Models of disability
Models of disability are analytic tools in disability studies used to articulate different ways disability is conceptualized by individuals and society broadly. Disability models are useful for understanding disagreements over disability policy, teaching people about ableism, providing disability-responsive health care, and articulating the life experiences of disabled people.
The most frequently discussed models are the medical model of disability, which views disablement as caused by medical disorders; and the social model of disability which instead views disablement being a result of societal exclusion and discrimination.
Different models can be combined: the medical model is frequently combined with the tragedy model, which views disability as a personal misfortune. Together they form hegemonic views of disability in Western society. Other models exist in direct opposition: the affirmation model, which views disability as a positive form of social identity, is inherently incompatible with the tragedy model.
Different models can be used to describe contrasting disabilities: for example, an autistic person who also has myalgic encephalomyelitis/chronic fatigue syndrome may view their autism through the affirmation model, but their ME/CFS through the medical model.
Deficit-focused models
This category of models centre on different deficits held by disabled people, such as the medical model and the rehabilitation model.Disability as a personal problem
Tragedy model
The tragedy model views disability as an individual's misfortune. It is one of the most dominant conceptualizations of disability in Western society. It is generally an individualistic view of disability: each disability is an individual, personal tragedy.The tragedy model is criticized for being ableist; it is associated with the view that living with a disability is worse than death. In the tragedy model, pity is seen as an appropriate response to disability, and used to justify infanticide and other murders of disabled individuals. The tragedy model underlies the supercrip stereotype: if a disabled person is seen as thriving, it is because they did so in spite of their disability.
Charity model
The charity model positions disabled people as pitiable victims, and abled people who provide them with charity as beneficent saviours. This model is frequently combined with other deficit models, such as the tragedy and medical models.This model is criticized by disabled people, as it centres the people who provide the charity, rather than those ostensibly being "helped". Disability acts as a means for abled people to feel good about themselves, through providing charity—without regard for whether this charity was wanted or effective.
Moral and religious models
The moral model of disability, also known as the religious model, views disability as a form of punishment for having a deficit in one's morality. In Judeo-Christian tradition, disability may be viewed as a punishment by God for having sinned; in Hindu tradition, disability may be understood as karma for misdeeds committed in one's past life. The moral model is characterized by a distrust of disabled individuals.The moral model is frequently seen regarding disabilities where individuals' actions may have contributed to acquiring the disability, such as AIDS, type 2 diabetes, obesity, and addiction. Concerning addictions, the moral model is often contrasted with the medical model: addiction is less likely to be seen as a moral failing if one understands it instead as an involuntary, medical condition.
Expert/Professional models of disability
In the expert or professional model of disability, disability is a problem that requires expert professionals to identify and then prescribe a series of interventions. This model produces a power dynamic where an abled, authoritarian service provider acts on behalf of a passive, disabled client. At its extreme, disabled people are given no authority or autonomy over their care or everyday life. It has been described as a fixer/fixee relationship.Medical model
The medical model, also known as the normalization model, views disability as a medical disorder, in need of treatment and ultimately cure. Its endpoint is a world where disability no longer exists, as all disabilities have been "cured".In the medical model, physicians are the primary authorities on disability. It is categorized as a deficit model, as it views disability as a deficit in health. It is also categorized as an individualistic model, in that disablement is a result of each individual's body/mind. The medical model has been heavily critiqued by the disability community, as many disabled people do not wish to be cured, and reject the deficit framing.
Rehabilitation and functional limitations models
The rehabilitation model, also known as the functional limitations model, aims to "rehabilitate" disability through alterations both to the disabled individual and their environment. Like the medical model, it is categorized both as an individualistic model and as a deficit model, but instead of a deficit in health it is a deficit in employment. Unlike the medical model, the rehabilitation model does not aim to alter the underlying cause of a person's impairment; the focus instead is on functional capacity.Unlike the medical model and the eugenic model, the goal is not to eliminate disability. The desired endpoint instead is to minimize the effects of disability in society. This model expects disabled people to conform as much as possible to society. Similar to the medical model, it places rehabilitation experts as the authorities on disability, rather than disabled people.
Technological model
The technological model, also known as disability technoscience, aims to reduce the effect of disability through technological means. It is a subtype of the rehabilitation model which focuses specifically on how technology can reduce functional limitations. Unlike the rehabilitation model, it positions engineers and designers as the authorities on disability.This model has been criticized by disability advocates for expecting disabled people to need complex, expensive technologies rather than implement changes in society. For example, why design a costly and likely unsafe "stair-climbing wheelchair" when instead building codes should be changed so ramps and elevators are provided? In their Crip Technoscience Manifesto, scholars Hamraie and Fritsch further critique the implication "that disabled people are not already making, hacking, and tinkering with existing material arrangements".
Biopsychosocial model
The biopsychosocial model was developed by mental health practitioners to recognize how the interactions between biological, psychological, and social factors can influence the outcome of any given medical condition.The model has been critiqued by both disability and medical communities as the psychological element is often overemphasized in clinical practice. For example, the biopsychosocial model has been used by physicians to dismiss myalgic encephalomyelitis and medically unexplained symptoms as psychosomatic in nature without adequate investigation to somatic causes nor consideration of social determinants of health.
Disability advocates have criticized the biopsychosocial model as victim-blaming. According to Inclusion London, the biopsychosocial model treats the primary cause of unemployment amongst disabled people not due to workplace discrimination but instead due to the disabled individuals themselves having negative attitudes and behaviours about work. If a disabled person becomes depressed because they repeatedly encounter workplace discrimination, and stop applying for jobs, the biopsychosocial model places the onus on the disabled person for not having tried hard enough.
Disability as a collective problem
Economic model
The economic model understands disability as a deficit to the economy. The model uses the lens of economic analysis to quantify the effect of disability on economic productivity, such as through the Disability-adjusted life year. The value of a disabled person is hence reduced to their ability to contribute to capitalism, and is criticized for being dehumanizing and disconnected from the broader sociological forces.It is similar to the rehabilitation model for its focus on how disability prevents people from working. However, where the rehabilitation model focuses on qualitative, social functioning; the economic model focuses on quantitative, financial impact.
Although the economic model can be applied on an individual basis, the financial impact of disability is more often evaluated with respect to employers and nation-states. Indeed, this model is often invoked in policy-making in Western countries.
Bureaucratic and compliance models
The bureaucratic model of disability, also known as the compliance model, treats disability as a question of legal compliance for institutions. Disabled people are understood deserving of special exceptions to rules, but only if the disabled person has the exact requisite paperwork to prove their worthiness.The end goal of this model is to shield institutions from legal liability. Disabled people are hence seen as a deficit in rule-following. This model is used by disability advocates to criticize how bureaucratic accommodations for disabled people are often one-size-fits-all, rigid, ineffective, and inaccessible to many who need them.
Eugenic model
The eugenic model argues that the human race should take an active role in selectively breeding for desirable physical and mental characteristics. In the eugenic model, people are categorized as fit or unfit. Its end goal is a population composed solely of those who are "fit", and has been used as justification for mass-sterilization and mass-murder of those seen as unfit.In the eugenic model, disability is not merely an individual deficit but a threat to the collective gene pool. Eugenic thought was built upon a misunderstanding of evolution: genetic variation is important for a species' evolution and resilience. In contrast, the evolutionary model understands disability as contributing positively to the gene pool.
Disability activists and scholars stress that eugenic thought remains alive and active in society. For example, the COVID-19 pandemic brought to light how common it is for abled people to see disabled lives as expendable, such as through the common refrain that "only the old and sick will die" and medical rationing policies that explicitly discriminate against disabled people.
Similar reports are found of disabled people treated as expendable with regard to climate change and disaster preparedness, and have been termed "Climate Darwinism". Certain environmentalist discourses which focus on fixing "overpopulation" are criticized for often implying the "solution" is to rid the world of degenerate people.