Week 5 Disability Lecture Slides PDF

Disability Week 5 | 7-11 Oct Johannes Machinya  Introduction Attitudes towards disability affect the way people think and behave towards disabled people. They also impact on outcomes for disabled people in the way they are treated and able to participate in society. The atti...

Disability Week 5 | 7-11 Oct Johannes Machinya  Introduction Attitudes towards disability affect the way people think and behave towards disabled people. They also impact on outcomes for disabled people in the way they are treated and able to participate in society. The attitudes disabled people experience inevitably affect the way disabled people interact with others.  A disability is any condition of the "Disability is the disadvantage or body or mind (impairment) that restriction of activity caused by a makes it more difficult for the society that takes little or no person with the condition to do account of people who have certain activities (activity impairments and thus excludes limitation) and interact with the them from mainstream activity” world around them (participation (Western Cape Government): restrictions) (Centers for Disease Control).  Different approaches to understanding disability There are two main models in terms of disability how disability is considered: i. The medical model ii. The social model There are other models of disability, but these two are the most common ones due to their conflicting representations of disability  The medical model of disability Frames disability primarily as an “individual deficit”/impairment that needs to be fixed/treated to align the person with societal norms of what is considered "normal" Focuses on the impairment as the cause of disabled people being unable to access goods and services or being able to participate fully in society Suggests disability is a deviation from a standardised notion of health and functionality, placing emphasis on the individual's body or mind as the site of the problem Statements like, “He can’t read that newspaper because he’s blind” show the influence of the medical model in understanding disability  What is problematic about the medical model? 1. Individualises disability: By treating disability as an individual deficit, the model isolates the experience of disability to the individual’s body or mind. This can overlook broader social, structural, and environmental factors that shape the lived experiences of disabled persons. ❖ The focus becomes rehabilitative, striving to restore/fix the person to a “normal” state, rather than addressing systemic inequalities or environmental barriers that contribute to disability.  2. Pathologises That disability as “an individual deficit that necessitates intervention to bring that person back to what is perceived to be normal” (Cheng, p. 113) implies that there is an ideal state of being or functioning that everyone should strive towards This not only pathologises disability but also promotes a narrow and exclusionary definition of normalcy As a result, the uniqueness of individual experiences is often disregarded, and the emphasis is placed on conformity to able-bodied standards The focus on individual pathology leads to a marginalisation of the disabled community by reinforcing the notion that they are unable to participate fully in society until their impairment is addressed or "normalised" This approach not only overlooks the capabilities and contributions of people with disabilities but also frames them as dependent or burdensome if they cannot achieve certain predefined standards of health or productivity. This can lead to interventions that prioritise physical or cognitive changes over enhancing social inclusion, accessibility, and quality of life.  The social model of disability The social model identifies the way society is organised and the barriers it puts in place for disabled people as the problem, rather than the individual’s impairment or difference Disability arises not solely because of an individual’s impairment but rather because of the way society is organised and the barriers that it constructs, both physical and attitudinal. “The social model sees ‘disability’ is the result of the interaction between people living with impairments and an environment filled with physical, attitudinal, communication and social barriers. It therefore carries the implication that the physical, attitudinal, communication and social environment must change to enable people living with impairments to participate in society on an equal basis with others” (People with disability Australia) These barriers include inaccessible buildings, discriminatory employment practices, social exclusion, and negative stereotypes. For example, while the medical model might see a person who uses a wheelchair as impaired because they cannot walk, the social model would argue that the disability stems from the fact that society has not made public spaces accessible. A social model perspective does not deny the reality of impairment nor its impact on the individual. However, it does challenge the physical, attitudinal, communication and social environment to accommodate impairment as an expected incident of human diversity.  The social model of disability The barriers can take the following forms: 1. Organisational barriers: The way things are set up in society causes barriers and problems for disabled people, e.g., when, in one hospital, an audiology (hearing) department only allows appointments to be booked over the phone 2. Physical barriers: This is where things have been built in a society which is inaccessible, e.g., buildings with steps without either a ramp or lift 3. Attitudinal barriers: This is where people can have negative attitudes towards disabled people, e.g., low expectations of disabled people’s ability or intelligence  The social model Social construction of disability According to social constructionist theories, dominant groups in society – those with power and authority – create and maintain definitions of what is considered “normal” and “deviant” behaviour or abilities These definitions are not neutral or objective; rather, they reflect the values of those in power Consequently, what is deemed as a deviation from the norm (e.g., disability) is contingent upon the standards set by these groups e.g., if walking on two legs is considered the norm, then a person using a wheelchair might be labelled as “disabled” and thus “deviant” from this standard These labels can shape social attitudes, policy decisions, and resource allocations in ways that disadvantage those who fall outside the prescribed norms ❖ Disability is understood as a socially defined form of deviance This label of deviance is not inherent to the individual’s characteristics but is a result of social processes that define and categorise bodies and abilities In this sense, disability is perceived not simply as a medical or physical condition but as a status that is assigned and maintained through social norms, practices, and institutions.  Critique: limitations of social constructionist theories The model shifts focus from disability as an individual, medical issue to one that is socially constructed and maintained through environmental barriers, discriminatory attitudes, and exclusionary practices Instrumental in advocating for disability rights, emphasising need to remove barriers in society rather than “fix” disabled individuals But its emphasis on external barriers separates disability from embodied experience This can result in overlooking physical and emotional realities of living with impairment, e.g., chronic pain The model fails to adequately include the personal, embodied experiences of disabled persons The model’s tendency to treat the body as merely a site of symbolic and social meaning can lead to an erasure of the actual, physical experience of disability This risks diminishing the complexities of disabled embodiment and the lived realities that accompany it. For instance, chronic pain, physical limitations, and the need for assistive devices are not just metaphors for oppression; they are concrete aspects of disabled people's lives that influence how they experience the world Ignoring these bodily realities can make the social model appear disconnected from the very people it aims to represent and advocate for.  Feminist and gender theories of disability 1. Intersectionality Feminist disability scholars emphasise that disability cannot be understood in isolation from other social identities Like gender or race, disability is a socially constructed category that intersects with other forms of oppression Intersectionality highlights how different axes of identity – e.g., gender, race, class, sexuality, and disability – interact and create complex systems of discrimination and privilege These compounded disadvantages are not simply additive; they interact in dynamic ways that shape her social reality and limit access to resources and power Feminist disability theory seeks to bring these intersecting oppressions into focus, advocating for approaches that address these multi-layered dimensions rather than single-axis analyses that consider only gender or disability alone  2. The normative male standard Feminist disability scholars critique the way patriarchy positions men as the normative standard against which everyone else is measured This concept of the "normative male" extends to the way both gender and disability are perceived Women, particularly women with disabilities, are seen as deviations from the male norm, thus viewed as "lacking" in comparison This differential positioning gives rise to a power imbalance that allows men to maintain dominance over women, a dynamic that is further complicated when disability is added to the equation For example, in traditional gender roles, men are seen as strong, independent, and capable, while women are perceived as more nurturing, dependent, and passive. Disabled women disrupt these stereotypes because they may be perceived as "doubly dependent“ – first because of their gender and second because of their disability This dual dependency can render disabled women more vulnerable to various forms of control and violence  Disability, sexuality, and the politics of asexuality Feminist and gender theories interrogate how disability impacts perceptions of sexuality Disabled individuals are stigmatised as asexual, sexually undesirable, or sexually deviant These stereotypes can have profound implications for their sexual health and well-being Women with physical disabilities may find that their questions regarding sexual pleasure, reproductive health, and body image are dismissed or ignored by healthcare providers, reflecting a deep-seated belief that disabled women do not have sexual needs or desires This erasure not only limits access to appropriate healthcare but also contributes to a sense of shame and invisibility regarding their sexual identities Disabled women have historically been subjected to coercive practices, such as forced sterilizations and abortions, in the name of “protecting” them from unwanted pregnancies Such practices are rooted in the assumption that disabled women are unfit to be mothers or that their reproductive choices need to be controlled This denial of reproductive rights is a form of gendered and ableist violence that reinforces the marginalisation of disabled women and denies them agency over their own bodies.  Queer theory of disability 1. Reconfiguration of objectivity and subjectivity Robert McRuer (2003) identified how queer theory and disability studies reconfigure the notions of objectivity and subjectivity Objectivity and subjectivity help us understand how these categories are socially constructed and perceived as "natural" or "normal," while other identities (e.g., disability or queerness) are framed as "deviant" or "abnormal." ❖ Traditional understandings of objectivity often frame able-bodiedness and heterosexuality as natural, neutral, and unmarked or invisible categories – so much so that they are taken for granted and left unexamined categories But disability and queerness are positioned as marked and subjective deviations from the norm Queer theorists argue that objectivity is shaped by power dynamics that privilege certain identities over others, i.e., what is considered "normal" is not an objective fact but a socially constructed standard that is maintained through the exclusion of non- normative bodies and desires. 1. Reconfiguration of objectivity and subjectivity – cont’d ❖ McRuer introduces the concept of “heteronormative epiphanies” to describe moments when able-bodied and heterosexual individuals experience a subjective sense of completeness and normalcy mainly through the dislocation and stigmatisation of queerness and disability This means that the very notion of being “whole” or “complete” is contingent upon positioning others as deviant, lacking, or incomplete Able-bodied and heterosexual identities are not inherently objective or self-sufficient; rather, they rely on the existence of those who do not fit these categories to define and affirm their own sense of normalcy By reconfiguring how objectivity and subjectivity are understood, queer and disability theorists expose the relational nature of identity formation, showing that the self- perception of being “normal” or “natural” is not an independent or stable state but one that is constructed through the marginalisation of “abnormal” identities. Disability and COVID-19 To understand how healthcare triage policies can marginalise disabled people. To discuss broader sociological implications for healthcare access and equality. Context: COVID-19 has disproportionately impacted marginalised communities, including disabled people. Disabled people often face additional barriers during health crises due to systemic inequalities and discrimination. The intersection of disability, health, and societal structures Disability is not just a medical condition but a social construct influenced by cultural norms, values, and policies. Sociological theories (social constructionism, intersectionality) help explain how disability intersects with other social categories like race, class, and gender. Healthcare access, education, employment, and daily living conditions are shaped by societal attitudes, social environment, and policies toward disability. Disability and the COVID-19 pandemic Disabled people face higher risks of contracting and dying from COVID-19 due to underlying health conditions and living conditions (e.g., institutional settings). In South Africa, disabled people have limited access to healthcare services and essential resources during the pandemic. The United Nations (UN) and World Health Organization (WHO) have emphasised the need for disability-inclusive responses to COVID-19. Policies must ensure that disabled people are not left behind in the allocation of resources. Healthcare triage and resource allocation Triage refers to the prioritisation of healthcare resources (e.g., ICU beds, ventilators) based on who is most likely to benefit. During COVID-19, healthcare workers had to make difficult decisions due to scarce resources. Triage Models Utilitarian Model: Maximises benefits by saving the most lives or the most life-years. Egalitarian Model: Focuses on equal access for all, regardless of conditions. Libertarian Model: Prioritises individual liberty and choice. Communitarian Model: Considers social and cultural values in allocation decisions. Triage Policies in SA South Africa's healthcare system is marked by deep inequalities between the public and private sectors. Disabled people, particularly those relying on public healthcare, are at a disadvantage in accessing critical care. Clinical Frailty Scale (CFS) - used in triage to classify patients from "Very Fit" to "Severely Frail." Disabled people may be unfairly categorised as "frail," reducing their chances of accessing life-saving treatment. Ethical and legal concerns Triage decisions raise questions about the value and worth of different lives. Utilitarian frameworks might prioritise able-bodied individuals over disabled people, reinforcing ableist biases. Sociological implications of triage policies Triage policies can reflect and reinforce societal prejudices against disabled people. Assumptions that disabled lives are less valuable can lead to exclusion from critical care. Excluding disabled people from healthcare resources contributes to broader patterns of marginalization and inequality. Raises concerns about social justice and human rights in the health system. Need for inclusive triage policies 1. Inclusion in policy design: Involve disabled people and disability rights organizations in designing and implementing healthcare policies. 2. Transparent decision-making: Ensure triage policies are evidence-based and do not rely on stereotypes or assumptions about disability. 3. Training healthcare workers: Educate healthcare providers about disability rights and the unique healthcare needs of disabled people. 4. Legal and ethical oversight: Establish clear guidelines and accountability mechanisms to prevent discrimination in healthcare. Broader implications for society Long-term implications: The exclusion of disabled people from healthcare can deepen existing social inequalities. Reflects broader societal attitudes toward disability and human value. Need for structural change: Sociological interventions are needed to change how society views and treats disabled people in all spheres of life. Key takeaways COVID-19 has highlighted existing disparities in healthcare access for disabled people. Triage policies need to be inclusive and consider the rights and dignity of all individuals.  How do societal perceptions of disability affect the lives of disabled people during a health crisis? Should disability be a factor in deciding who gets access to life-saving treatment? Why or why not? How can we use the lessons learned from the COVID-19 pandemic to create a more equitable healthcare system?