2 What does it mean to be disabled?
2.1 Definitions of disability
What do we mean by the term ‘disability’? Disability groups and other organisations may have their own definitions of disability. Two definitions are presented here: one developed for the Disability Discrimination Act (DDA), and the second from the World Health Organization (WHO).
The DDA sets out the circumstances under which a person is ‘disabled’. A person is considered to be disabled if:
- they have a mental or physical impairment
- the impairment has an adverse effect on their ability to carry out normal day-to-day activities
- the adverse effect is substantial and long-term (meaning it has lasted for 12 months, or is likely to last for more than 12 months or for the rest of the person's life).
In addition there are also some special provisions under the Act that cover, for example, progressive conditions and past disabilities.
In defining ‘normal day-to-day activities’ the DDA states that at least one of the following areas must be badly affected:
- manual dexterity
- physical coordination
- ability to lift, carry or move everyday objects
- speech, hearing or eyesight
- memory or ability to concentrate, learn or understand
- understanding of the risk of physical danger.
This information is adapted from Disability Rights Commission at definition of disability.
Think back to the people introduced in the last section (the woman who has broken her leg, the woman with the eyesight problems making her unfit to drive, the man with the hearing aid, the man with schizophrenia). Which of these do you feel is disabled according to the DDA definition?
When I considered this activity, I was struck by the fact that the DDA definition above is not as straightforward as it appears at first sight, and requires interpretation. I decided that the second point (on the adverse effect on the ability of a person to carry out normal day-to-day activities) was more important than the third (regarding the length of time of the adverse effect).
Under this interpretation:
I think the woman with the broken leg should be considered disabled under the terms of the DDA as the broken leg impedes her normal day-to-day activities, even though the adverse effect is unlikely to be long-term.
The woman with the eyesight problems (me!) does not consider herself disabled since car driving is not a central facet of her life and there are public transport alternatives, so her day-to-day activities are not adversely affected.
The man with the hearing aid should not, I think, be counted as disabled while he is wearing his aid, given that this satisfactorily addresses his impairment. His situation is made more complex by the fact that he won't always be wearing it (for example, he presumably wouldn't wear it in bed), and this has implications such as the smoke alarm in his bedroom should give both visual and audio alerts.
The man with schizophrenia would be considered disabled, given that the effects of his medication might make it difficult for him to work or study without special support.
The main lesson I learned from this activity is how difficult it sometimes is to interpret a definition, even one developed within a legal context.
The World Health Organization (WHO) commissioned a classification system for disability in 1980 and the following definitions were developed:
- Impairment: any loss or abnormality of psychological, physiological or anatomical structure or function.
- Disability: any restriction or lack of ability resulting from an impairment to perform an activity in the manner or within the range considered normal for a human being.
- Handicap: a disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfilment of a role that is normal (depending on age, sex and social and cultural factors) for that individual.
According to the above classification a person may have an impairment, and this may result in the person being disabled (restricted from performing ‘normal’ activities) or handicapped (prevented from fulfilling a ‘normal’ role).
As with the DDA definition, this is far from simple. ‘Disability’ refers to performance of activities; ‘handicap’ to performance of a role, and yet the fulfilment of a role depends on performing activities. It seems that ‘disability’ and ‘handicap’ are not independent concepts.
Criticisms of the WHO definition include concerns about the definitions of normality and abnormality; about the lack of cognisance of environmental factors (for example, if we didn't have access to parts of buildings dependent on stairs, wheelchair users would not be handicapped), and because a focus on disability and handicap caused by psychological and physiological impairments leads to an emphasis on a cure – a medical focus – rather than on addressing the issues as they stand – a social focus – as we will now discuss.