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The aim of this assignment is to discuss the strengths and limitations of the social model of disability and how nurses can promote anti-discriminatory practice in relation to people with disabilities. Defining disability is said to be very difficult due to the fact that disability is a ‘complicated, multidimensional concept’ (Altman 2001). Furthermore Slater et al (1974) has gone as far as stating that constructing a definition that would fit all circumstances is in ‘reality nearly impossible’. However attempts have been made by various different people, legislation and models in different ways.
According to Altman (2001) these attempts are the reason why there has been a lot of ‘confusion and misuse of disability terms and definitions’. The Disability Discrimination Act defines a disabled person ‘as a person who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities’. (DDA 2005) However the medical model of disability sees disability as the individual’s problem and that it should not concern anyone other than the disabled person, for example, if a student who is in a wheelchair is unable to get into the building due to the steps, the medical model would assume that it is due to the wheelchair rather than the steps. Whereas on the other hand the social model would say that the steps are acting as a barrier to the student, therefore the barrier should be removed.
The social model of disability was brought about by activists in the Union of the Physically Impaired Against Segregation (UPIAS) during the 1970s. This model is seen as the main theory which tests disability politics in Britain (Shakespeare et al 2002). The UPIAS argued that there is a major difference between impairment and disability. They defined impairment as ‘lacking part or all of a limb, or having a defective limb, organ or mechanism of the body.’ They have also defined disability as ‘the disadvantage or restriction of activity caused by a contemporary social organization which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities’ (Giddens 2006).
The social model of disability can be defined as an idea that it is society that disables an individual with the way everything is constructed to meet the needs of the majority who are not disabled (Shakespeare et al 2002). Whereas, the social model can be compared with the medical model of disability which tends to focus purely on finding a cure and that to be able to fully participate in society they need to treat their ‘impairment’ (Crow 1996).
The model has several key points. First it describes disabled people as an oppressed social group (Shakespeare et al. 2002) meaning that on top of their impairment, disability is something more deep that excludes and isolates them from participating in society (Oliver 1996). The difference between the impairments that people have to deal with and the oppression which they experience is fundamental to the British social model. Finally, the model defines disability as a form of social oppression, not a form of impairment (Shakespeare et al. 2002). Therefore the aim of the model is to empower disabled people so that they don’t feel as though their condition is the problem, but that society is the problem due to the number of barriers it places on disabled people (Giddens 2006). For example, everywhere you go there will be steps, steps to get into a building, steps to climb floors and it is this barrier which causes problems for disabled people therefore the social model provides a solution saying that ramps and lifts should be fitted in all buildings, the problem of not being able to stand for too long should be tackled by placing more seats in public places. It is barriers like these that the social model aims to find solutions to.
The British disability movement has found great importance in the social model in various different ways. Hasler (1993) describes it as the ‘big idea’ of the British disability movement. For example, identifying a political strategy to remove barriers in society that played a large role in disabled people’s lives, which was also the main strength of the social model (Shakespeare et al. 2002). Examples of barriers that disabled people faced in all areas of life were the inability to access public transport systems due to the fact that a person was in a wheelchair or had visual or hearing impairment, their inability to find work because employers felt that the disabled person was incapable of doing the job, housing problems and so forth (Thomas 2004). The removal of such barriers would mean that if those people with impairments felt disabled by society then by taking away these barriers would help to empower and promote the ‘inclusion of people with impairments’ (Shakespeare et al. (2002).
The model tries to bring about change in society to suit the individuals need rather than taking up a medical view where you try and look for a cure, or rehabilitation (Shakespeare et al.2002). For example, people who have schizophrenia have to take medication in order to live normal lives. However it is argued that the social models complete view of changing society has become too simplistic or rather an over- socialised explanation. Furthermore, Vic Finkelstein (2004) argues that the social model looks at enabling people to be ‘human’ in a society rather than having access to their ‘rights’.
However the medical model of disability has a different perspective. They believe that people with disabilities need to be assessed, that they are incapable of making their own decisions, that they are the problem and that people with disabilities have to be adapted to fit into the world, but if this is not possible then they are placed in specialised institutions or ‘isolated at home’ where only basic needs are met (Rieser, 2009).
A second strength seen from the model was the actual impact on the disabled people themselves. The social model made disabled people feel free as they lifted the view of a medical approach, where the problem was the individual and placed it on society saying that social oppression was the root of the problem. This as a result made people feel liberated and empowered as they were made to believe they were not at fault: ‘society was’, that society was in need of the change: not the individual (Shakespeare et al. 2002). The social model helped to bring disabled people to ‘come out’ like raising feminist consciousness in the seventies, or lesbians and gays ‘coming out’ (Shakespeare et al. 2002).
The social model has played a very important part in many disabled people’s lives, however, despite these strengths to the model there are a number of limitations. Firstly, the social model has been criticised for being unable to deal with the realities of impairment (Oliver, 2004), meaning that the model is not about peoples personal experience of impairment (Oliver, 1996) but about peoples collective experiences of disablement in society (Oliver, 1990).
Another point criticised is that other social divisions such as race, gender, ageing, sexuality and so on are not incorporated in to the social model (Oliver, 2004). However Oliver (2004) that just because the social model hasn’t incorporated these divisions does not mean that they are unable to. Oliver (2004) states that those who criticise the model are the ones who should try and ‘forge the social model into action’ when dealing with issues such as race and gender and age and sexuality.
Cultural values have also been pointed out to be ignored by the social model. There is an argument about the issue of otherness, meaning that it is the cultural views that people hold which place disabled people as ‘others’, not the physical and environmental barriers (Oliver, 2004).
Furthermore, another limitation of the social model is that it clearly neglects and ignores the experiences of impairments and disability which are the main cause of problems in most disabled people’s lives (Giddens, 2006). Shakespeare and Watson (2002) argue that ‘we are not just disabled people, we are also people with impairments, and to pretend otherwise is to ignore a major part of our biographies’. Against this accusation, Oliver (2004) finds it difficult to accept that disabled peoples experiences are not considered because it is after all the main reason why the model emerged to begin with-due to a number of disabled activists in the 1970’s. Furthermore defenders of the model argue that the social model merely focuses on social barriers that disabled people face rather than denying them of everyday experiences due to their impairment (Giddens, 2006).
The social model has been criticised as being ‘inadequate as a social theory of disablement’ (Oliver 2004). Corker and French (1998) talk about social model theorists and then conclude that the social model is not a theory, however Oliver (2004) argues that how can people criticise the social model for something it has never claimed to be? Oliver (2004) states that most people who have developed the social model have claimed that they have said the social model of disability is not a theory of disability.
Leading on from the strengths and limitations, there is a substantial amount that nurses can do to promote anti-discriminatory practice in relation to people with disabilities by maintaining a positive attitude towards people with disabilities as they are constantly involved with the treatment and care of people with physical or intellectual disabilities (Klooster et al. 2009). Nursing schools as like other professions, tend to be based around the medical model of care where they aim to diagnose and treat diseases (Klooster et al. 2009). However as Byron et al (2000) has stated that not all disabled people are unwell and may not have a disease.
Nurses have an important role, like other health professionals, in influencing a disabled person’s response to treatment (Oermann &Lindgren, 1995). Therefore Carter et al (2001) has stated that inappropriate attitudes and behaviours from staff are the biggest barriers which disabled people face, which has led to further research indicating that nursing students should move away from the medical model of care when working with people with disabilities and should focus on a more social model perspective (Scullion, 1999).
Further research has indicated that nursing student’s attitudes towards disabled people may be improved by educational programmes which can help nurses to be in direct contact and to work with disabled people (Oermann &Lindgren, 1995). However, the research literature suggests that this is currently not happening in nursing practice (Klooster et al 2009). For example, Brillhart et al (1990) found that nursing students had more negative attitudes then the person with the disabilities themselves.
Nurses can help to provide clear information as Hammel (2003) states that professionals need to ‘listen to what people are telling them’ and that ‘actions and non-verbal messages can speak very loudly’. Nurses can form strategies to communicate with disabled people in order to make their life easier (Hammel, 2003). However it is common that fewer health care professionals are reluctant to provide services for disabled people as they age (Hammel, 2003).
By providing clear information nurses also involve other people who are important in the disabled person’s life and ensuring that they are informed about options and benefits for the disabled person as well as themselves. Nurses can also act as advocates for disabled people so that they have equal use of services or even provide information of advocacy groups for the disabled person for example Centres for Independent Living (Hammel, 2003).
Furthermore, where young people are concerned nurse can give advice to families about possibilities for independence and can also refer them to community resources that may help young people pursue further education, find a job and live independently (Blomquist et al. 1998)
Lastly the Disability Discrimination Act is a guide for nurses to help them provide better care for people with disabilities and also how they can develop their practice (Aylott, 2004).
There are many aspects with which nurses can help promote anti-discriminatory practice in relation to people with disabilities however, nurses need to keep a positive attitude towards people with disabilities in order for the anti-discriminatory practice to work.
In conclusion for there to be equal rights for people with disabilities, Oliver (2004), states that people spend too much time discussing the strengths and limitations of each model therefore he suggests that both models should be integrated, ideas of both models should be put together and used in concordance so as to actually help people with disabilities. Oliver (2004) claims that ‘if we imagine that throughout history carpenters and builders of the world had spent their time talking about whether the hammer was an adequate tool for the purpose of building houses, we would still be living in caves…’. Therefore there is a hammer in the disability movement and if it was used properly then the social model of disability can become the ‘hammer of justice and freedom for disabled people’ (Oliver 2004).
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