Impairment is a physical fact, but disability is a social construction

Intro

This essay will discuss disability as a socially constructed concept, as viewed from a historical viewpoint the first as a physical fact and the second as socially constructed condition. The manner by which this will done is to investigate disability from an historical viewpoint and the socially constructed viewpoint, this will concluded in an evaluation.

Oliver (1996) defines impairment as “lacking part of or all of a limb, or having a defective limb, organ or mechanism of the body.” And disability “as the disadvantage of activity” (Oliver 1996:22).

Barnes (1991) suggests that disability is a recently modern term used to describe a system in which society discriminates by enforcing ‘social restrictions’ on people with impairments. It would be almost impossible to go back in time and identify when exactly society began to discriminate against people with impairments. Although it has been suggested that society’s view of impairment and disability came about as a result of people’s psychological fear of the unknown. As the perception of what is normal is transmitted by accepted values and beliefs through learning and culture from other people in society. (Douglas, 1966)

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Historians have found evidence from ancient times that suggests different societies generated their own ideological thoughts through out history, about people who suffered impairment. In Israel a 46,000 year old skeleton of a man was found, which showed he was born with an impairment that would have required the support from his society through out his life. This individual had severe impairment and yet his survival was the result of respect from his society (Rudgley, 2000) however not all societies had the same ideological responses to impairment. An excavated burial site (c.100, 000BC) in Turkey demonstrated how an individual with a hunched back was dumped on a rubbish tip, instead of being buried the traditional way as society viewed him as an outcast. (Rudgley, 2000) giving an early example of someone with a physical impairment being isolated from society. It was during the industrialization of 19th century that an extreme policy of exclusion was envisioned by segregating people with impairments from society by placing them in institutions.

The term ‘institution’ is used to describe a number of social organisations that range from hospitals, asylums, workhouses and prisons that use organized long term provision in a residential setting with the emphasis being on ‘care’ ‘treatment’ or ‘custody’ (Jones and Fowles, 1984) Institutions were first established to deal with the problem of ‘mental defectives’ these were people with learning disabilities and mental illness. As previously Individuals who had severe impairments were taken into small medieval hospitals where the sick or bedridden were kept. The philosophy of these hospitals was religious based, seeking to ‘care’ than to ‘cure’. (Skull, 1984) However this philosophy changed as the institutions were built with the belief that people with learning disabilities could be educated and trained and then let back in to society once rehabilitated. (Race,1995)

As prior to industrialisation people with learning disabilities had managed to cope in society by doing simple manual work, as literacy and numeracy were only prerequisites of the higher classes. Until industrialization brought a faster work pace and created a new bourgeoisie based on a person’s position in society and their individual attributes, (Hobsbawm 1962) resulting in the social exclusion of people with learning disabilities. (Skull 1979)

Therefore capitalism was a way of controlling and giving discipline to individuals who could not obey the rules of new working practices. Therefore to enforce greater control there was a increase in ‘institutions and asylums (Skull, 1979) there was an increasing fear that people with learning disabilities were contributing to the degeneration of society, therefore the regimes within the institutions were in place to contain people than reform them.

The reason for people with learning disabilities being segregated from people in society was through the negative image given by labelling that resulted in stigmatisation. As in the first half of the century people classed as learning disabled were labelled ‘idiot’ (very severe) ‘imbecile’ (severe) feebleminded (less severe) other derogatory labels used were ‘moron’ and ‘moral defective’. Even at the present time people with learning disabilities are still being stigmatised through labelling, that resulted from the past. As the term ‘mental handicap’ to classify people with learning disabilities gives the illusion of mental illness, and the term ‘handicap’ gives an image of a person with a cap in their hand begging and depending on the charity of others. The terms ‘idiot’ and ‘imbecile’ are labels still used to describe people in language used today. Indeed it was not the view that people with learning disabilities were a financial burden to society that was seen as a threat, but the way that they bred and spread the ills of society that caused concern for people. As it was believed that people who referred to as ‘feebleminded’ were the cause of many problems in society such as prostitution, alcoholism and crime. It was this negative image of labelling learning disabilities that would lead the way for the science of eugenics. (Borsay, 2005)

It is Francis Galton (1883) who is recognized as being the founding father of ‘eugenics’, which was defined as a “science of improving inborn human qualities through selective breeding.” (Galton, 1883) this meant only the most desirable people in society were allowed to procreate.

This idea was to prove popular with social thinkers and politicians of the time and attracted approval from many people in society. Policies were made as a result and one such policy was that sterilizing or segregating people with learning difficulties was much lower than, the higher cost that society would accrue in supporting generations of “defectives” in the future. (Larson,1995) showing how easy it was for social policy makers to be persuaded into making policies based on welfare costs with little regard on how it would effect people with learning disabilities . (Porter 2000)

Even the nazi doctors under Hitler’s command committed genocide by measuring disabled peoples lives in term of economic importance. (Burleigh 1994) Medical professionals took part in the operation of the Nazi eugenic programmes (Lifton, 1986) that lead to people with impairments being sterilized against their wishes and resulted in the death of 2000,000 to 275,000 the majority of which had learning disabilities. (burleig 1994)

Pfeifler (2000) argues that even at present, the classifications of the medical model in disability still occupy the “eugenic agenda” (Priestly) As ground breaking advances in science and medicine gave medical professions the power to dictate in the lives of people with impairments. With Genetic screening being seen as favorable in choice and cost effective, as the cost of genetic screening and abortion is cheaper to perform than the long term cost of supporting people with defective impairments. (Vintzileos et al, 1998)

The medical model has been highly influential on setting the parameters for how people with impairments were treated by society. As Chernovsky (1997) states that research carried out into intelligence was one way in which psychologists helped maintain the status quo in society, by creating social inequality. This can be seen in the intelligence tests that were used to decide whether an individual was incapable of living in society. These tests made little attempt at assessing an individuals capabilities, by getting the individual to distinguish the difference between a fly and butterfly or how many feathers were on a chicken or how many miles it was to America (National Council for Civil Liberties, 1951; Potts and Fido, 1991) this test made sure that the doctor could certify the individual as being incapable and institutionalise them for not being able to answer.

In the second half of the century a transformation came about that changed how society viewed a person with learning disabilities. During the 1950s the effects of war and polio epidemics highlighted the inequalities faced by people with disabilities, this led to the development and campaigning of human and rights movements as well as policies to combat these inequalities, including the European Convention of Human Rights 1950. Sociological studies were carried out and gave evidence to show that people with learning disabilities who had been lock away in institutions away from society, did have intellectual and social capabilities necessary to live in the community and that institution life was blocking this ability. (Race,1995)

Tizard and O’Connor (1952) discovered from their research that people with learning disabilities living in institutions who had been previously labelled as being ‘unemployable’ did have the essential skills required to complete a job in a work environment. Clarke and Clarke (1959) found evidence that the environment had an effect on a person’s performance, and the poor conditions inside institutions had a bad effect on the people living within them.

Goffman coined the term ‘total institutions’ to describe where people are cut off from the offside world and from family and friends. Procedures involve calling people inmates and humiliating them by removing their personal identity and by using a system of punishments and rewards. As well showing that people behave in accordance to label assigned to them, if people are labelled deviant, they will become deviant, and this in turn reinforces the beliefs up held by society about people with learning disabilities.

The studies showed the damaging effects that institutions had on the development of the individual and in the 1960’s a number of academic reports were published that detailed findings of research carried out into the conditions of institutions. The most renowned of these was the ‘Report of the Committee of Enquiry into Ely Hospital’ (Howe Report, 1969). The report described the impoverished and neglected living conditions, as well as lack of privacy that people with learning disabilities suffered from under the custodial regime carried out by staff. Due to public opinion the above reports resulted in a change in the law, the new Mental Health Act (1959) changed the certified term ‘mental deficiency’ to ‘mental subnormality’ this meant that most people with learning disabilities who were not being detained for a legitimate reason were free to leave and could return to the community. (Clarke 1983)

The introduction of White Paper Better Services for the Mentally Handicapped in 1971 led to a 50% reduction in hospital places by 1991 and led to the provision of local authority-based residential and day care. It also called for an end to custodial methods of care in hospitals and recommended the re-training of hospital staff. In 1979, The Jay Report re-emphasised the need for local authority-led care and, importantly, a service philosophy based on the principles of normalisation.

In the 1980s, this was redefined as ‘social role valorisation’ to include reference to strategies used in the creation, support and defence of valued social roles for people at risk of devaluation (Wolfensberger, 1998). In the UK, the principles of normalisation adopted were those interpreted by O’Brien and Tyne (1981) as the five service accomplishments. These have become the developmental goals which organisations then and now strive towards

A new philosophy was constructed that emphasised ‘care in the community’ this change resulted in the closure of all the old ‘asylums’. Community care was designed to bring about positive changes, these were governmental values aimed at allowing people with learning disabilities to live on their own, in their neighbourhood with services to support them. The government hoped to develop community based services made up of day centres, supported accommodation, support workers, training and employment, these services were to help people with learning disabilities be included into society.

The development of care in the community was result of reforms introduced by the Conservative government