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Disability is in the news, partly because of the forthcoming Paralympics and partly because of benefits and other cuts. Despite the familiarity of the term however it is very hard to say precisely what disability is. Indeed, some groups deny that there is such a condition.
One line is to say that some people are simply ‘differently abled’. That might mean that if, say, you are blind, you will develop other senses, such as hearing, to a higher degree than the sighted population. For example, this is said to be common among blind musicians. Some associations for the deaf point to their sign language and the shared experiences which go with a shared language and take this as evidence that they are simply culturally different rather than disabled.
Other groups again use terms such as ‘challenged’ – visually challenged, intellectually challenged and so on, or they might speak of ‘learning difficulties’. Others again might argue that if the groups in question encounter problems in their daily lives the problems are created by society and social arrangements which do not facilitate their lives with adequate ramps and other appropriate provisions. Down this route we find terms such as ‘special needs’.
It is easy to understand and sympathise with what lies behind all such attempts. They show a laudable desire to get away from the harsh terminology of the past, and to stress that the groups in question are like the rest of us, fully paid-up members of the human race with entirely reasonable demands to be treated as such. But the attempts carry the risk of encouraging the public and the care-providing authorities to view the problems in an inappropriate way. If the public is to be persuaded to create arrangements and to pay taxes to enable disabled groups to have worthwhile lives then disability must be seen as a real phenomenon.
We might try the following as a definition: Persons are disabled but only if they are prevented from leading a normal life by a physical or mental condition. This attempt is open to three criticisms. It will be said by some disabled groups that ‘leading a normal life’ is not a necessary condition of disability since many of the disabled can and do lead a ‘normal’ life.
Secondly, families in poverty might argue that ‘leading a normal life’ cannot be a sufficient condition of disablement since they cannot lead a ‘normal’ life, not because they are disabled but because they are too poor.
Thirdly, it might be said that the whole idea of a ‘normal life’ is one of the main points at issue so cannot be built into the definition of disability. Similar difficulties arise with any attempt to provide a definition of disability which will include all types of problem and all types of sufferers from those who require 24-hour care to a cabinet minister guided by a dog.
It is helpful to compare the concept of disability with that of disease, because the problems of defining disease have similarities to those of defining disability. Since the time of Aristotle there have been attempts to classify diseases in terms of the features they may have in common. This biological approach is the dominant one at the moment and its popularity has been increased by the spectacular rise of genetics, the attempt to isolate the faulty gene ‘for’ a given disease. Diseases thereby become objective occurrences independent of the experiences of those who have the disease.
As distinct from this there is a view that diseases are cultural phenomena. What counts as a disease in one culture – obesity, say – may be seen as sign of success in another. There is interesting discussion to be had on this issue, but for practical purposes we seldom need definitions. Clinicians, for example, are less interested in definitions of disease and more interested in clinical problems. More generally, you can arrange to meet a friend at 12.30 outside the underground without being able to define space or time.
From this practical or don’t-worry-about-a-definition point of view problems of disability have three aspects: medical, technological and attitudinal. Some disabilities benefit predominantly from medical interventions and others predominantly from improved facilities. Indeed, there is a large and developing industry of bio-engineering or bio-technology which sits midway between what is medical and what is infrastructure improvement. But what is needed as a foundation for improvements in either medical treatments or in technology is improvement in political and social attitudes.
Politically, governments and local authorities are under pressure to meet the needs of disabled groups. But they are also under pressure to meet the needs of many groups in society, so they are faced with the political problem of balancing individual rights and general utility. Decisions here turn on many factors, but especially resources and opportunity costs. There is no easy solution.
Social attitudes to the disabled are complex and variable. Everyone has sympathy with a disabled serviceman in a wheelchair. The difficult cases are the ones where the disability shows itself in ways which many people find embarrassing or repellent. For example, many people find muttering or shouting or eating in an off-putting manner more than they can face. The public is often criticised for this kind of reaction, but there may be a built-in recoil from certain physical manifestations, and it takes training and experience to overcome this.
Quite apart from instinctive reactions people may simply not know how to behave. This can vary from the traditional ‘Does he take sugar?’ to attempts to avoid disabled people altogether. There is no easy solution to the problem of public attitudes, but obviously education about disabilities will help.
Robin Downie is emeritus professor of moral philosophy at
Glasgow University
