Definitions of Disability Module 3
The definition of disability is highly debatable for several reasons. First, it is only in the past century that the term “disability” has been used to refer to a distinct class of people. Historically, “disability” has been used either as a synonym for “inability” or as a reference to legally imposed limitations on rights and powers. Indeed, as late as 2006, the Oxford English Dictionary recognized only these two senses of the term (Boorse, 2010). As a result, it is hard to settle questions about the meaning of “disability” by appeal to immediate knowledge, since immediate knowledge may be confused by the interplay between older, ordinary-language definitions and newer, specialized ones.
Second, many different characteristics are considered disabilities. Paraplegia, deafness, blindness, diabetes, autism, epilepsy, depression, and HIV have all been classified as “disabilities.” The term covers such diverse conditions as the congenital absence or adventitious loss of a limb or a sensory function; progressive neurological conditions like multiple sclerosis; chronic diseases like arteriosclerosis; the inability or limited ability to perform such cognitive functions as remembering faces or calculating sums; and psychiatric disorders like schizophrenia and bipolar disorder. There seems to be little about the functional or experiential states of people with these various conditions to justify a common concept; indeed, there is at least as much variation among “disabled” people with respect to their experiences and bodily states as there is among people who lack disabilities.
At the same time, defining “disability” solely in terms of social responses like stigmatization and exclusion does not distinguish disability from race or sex (Bickenbach, 1993)—a result that some disability scholars might welcome, but that begs, or obscures, an important question. The challenge of distinguishing “disability” from other concepts, without taking a basic or reductive view of it, has been taken up by various specialized definitions.
Two common features stand out in most official definitions of disability, such as those in the World Health Organization (2001; 1980), the U.N. Standard Rules on the Equalization of Opportunities for People with Disabilities, the Disability Discrimination Act (U.K.), and the Americans with Disabilities Act (U.S.) : (i) a physical or mental characteristic labeled or perceived as an impairment or dysfunction (in the remainder of this entry, we will refer to such characteristics as “impairments,” without assuming the objectivity or validity of that label) and (ii) some personal or social limitation associated with that impairment. The classification of a physical or mental variation as an impairment may be statistical, based on the average in some reference groups; biological, based on a theory of human functioning; or normative, based on a view of human flourishing. However classified, impairments are generally seen as personality of the individual that he or she cannot readily alter. Just what makes a condition a attribute or attribute of an individual is obscure and debatable, but there seems to be agreement on clear cases (Kahane and Savulescu, 2009). Thus, poverty is not seen as an impairment, however disabling it may be, nor is tasteless clothing, even if it is a manifestation of impaired fashion-sense rather than scarce income. On the other hand, diseases are generally classified as impairments, even though they are rarely permanent or static conditions. Diseases that are not long-lasting, however, such as the flu and the measles, do not count as impairments.
The notion of a limitation is broad and elastic, encompassing restrictions on such “basic” actions as lifting one's arm (Nordenfelt, 1997; compare Amundson, 1992: actions “at the level of the person”); on more complex physical activities such as dressing and toileting; and on social activities like working, learning or voting (see Wasserman, 2001).
The characterization of both features is disputed. Several scholars have challenged the prevailing view of impairment as objective and biologically grounded (Shakespeare, 2006; Davis, 2002; Tremain, 2001; Amundson 2000). There is also disagreement about the conceptual and practical need for two categories of limitations, one involving personal activity, the other social or political participation—“disability” and “handicap,” respectively (Wright, 1983; Edwards, 1997; Nordenfelt, 1997; Altman, 2001). But the most controversial issue in defining disability is the relationship between the two. At one extreme are definitions that imply, or are read to imply, that biological impairments are the sole causes of limitation. The definitions in the World Health Organization's 1980 International Classification of Impairment, Disability, and Handicap, and the Disability Discrimination Act (UK) have been interpreted this way. At the other extreme are definitions that attribute the limitations faced by disabled people solely to “contemporary social organization,” such as the definition given by the Union of the Physically Impaired Against Segregation (UPIAS, 1976). Such definitions appear to treat impairments merely as “suggestive” causes—as conditions that are subject to exclusion and oppression. They have been criticized for ignoring disadvantages that cannot be attributed to social attitudes and practices (Terzi, 2009, 2004; Shakespeare, 2006). But in characterizing disability in terms of exclusion, these definitions need not deny that impairments have undesirable aspects, such as pain or discomfort—merely that those aspects are not within the scope, or part of the meaning, of disability.
In-between are definitions which assert that individual impairment and the social environment are jointly sufficient causes of limitation. Perhaps the best-known example is the WHO's International Classification of Functioning, Disability and Health (ICF, 2001), which emphasizes that disability is a “dynamic interaction between health conditions and environmental and personal factors.” Such interactive definitions predominate in current law and commentary on disability; even the UNCRPD and DDA can be interpreted as compatible with this approach. The ADA is generally seen as adopting an interactive approach to disability, although it contains an amalgam of definitional features.
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