in a fostered home, where somebody will take care of him."
"Perhaps there is some medicine or treatment which could improve his perception. He should try a psychiatrist."
"It's a good solution that he lives with his brother, so he is surrounded by non-disabled people."
"Where does he want to live? Let's go and ask him!"
Parents with a hearing-impaired daugther
"It must be very sad having a child and knowing that she will never be able to live on her own."
"I'm sure in a few years there'll be a hearing aid available which will make this child able to hear better."
"We should all learn sign language, so that we can communicate with this child and all other hearing-impaired people."
"When this child grows up, she'll study at university, if she wants to."
Coleridge, Peter (2001): Disability, Liberation and Development. An Oxfam Publication. Oxford. Chapter 1: “Why This Book?”.
Harris, Alison with Sue Enfield (2003): Disability, Equality and Human Rights: A Training Manual for Development and Humanitarian Organisations. An Oxfam Publication in association with Action Aid on Disability and Development (ADD). Oxford. Chapter 1 on “Defining Disability” and Chapter 9 on “Disability Equality in Practice”.
Disabled People South Africa (2000): Pocket Guide on Disability Equality: An Empowerment Tool. Available at: http://www.dpsa.org.za/documents/Pocket%20 (in the "Publications" section). Chapter 1 covers “Disability, Definitions, Models and Terminology”.
The website of Disability Awareness in Action (DAA) offers an interesting discussion on definitions: Definition of Disability – A Briefing Paper.