Impairment – Any loss or abnormality of psychological, physiological or anatomical structure or function.
Disability – Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.
Handicap – A disadvantage for an individual, resulting from an impairment or disability, that limits or prevents the fulfilment of a role (depending on age, sex, social and cultural factors) for that individual.²

This set of definitions was designed to address ‘loss or abnormality’ due to impairments. These impairments are measured by a medical diagnosis concerning ‘psychological, physiological or anatomical structures’. Disability is defined as directly resulting from impairment and is seen in terms of inability to perform various activities. The problematic term ‘handicap’ then defines any disadvantage that a disabled person experiences due to inability to fulfil a role that society assumes to be normal for a human being. It is this explicit focus on the individual and their impairment, from which disability and handicap are assumed to arise, which led this set of definitions sometimes being referred to as the Individual/Medical Model of Disability.³
 

By way of illustration the medical condition that I have, spina bifida, is the described as an impairment. My disability refers to my inability to walk which is a direct result of my impairment. My handicap [sic] is the disadvantage that I experience due to my disability, which in turn arises from my impairment. So any discrimination that I experience is understood to have its root cause in the medical condition which I was born with.

Within this understanding of disability the ‘solution’ to the so-called problem of disability has been focussed on ‘normalising’ the disabled person so that they can fit into and live within mainstream non-disabled society. For example, considerable research, time, money and effort is focused on restoring the ability of a particular person to walk after an accident or illness. While this does have some positive outcomes, it is possible that the use of a wheelchair may be more realistic.

Changes in society from the eighteenth to mid-twentieth centuries resulted in an intentional distancing of disabled people from mainstream, non-disabled society. This has occurred throughout community life: from housing, education and work to social spaces, including churches. Consequently, highly asymmetrical relationships between empowered non-disabled and disempowered disabled people permeated society.⁴

This model significantly affected the experiences of disabled people throughout the nineteenth and twentieth centuries. Although there was a significant shift in the understanding of disability during the latter part of the twentieth century, there are aspects of this model that continue to shape contemporary understandings of disability.

The idea that disability is located in an individual, directly related to illness, injury or congenital impairment, persists. This may lead to disabled people being referred to by their medical condition. For instance, I have been referred to as ‘the wheelchair’ by railway staff requesting platform assistance, as in, ‘There’s a wheelchair on its way to the platform that needs assistance.’ The group of disabled people with spina bifida who were operated on by the same surgeon as I were referred to for many years as ‘Mr Nash’s back’. This objectifies disabled people and sees the relationship with non-disabled people in terms of ‘I-It’ rather than ‘I-Thou’. The perception remains that disabled people need to be cured or healed through medical or scientific advances to make them ‘normal’, as does the assumption that disabled people are passive recipients of care and support from active non-disabled people.⁵ The assumptions about disabled people being reliant on others has also been perpetuated by some charities, voluntary groups and other organisations run by non-disabled people for disabled people. All of these factors may reinforce the idea that disabled people must conform to the ‘sick role’ of being a patient with an illness. For example, many concessions for disabled people provide a free or discounted admission for their ‘carer’ rather than ‘companion’.

The implications of this understanding of disability for churches are outlined in a related article on this website.
 

 

Creamer, D. B. (2009). Disability and Christian Theology: Embodied limits and constructive possibilities: Oxford University Press.
Goodley, D. (2010). Disability studies: an interdisciplinary introduction (First ed.). London: SAGE.
Jacobs, N. L. (2019). The Upside-down Kingdom of God: A Disability Studies Perspective on Disabled People’s Experiences in Churches and Theologies of Disability. SOAS University of London.  
Oliver, M. (1989). 'Disability and dependency: A Creation of Industrial Societies'. In L. Barton (Ed.), Disability and dependency (pp. 6-22). London: Falmer Press.
Swain, J., French, S., & Cameron, C. (2003). Controversial issues in a disabling society. London: Routledge.
WHO. (1980). International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of disease; publ. for trial purposes in accordance with resolution WHA29. 35 for the Twenty-ninth World Health Assembly, May 1976. Geneva: World Health Organization.
 

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1  The Medical Model of disability has largely been replaced by The Social Model which is described in a related article on this website.
2  (WHO, 1980, pp. 27-29).
3  (Creamer, 2009, pp. 22-25) outlines and critiques the Individual/Medical Model of Disability.
4  Oliver argues that dependency of disabled people arises from industrialisation and its impacts: (Oliver, 1989).
5  (Goodley, 2010, p. 7; Jacobs, 2019, pp. 44-50, 143-174, 192-202; Swain, French, & Cameron, 2003, pp. 22-24)