Models for person with disability in India
The models of disability are, in fact tools for defining impairment. Different people conceptualize the phenomenon of disability differently. Accordingly each person will have different meaning for the term disability and rehabilitation strategy to be followed. The conceptions regarding disability have undergone changes from time to time, from place to place, and from person to person. The meaning of disability for a doctor is different from that of psychologist, economists, and social worker. Accordingly we have different models of disability evolving from disability movement worldwide.
Virtually all the literature on disability outlines the shift in disability policy thinking from the charity and medical models of disability towards social model of disability. The various models of disability can be described briefly as follows:
1. Religious or Moral Model
The oldest model of disability was moral model. Under this model person with disability were seen as sin. Disability was considered as punishment from God for the wrong Karma done in the past. Thus persons with disabilities were treated as alien. They have no right to live in the mainstream society. They are not entitled for any right to education, social life and employment available other members of the society. They themselves are responsible for what they are. The family with disabled member was seen with suspicious. To avoid this disabled member were generally hided by their family. Neither government nor society was concerned with the problems faced by them. However, there are many cultures that associate disability with sin and same. This model views disability as a retribution for actions committed in previous birth. It is viewed as a punishment inflicted upon an individual or family by God.
2. Medical Model
The Medical Model of Disability relies on a purely medical definition of disability. This model is also referred as bio-centric model of disability. Thus equates the physical or mental impairment from a disease or disorder with the disability that the person experiences. From a policy viewpoint, the person with disability is viewed as the “problem”, and in need of cure and treatment. In terms of services, the general approach within this model is towards special institutions for people with disabilities, e.g. special schools, sheltered workshops, special transport etc. The medical model approach to disability holds that disability result from an individual’s physical or mental limitations. The development of medical science and curative approach of the physician has contributed the medical model. Since many disabilities have medical origins the problems that are associated with disability are deemed to reside within the individuals. The individual with a disability is in the sick role under the medical model. In other words, if the individual is “cured” then these problems will not exist. On this basis persons with disabilities are considered as ‘abnormal’ in comparison with ‘normal human being’. Such a view encourages dependence on doctors, rehabilitational professional and charity. This approach thus lays all emphasis in clinical diagnosis and medical treatment rendering the disabled individuals as the recipient of public assistance and charity.
The medical welfare approach offers four assumptions that:
- Disability is basically a disease state and absolutely falls under clinical framework and essentially a problem focusing on the individual as a deviation from the norm, the role of the medical and paramedical professionals is to cure and ameliorate this problem in order to enable them to be as normal as possible;
- There is an objective state of normality which within the medical profession entrusts professionals, a crucial role and leaves little scope for the disabled and their families to participate in the decision making process;
- The disabled individuals are biologically and psychologically inferior to their able bodied counterparts and they are, thus, not treated as fully human and by implication, lack the competence to decide for themselves, and;
- The phenomena of disability is visualized as a personal tragedy, which occasionally affects individuals.
Medical model support the postulate that persons with disabilities are biologically and psychologically inferior to other able bodied counterparts. So they are not treated as fully human because they lack the competence to decide for themselves. This model reduces disability to impairment and sought to locate it within the body or mind of the individual while the power to define, control and treat disabled individual was located within the medical and paramedical professionals. This model restricts the rehabilitation efforts to medical treatment in terms of protection and care.
Such an approach towards the disability may be regarded matter of personal tragedy which encourages dependence on medical and paramedical professional, rehabilitational professionals and charity. Obviously, the medical paradigm stigmatizes the disabled people by describing them as not normal. The medical welfare approach to disability has been well represented by the World Health Organisation. The classification of disability made by World Health Organisation in 1980 also supports the medical welfare approach which lays all emphasis on clinical diagnosis and medical treatment rendering the disabled individual as recipient of public assistance and charity.
3. Charity Model
Charity model of disability also views the person with disabilities as the problem and dependent on the sympathy of others to provide assistance in a charity or welfare. This model treats the disabled as dependent upon the society. It has an emotional appeal towards the disabled. The disabled are treated as helpless victims needing ‘care and protection’. Under this model disabled people are depicted as people deserving pity. The charity model approach makes the disabled as individuals powerless instead of empowering them. Employers will view disabled people as charitable cases. Instead of addressing the issue by creating a suitable work environment for people with disabilities, the employer may donate money and avoid responsibility.
Charity model is driven largely by the emotive appeals. This model relies heavily on the charity and benevolence rather than justice and equality. This model accepts the act of exclusion of persons with disabilities from social arrangements and services in public domain. Charity model justifies the exclusion of persons with disabilities from the mainstream education and employment. Entitlement rights are substituted by relief measures creating an army of powerless individuals, without any control or bargaining power, depending either on the state allocated fund or benevolent individuals. This model asks for social support mechanism for the benefit of person with disability. Initial efforts of the government and individuals were based on this model. Government was allocating large chunk of fund for the welfare of persons with disabilities. The non-governmental organisations’ working for the benefit of persons with disabilities also relies on the donations and government grants.
4. Social Model or Functional
The contemporary disability discrimination discourse rejects the medical welfare model and locates disability in social context. The social relations model treats human differences as constructed by and residing in a social relationship. The advocates of social relations model, therefore, insists that the society as a whole has the responsibility to eliminate social and physical structures that exclude people with disabilities in having access to opportunities . The social relations model also emphasises the concept of “independent living” which means that the disabled persons are the best judge about their own concern and are full citizens with equal civil rights. The disability rights discourses insists on a concept equality that is based on the needs of all members of the society rather than on those deemed “normal”. The demand for equality is based upon the concept of human autonomy, which consists of personal capacities to have an access to the opportunities that society offers to all the people.
This model of disability places the emphasis on promoting social change that empowers and incorporates the experiences of person with disabilities, asking society itself to adapt. This model emphasizes institutional, environmental and attitudinal discriminations as the real basis for disability. Thus it is the society at large which disables the person with disabilities through discrimination, denial of rights, and creation of economic dependency. In the social model of disability the difficulties experienced by a person are seen as arising from the society’s incapacity to match to the biological condition of the disabled person. In this model disabled people are not stereotyped as individuals who are unable to function, who deviate from the normal, or who naturally have a poor quality of life, but they are accepted as citizens who are prevented from realizing their personal and civil rights that are supposed to be common to all. The social model is also known as functional model and is similar to the medical model, it regards the person with disability as in need of services from a rehabilitation professional who can provided training, therapy, counseling or other services to make up for the deficiency caused by the disability. A key element of this new concept is the recognition that exclusion and segregation of people with disabilities do not logically follow from the fact of impairment, but result from political choices based on false assumptions about disability.
In contrast to medical model, which locates disability within the person with disabilities, social model postulates that a person is disabled because of architectural, attitudinal and social barriers created by the society. The social model presents disability as a consequence of oppression, prejudice and discrimination by the society against disabled people. It is the society, which constructs economic, social, health, architectural, legal, and cultural and other barriers in order to deliberately prevent people with impairments enjoying full benefits of social life. The social model shifts the emphasis from a disabled individual to the society and its disabling attitudes and environment. People who believe on social model are of the view that handicap is made and not acquired. The therefore solution lies in social management by all necessary environmental modification.
A disability is regarded as a result of interaction between societal barriers and the impairment. A person is disabled not because of his personal tragedy but because of the disadvantages suffered by him by a disabling environment besides the prevalence of stereotypes, prejudices and neglect of the so called ‘normal’ individuals. The advocates of social relation approaches, therefore, insist that the society as whole has the responsibility to eliminate social and physical structures that exclude people with disabilities in having access to opportunities.
5. Rights-Based Model
Rights-based model of disability builds on the insights of the social model to promote creation of communities which accept diversities and differences, and have a non-discriminating environment in terms of inclusion in all aspects of the life of society. The disability rights model position disability as an important dimension of human culture. This model regards disability as normal aspect and that the disabled are equally entitled to rights as others. This model is also known as the human rights model which affirms that, all human beings irrespective of their disability have certain rights which are inalienable. This model ensures that criteria for support programmes are prioritized by people themselves respecting their autonomy and freedom of choice. The disability rights model focuses on equality and non –discrimination, reasonable accommodation, accessibility, breaking down barriers, equal participation and inclusion and private and public freedom. The disability rights model has over the years evolved to afford greater protection to the rights and freedoms of disadvantaged groups in both public and private domain by enlarging the obligations of the states in relation to actions of private entities. With the paradigm shift from the medical to the social model of disability, disability was reclassified for disabled people and to expose their segregation, institutionalization and exclusion as typical form of disability based discrimination. Hence, the disability rights discourse insists on a concept of equality and not based on discrimination. Hence, the disability rights discourse insists on a concept of equality that is based on the needs of all members of the society rather than on those deemed “normal”.
This new dimension of disability law has been welcomed as a major milestone on the path towards eventual recognition of the human rights of disabled people, a path which more and more governments seem to be willing to take. Thus the human rights approach to disability regards legal measures as constituting the fundamental framework by which mechanism for equality can be ensured.
Thus, the human rights discourse on disability recognizes the disability rights and insists on a concept of equality that is based on the needs of all members of the society. The equal opportunity principle should be the basis of interpretation which implies that affirmative action programmes are essential for reasonable accommodation to ensure social integration of people with disabilities. Disability is positioned as an important dimension of human culture by human rights model. According to human rights model all human beings irrespective of their disabilities have certain rights, which are unchallengeable. By emphasizing that the disabled are equally entitled to rights as others, this model builds upon the spirit that ‘all human beings are born free and equal in rights and dignity’ enshrined in the Universal Declaration of Human Rights, 1948. This model emphasis on viewing persons with disabilities as subjects and not as objects thus locating the problem outside the disabled persons and addresses the manners in which the economic and social processes accommodate the differences of disability.
6. Economic Model
The economic model of disability tries to establish the linkages between the individual and society in term of their contribution to productive capabilities towards the society. The emphasis here is on health related limitations on the amount and kind of work performed by persons with disabilities. This approach suggests that the employment problems of person with disabilities stem from faulty economic system and deficiencies on the part of such disadvantage individuals. The vocational rehabilitation programmes or income generation programmes may be the solutions to the problems faced by persons with disabilities. Existing policies plays a greater role in condemning the disabled man and women to a life of perpetual dependency thus providing low pay work ad limited opportunities for all around development. Unlike other models, economic model suggest that the modifications in the persons in the form of education, training and employability, rather than changing the environment and worksite changes or changes in the perception of employees is the most desirable means of fulfilling the social and economic needs of the disadvantages strata of the society.
Disability movement has succeeded in changing the approach towards disability from moral model to charity model but limited has been achieved in the direction of human rights model. Collective efforts on the part of person with disabilities, their advocates, voluntary organisations, government and society at large are required to create real world where abilities and disabilities are not seen on the basis of physical or mental impairment but disability is seen as diverse abilities.