The medical model of disability

III. (LEGAL) ASSUMPTIONS ABOUT DISABILITY IDENTITY AND EXPERIENCE This Article contrasts two prominent ways of thinking about disability: the medical model and social model. These two models rely on fundamentally different assumptions about people with disabilities. The medical model frames disability as an individual defect, or deficit, in need of diagnosis, treatment, and remediation.16 Under the medical model, a person with cerebral palsy is understood to be inherently limited by the physical demands of her condition, as compared to a “normal” body. Society has traditionally relied on this model, and indeed many people may consider this model the only way to think of disability. First developed in the field of disability studies,17 the social model conceptualizes disability as constructed in the environment, rather than in the individual.18 The social model recognizes a person with cerebral palsy is limited not by her body, but by places or institutions that are not designed to be accessible. The social model thus develops a more relational and holistic theory of disability, focused on the person, not the problem. The social model of disability contextualizes medical realities in a social justice framework.19 A person with cerebral palsy really does have differences in a biological sense from a person who does not have cerebral palsy. However, society can choose to make that cerebral palsy a defining aspect of their personality,20 or merely an ancillary one, like brown eyes or dark hair. While many people would chafe in a society where worth was determined by eye color, people with cerebral palsy and other disabilities today face equally arbitrary barriers to social acceptance and survival. The question of differential treatment may be complicated and highly personal for people with disabilities. For instance, some disability rights activists have likened disability to racial identity, noting that some disabled people may want to reclaim their disability and fight against the stigma.21 Others may argue 2020] DISABLING INEQUITY 151 that disabled people should not be treated differently from able-bodied people in any way, regardless of the intentions behind differential treatment. Indeed, not everyone with a disability is proud to be disabled.22 The social model of disability roots disability identity in repeated experiences with inaccessible rules, policies, and structures, rather than medical or biological difference.23 Though there is no biological basis for race,24 being a person of color can become a permeating part of one’s identity because of the constructed norm of whiteness.25 As such, even everyday interactions with white individuals or institutions signal to people of color the various privileges that white people receive at their expense.26 The social model of disability posits a similar experience for people with disabilities. By focusing solely on the physiological nature of disability, the medical model tacitly accepts that society may accommodate some conditions more than others. The social model of disability demands a world designed for all abilities. The social model also argues that when we design environments for everyone, they are improved even for the nondisabled. A pregnant woman may not need a ramp, but it may improve her overall experience accessing a building. Put differently, the medical model is inherently-diminishing, carrying implications of weakness, helplessness, and dependency, precisely because it tends to reduce an entire individual to her impairment,27 while the social model recognizes that there are 152 N.Y.U. REVIEW OF LAW & SOCIAL CHANGE [Vol. 44:145 other aspects to a person’s identity in addition to the diverse ways in which they move. Additionally, the social model emphasizes that the experience of being labeled disabled or abnormal is often more impactful for people with disabilities than biological differences alone.28 For the cafeteria worker, the experience of being labeled disabled and the social stigma of applying for social security disability benefits is likely the source of anger and frustration, rather than the aging body.