the body politic: theorising disability and impairment

The Body Politic 169

© Society for Applied Philosophy, 2007© Society for Applied Philosophy, 2007, Blackwell Publishing, 9600 Garsington Road, Oxford, OX4 2DQ, UK and 350 MainStreet, Malden, MA 02148, USA.

Journal of Applied Philosophy, Vol. 24, No. 2, 2007

The Body Politic: Theorising Disability and Impairment

PHILLIP COLE

ABSTRACT In her critique of the social model of disability, Lorella Terzi argues that it over-socialises disability, and that some kind of connection must be made between disability and bodilyimpairment. In this paper I argue that, far from over-socialising disability, the social model doesnot go far enough. The important contribution of the social model is that it politicises disability.I argue that bodily impairment must itself be politicised, and the insights of the social modelshould be extended to the body itself.

1. Introduction

The field of disability studies has, since the 1980s, been significantly shaped by what isknown as the social model of disability: that what disables people is not impairment totheir body, mental or physical, but the society around them.1 This is a highly politicalapproach to disability, and indeed its major proponents have insisted that it is not atheory of disability as such, so much as a political tool for action.2 However, the modelhas led to much rethinking about how disability should be understood, and in herimportant contribution to that debate Lorella Terzi3 identifies areas where the socialmodel needs clarification and extension; two areas in particular are in need of reform,the causal relationship between bodily impairment and disability, and the idea ofnormality as average human functioning. She concludes that the social model over-socialises disability, and that we must re-connect disability with bodily impairment. Inthis paper I attempt to provide some of the clarifications and extensions Terzi calls for,and focus on the areas of causality and normality. However, I conclude that far fromover-socialising disability, the social model under-socialises it, in that the idea of bodilyimpairment itself must be understood in social, political and cultural terms. In the end,the fact that the social model is primarily meant as a political tool for critique of societyhas to be kept in mind, and I argue that what counts as a bodily impairment must beseen as politicised. This is not to make the body itself disappear from the account, butit is to see the body itself as a political, social and cultural object. The purpose in doingthis is not to take the debate into an over-theorised world where nothing can be takenas a fixed point, even the material body, but rather to connect the discussion moreclearly with the political critique of a disablist society.

2. Causality

The social model of disability was a response to the individual/medical model that,according to Jonathan Glover, dominated until the 1990s.4 According to that approach:

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© Society for Applied Philosophy, 2007

‘Some physiological or chemical system might be missing or atrophied, or might havebeen damaged through illness, accident, or some other trauma. The absence or mal-functioning of such a system results in the person having impaired abilities to copewith life. A malfunctioning visual system causes the disability of blindness. A malfunc-tioning auditory system causes the disability of deafness. A stroke that disrupts systemsinvolved in speech or movement causes corresponding disabilities’.5 For Terzi, this model‘establishes a causal relation between individual impairment, seen as departure fromhuman normality, and disability, seen as restriction in abilities to perform tasks’.6 Thesocial model breaks this causal connection between bodily impairment and disability:disability is not physical, it is social. ‘Disablement is . . . caused by the oppression ofsocial and economic structure on disabled individuals who are, consequently, an op-pressed group in society’.7 Carol Thomas says that according to the social model,‘. . . disability was an entirely socially caused phenomenon. Disability was reformulatedto mean the social disadvantages and exclusions that people with impairment faced inall areas of life: employment, housing, education, civil rights, transportation, negotia-tion of the built environment, and so forth’.8 According to this approach, disabilityresides ‘principally in the socio-structural barriers that serve to disadvantage and ex-clude people with impairments’.9

But this, Terzi argues, is to over-socialise disability. Bodily impairments drop out ofthe picture, when in fact they have an enormous impact on the lives of those who havethem.10 Bodily impairments have effects in terms of the ‘restriction of activities or thepossible inabilities to perform different functions’,11 and to overlook this is to overlook‘the importance of the relational nature of impairment, disability, and society’.12 Forexample, congenital blindness is an impairment ‘which can be considered a clearinability and a disability if referred to driving (at present society is structured to havesighted drivers only)’.13 What is at issue here is the relationship between bodily impair-ments and social disabilities, a relationship the social model displaces. If we take theexample of congenital blindness and driving a car, the issue is specifically the ability ofa person to get from one place to another by means of self-propelled transport. Whilewe can imagine the technology that would enable a blind person to do this, we canassume that as things stand it lies beyond our technological capacities. It is not merelythat society is structured to have sighted drivers only, but that there is no alternativestructure available to us at present or in the near future. If all this is true, then thisparticular case of the inability to drive a car looks as though it is caused by the bodilyimpairment of congenital blindness rather than social structure. Therefore this particu-lar disability cannot be socialised — it is primarily to do with the body not thesurrounding society.

But this would be too simplistic a move. An inability arises when something is missingthat would enable someone to have that ability. In some cases the missing element isthe knowledge or skill needed to perform an action: I cannot drive a car because I havenot learned how. In other cases it is the opportunity that is missing, and this lack ofopportunity is to do with the social structure: I cannot drive because I cannot afford toor because cars are not designed for my physical abilities when they could easily bemodified. A third possibility, though, is that I simply lack the capacity to do some-thing, such that I cannot learn how to do it and there is no modification of socialstructure that can enable me to do it: I cannot leap over tall buildings, and, if I amcongenitally blind, I cannot drive a car. In the latter case of blindness, the inability is



related to a bodily impairment and we call that inability a disability. However, thisrelationship between bodily impairment and disability always has a particular socialcontext: although the disability has a relationship with a bodily impairment, its exist-ence only arises in that social context. Therefore the disability is always social and thesocial model theorists are correct in socialising disability.

However, Terzi may object that this misses the point. What we can see is that thedisability is related to an impairment of the body and that relationship is causal. This iswhat the social model chooses to overlook. But the overall conclusion has to be thatthe social model is a relational model, and that the relevant relationships are between(1) a bodily impairment, (2) a particular action or ability, and (3) the social structure thatframes that impairment and the action or ability in such a way that the person with thebodily impairment cannot perform it. The causal relationship is not impairment→disability nor social structure→disability, but social structure+impairment→disability.This means that the disability can be corrected either by changing the social structureor by physical intervention on the body. For example, if my vision is impaired to somedegree I can be enabled to read either by making typefaces larger or by correcting myvision with artificial lenses. However, there may be some disabilities where a change inthe social context is impractical and intervention on the body impossible, and theexample of the inability of the blind person to drive a car seems to be such a case:surely here we have a case of what we might call a ‘brute’ disability, in which therelationships between social structure, impairment and action/ability are fixed in place.But still, this shouldn’t lead us to see the bodily impairment as the primary causalfactor here. It is still the complex relationship between body, social structure andaction which gives rise to the disability. And we still have options when it comes to thealteration of the social, in that we can alter some dimension of social context to preventthis particular disability — the inability to drive a car — from giving rise to others. Thisis to recognise that disabilities exist in a complex hierarchy and are related, not only tosocial context and the body, but also to each other. For example, if all shopping centresare out of town and can only be reached by private car, then the congenitally blind personcannot shop for herself. A particular disability, then, can be the effect of a series ofother disabilities running through the social structure, such that the relationship betweenthat disability and the bodily impairment is extremely complex and thoroughly social-ised. We have no reason to take bodily impairment as a primary causal factor.

Still, in the case of the congenitally blind person’s inability to drive a car we have adisability that cannot be characterised as social oppression, because there is no alterna-tive arrangement that would enable them to drive a car. And so to the extent that thesocial model characterised all disability as social oppression Terzi may have a pointthat it goes too far. Indeed, insofar is it is meant as a political tool in order to opposeoppression, in these cases the tool seems to have no purchase. Many disabilities are todo with the deprivation of opportunity and so are matters of social oppression, butsome disabilities may well involve no social oppression at all. We need to be able to tellthe difference between these kinds of disability and the social model may not allow usto do that. We need to ask whether this person is unable to operate a car because theyare being deprived of the opportunity by lack of political will, or because they simplylack the capacity to do it for whatever reason. This is not to say that the social modelover-socialises disability, but that it over-politicises it. I will look at this charge in moredetail in the next section, and reject it. For now, though, we can see that the disability

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remains a social, not bodily, phenomenon, as the disability can only be a disability insocial terms — it is always the inability to perform an action or possess an ability whenthat action or ability has a social context. It is the social context that makes a personunable to perform the action, not the bodily impairment. Certainly, the disability is theproduct of the interaction between bodily impairment and social context, but it is thesocial context that gives the action or ability its form and content, and indeed itscultural meaning, and so it is the social context that gives the disability its form andcontent. In a society with a very different transport system there may be no such actionas driving a car, and so no such disability. Therefore the social context is primary indetermining what the disability is. And as driving a car is loaded with cultural signifi-cance, there is a cultural dimension which we cannot ignore and which adds anotherlayer of complexity.

To conclude this section, a disability is in inability that is related to an impairmentof the body, but disabilities are always primarily social in that they only have form andcontent in a particular social context: a disability is the exclusion from an action orability which the social framework makes possible for others, but impossible for thedisabled. Whether or not that social framework can be altered, it is the primary factor,not the bodily impairment. That a congenitally blind person cannot operate a car maybe, as things stand, socially inalterable, but it remains a socially determined disability.Although I did describe the approach I take here in causal terms, talk of causality maybe misleading here. To say that the bodily impairment or social structure, either ontheir own or in combination, cause the disability is not sufficiently precise; there is aparticular kind of causality at work. The relationship between the body and the socialstructure makes certain actions and abilities possible or impossible. As an analogy, thepresence of water in a river makes it possible for me to sail a boat to the other side.The absence of water makes it impossible to sail the boat to the other side. And so myability to sail to the other side rests upon the presence or absence of the water. To playwith the analogy, if I do not have a boat it may be possible to use a bridge to get to theother side. Here my ability rests on the presence or absence of the bridge. It does makesense to say that the presence of the bridge causes me to be able to cross the river, orits absence causes me to be unable to cross. But it makes less sense to say that thebridge’s presence causes my ability, or its absence causes my inability. In a sense theproblem here is talk of my ability/inability. To talk of my ability or inability to crossthe bridge makes it seem as though the ability/inability is something to do with me,with my body. In fact what we are talking about here is the presence or absence of anoption, which itself rests on the presence or absence of an external social structure.The presence of the bridge creates an option; its absence removes that option. Theseoptions are external to me, part of the social structure surrounding me. And so whenwe say that the presence of the bridge causes me to be able to cross the river, we haveto remember that the presence of the bridge has no causal effect on me as such (I amnot altered) — it has a causal effect on the social structure around me, bringingoptions into being that were not there before. Therefore ability and disability alwaysexist in the social structure around me, in terms of the options that are opened areclosed. At that level, ability and disability have nothing to do with my body, andeverything to do with the social structure. The causal relationship is not between thesocial structure and the body, but between the social structure and the options that aremade possible or impossible for agents.



3. Normality

The social model rejects the idea of normality in favour of differences, and so opposes‘any idea of normality seen as ideologically constructed in order to control and excludedisabled people from the structure of a society that has no interest in accommodatingthem’.14 However, Terzi argues that the rejection of normality leads to some untenableconclusions: ‘. . . if we deny normality seen in terms of average human functioning,how would we evaluate impairment and disability?’.15 The very ideas of impairmentand disability require some reference point to the normal. Also, if we reject the normality/abnormality distinction in favour of difference, the question becomes: different fromwhat? Terzi says: ‘Ultimately, in my opinion, the total rejection of the concept ofnormality, and either the lack of a reference point or its substitution with an unspeci-fied concept of difference, show not only theoretical and political limitations, but alsoa mismatch between the theoretical basis of the social model and some of its practical,political aims’.16

However, it is not clear that the reintroduction of the idea of normality understood asaverage human functioning can help politically. Theoretically, the question ‘differentfrom what?’ can clearly be answered coherently without the need for a reference pointof the normal. We can simply be different from each other, where none of us are thenorm against which others must be measured. We could arrive at a statistical norm(putting aside whether by average here we intend the mean, mode or median) for thiskind of variation, but in many cases it isn’t clear that the statistical norm has any usefulrole to play. For example, we have different eye colours, but there is no question ofthere being a statistical average eye colour (there must be one, but who cares what itis?). We have different shades of skin colour, but again the average shade of skin is notimportant. When it comes to height and weight, the notion of being above or belowthe average may have some significance, but whether or not an average is significantdepends on its context.

There are other problems here. Personally, I am long-sighted and need correctivelenses to read ‘normal’ typefaces (recognising that what counts as a normally sizedtypeface is socially determined). But this does not mean that my eyesight deviates fromthe human average: most people could be long-sighted in this way. I could even haveabove average eyesight! And so it may be that in many cases the idea of the normal isnot the same as the idea of the average. When it comes to weight, the average weightof a certain population may be very high, and so certainly not ‘normal’. There are,therefore, two senses of normal at work here: firstly, the average, and secondly, theideal. There is an ideal weight, there is ideal eyesight, and the actual statistical averageweight or eyesight may deviate from the ideal. Jonathan Glover, in an extremely helpfuldiscussion of normality, concludes that: ‘The normality that is contrasted with disabil-ity is a hybrid of the numerical and the normative’.17 It is therefore a ‘messy’ concept,partly socially constructed and partly context dependent.18 The reintroduction of theidea of normality as average human functioning is, then, at least not straightforward. Isuspect that Terzi and others connect normality with average human functioning be-cause it then seems to have some objective physical status, while instead the idea of thenormal is notoriously cultural and ideological: the notion of the ‘ideal’ human being isa far more difficult and, in the end, dangerous concept, and the idea of ‘normality’ indiscussions of disability is, I believe, more shaped by this notion of the ideal than the

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idea of the average. If that is right, then those who want to re-introduce it must find away of doing so that avoids this cultural and ideological baggage.

4. Politics

While Terzi recognises that all people have social needs to some degree, she arguesthat people with physical impairments have a wider range of such needs than othersand that the difference approach taken by the social model overlooks this.19 However,the reference point when it comes to needs should not be a notion of average, or ideal,human functioning, but of citizenship understood as participation. This is exactly thepoint of the social model of disability — it is, at root, a political model, and at its centreis a conception of active citizenship, of the dimensions of society in which all membersare entitled to participate to the fullest extent. The problem with the idea of normalityunderstood as average human functioning is that it is a partner in the normal/abnormaldistinction and it cannot avoid identifying the disabled person as abnormal, or at leastas the opposite of ‘ideal’. If we focus on citizenship then we focus on the activity, notthe person, and we have the ideal of citizenship rather than of the ideal citizen. It is notthat the disabled person fails to be an ideal citizen, but that they are being excludedfrom the ideal of citizenship; society is failing, not the disabled person. We all haveneeds that have to be met if we are to participate equally in the activity of citizenshipand those needs differ. That someone has a broader range of needs or some distinctiveneeds does not pick them out as abnormal or as a deviant citizen. The focus mustremain on the activity not the person. That someone is disabled means precisely thatthey are being excluded from an important activity, and they are not being excludedbecause they are abnormal but because the social structure picks them out as abnormal.As we saw in section 2, in some cases the ‘picking out’ counts as a clear case of socialoppression, those cases where there is some alternative social arrangement which wouldnot pick them out and which is available to us. However, here we see a reason why wemight want to extend the idea of social oppression to the whole range of disability. Ifthe social structure picks out a social group as abnormal, then there is a reason to saythat group is being oppressed whether or not that social structure can be altered. Wewill still want to distinguish between those cases where the social structure can be, andshould be, altered, and those cases where it cannot; but we can now see the sense inwhich the physically disabled experience their exclusion as oppression in all cases.

There is another crucial aspect of this ‘picking out’. Although I am long-sighted, Iam not disabled. We do not want to say that anybody who needs corrective lensesbecause of long- or short-sightedness is disabled. Even if the average human eyesightwere perfect and my eyesight was a departure from that average, I would not bedisabled. But, far more significantly, we would also not want to describe me as bodilyimpaired. Obviously, my eyesight is impaired to some extent, but it is not the kind ofimpairment that counts as bodily impairment in terms of disability policy or politics. IfI were to try to join a disability action group because I am long-sighted, I doubt Iwould be greeted with much sympathy or support. There are many such cases where aperson differs from the norm, physically or mentally, but where we draw back fromdescribing them as bodily impaired. Above I suggested that a disability is an inabilitythat is related to a bodily impairment given a particular social arrangement; the disability



arises from the relationship between the impairment, the social arrangement, and aspecific action or ability. However, we can now see that this will not do, because mylong-sightedness meets this description: I am unable to read the vast majority oftypefaces without some kind of intervention, and the size of typefaces is a socialarrangement. It starts to look as though the idea of disability and the idea of bodilyimpairment are filled with social, cultural and political meaning, because only certainexamples of impairment count as bodily impairments in disability policy and politics.In an important sense, it is the political idea of disability that determines what countsas a bodily impairment. An aspect of the body — physical or mental — only counts asa bodily impairment under specific social, cultural and political conditions. We cannotassume a clear distinction between the body and the political, so that an aspect of thebody such as an impairment can be kept completely distinct, as a medical issue forexample, rather than as a political one.

The next step in the argument, of course, would be to describe what social, culturaland political conditions determine that an aspect of the body is an impairment ratherthan simply a difference or departure from the norm. Historically those conditionshave been highly oppressive and have centred on ideas of deformity or helplessness: thedisabled have been represented as monsters to be feared or as burdens to be charitablysuffered. The social model of disability, in a sense, plays the same political game, whichis why it is the political idea of disability that determines what will count as a bodilyimpairment. If we take a ‘purely’ philosophical approach, then there is no good reasonwhy my long-sightedness should not count as a bodily impairment, and therefore whymy inability to read texts should not count as a disability, and why I should not join adisability action group. But, politically, there are very good reasons why it should notcount. The social model identifies a framework of empowerment, liberation and par-ticipation, and in that framework the ideas of disability and bodily impairment take ona distinct meaning. I think that the best we can do philosophically is to describe anaspect of the body as an impairment if it would be unreasonable to expect the indi-vidual who has it to bear the cost of enabling themselves to be a fully active citizen —they are politically disabled. In that case my fuzzy eyesight is not a bodily impairmentbecause it is not unreasonable to expect me to bear the cost of corrective lenses, andconsequently it is not a disability. This means, of course, that the idea of bodilyimpairment becomes a socially, politically, and indeed economically relational concept.This may not meet our need for philosophical coherence, but that is not what is atstake in the social model of disability. This is a political project, not a philosophical one.

5. Applied Philosophy

Terzi believes that the social model of disability over-socialises disability, and also,I think, suggests that in making all disability a matter of social oppression it over-politicises it. We have to re-connect disability to bodily impairment. My counter-suggestion is that far from over-socialising and over-politicising disability, the socialmodel may in fact not go far enough, in that bodily impairment itself must be socialisedand politicised. The social model is a political tool with a particular political project. Itmay be argued that the task of applied philosophers is to clarify matters, make themmore coherent and consistent, and, philosophically, there are gaps in the social model

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that need to be filled. However, applied philosophers must always ask themselves whatcontribution they are making to the political project of opposing oppression. Terzienvisages a society in which all social oppression in terms of disability has beenremoved, and points out that people would still have bodily impairments and thoseimpairments would still have significant effects on how they experience their lives. Asthe social model has nothing to say about this world, it is flawed. But this is a world inwhich the social model and its politicised concept of disability would have no work leftto do, and a completely new comprehension of bodily impairment and its social signifi-cance would be called for. It is not that the social model is flawed, but that it isdesigned for a particular purpose in a particular kind of society, one in which socialoppression through disability exists. For the foreseeable future the social model ofdisability has an important project to fulfil, and at least one aspect of the role ofapplied philosophers is to contribute to the success of that project.

Department of Philosophy, Middlesex University, Trent Park Campus, Bramley Road,London, N14 4YZ, UK. [email protected]

NOTES

1 M. Oliver, ‘If I had a hammer: the social model in action’, in J. Swain, S. French, C. Barnes andC. Thomas (eds) Disabling Barriers — Enabling Environments (London, Sage Publications, 2004).

2 Oliver, op. cit., pp. 11–12.3 L. Terzi, ‘The Social Model of Disability: A Philosophical Critique’, Journal of Applied Philosophy, 21.2

(2004): pp. 141–157.4 J. Glover, Choosing Children: The Ethical Dilemmas of Genetic Intervention (Oxford, Clarendon Press, 2006),

p. 6.5 Glover op. cit. p. 6.6 Terzi op. cit. p. 142.7 Terzi op. cit. p. 143.8 C. Thomas, ‘Disability and impairment’, in J. Swain, S. French, C. Barnes and C. Thomas (eds) Disabling

Barriers — Enabling Environments (London, Sage Publications, 2004), p. 21.9 Thomas op. cit. p. 22.

10 Terzi op. cit. p. 150.11 Terzi op. cit. p. 152.12 Terzi op. cit. p. 152.13 Terzi op. cit. p. 152.14 Terzi op. cit. p. 153.15 Terzi op. cit. p. 155.16 Terzi op. cit. p. 155.17 Glover op. cit. p. 12.18 Glover op. cit. p. 13.19 Terzi op. cit. p. 155.

the body politic: theorising disability and impairment

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