Disability Notes

Disability Notes
According to the Merriam-Webster dictionary, disability is defined as being
incapacitated or physically or mentally impaired in a way that substantially
limits major life activities like employment or education. However, this definition
can be reframed; what is often seen as a pathology can also be viewed as a gift, as
illustrated by the Japanese legend of Fukusuke, which emphasizes alternative ways
of being as productive and meaningful.

Charity Approach

Under the Charity Model, activities aim to ‘help’ people with disabilities who are
‘helpless’ and outside of ‘normal’ society.

●​ Disability is seen as a problem in the person. People with disabilities are

seen as ‘unfortunate’, ‘dependent’ or ‘helpless’; and generally regarded as
people who need pity and charity.
●​ The charity model assumes that people with disabilities cannot contribute to
society or support themselves; efforts and activities work mainly towards
providing them with money or gifts, such as food or clothing.
●​ In this model, people with disabilities become long-term recipients of
welfare and support; as well as aid provided by specialist organisations, but
never included in mainstream development.
●​ People with disabilities are viewed as a separate group away from the rest of
society, to be treated differently.
Medical Approach

Under the Medical Approach, activities aim to ‘fix’ person with disabilities, who
are ‘sick’, so they can join ‘normal’ society.

●​ Disability is seen a problem in the person.​

●​ This is the more traditional model of understanding disability, that focuses

on a person’s impairment as the obstacle to their full participation in society
and seeks to ‘cure’ or ‘improve’ individuals to ‘fit’ them into society.​

●​ The medical model defines people with disabilities only as a patient with
medical needs; and as such, still segregates people with disabilities from the
mainstream.​

●​ Only medical help is offered, carried out by specialists;​

 ●​ This is a generally expensive approach, that tends to benefit a relatively
smaller number of people with disabilities.​

●​ In the medical model, management of the disability is aimed at a "cure," or

the individual's adjustment and behavioral change that would lead to an
"almost-cure" or effective cure.​

●​ In the medical model, medical care is viewed as the main issue, and at the
political level, the principal response is that of modifying or reforming
health-care policy.​

Social or Rights-based model: Inclusive Approach

Under the Social or rights-based model, activities aim to address barriers in society
so that people with disabilities are able to fully participate in all aspects of
community life.

●​ The focus is shifted on inclusion as people with disabilities are part of

society, rather than separate. Systems, policies, processes and attitudes in
society are recognised as the problem to be fixed, adapted and changed, not
people with disabilities.
●​ The model argues that people are disabled by society denying their rights
and opportunities, and sees disability as the social consequences of having
an impairment or functional limitation.
●​ The rights of people with disabilities such as rights to education, life and
opportunities and their needs such as the need for belonging, community and
love, are the same as people without disabilities.
●​ The model emphasizes that activities should focus on identifying and
removing attitudinal, environmental and institutional barriers that block
inclusion.

Common sense allows that persons unable to handle a difficult problem can be
labeled “disabled.” Social analysis shows that being labeled often invites a public
response that multiplies the difficulties facing the seemingly unable. Cultural
analysis shows that disability refers most precisely to inadequate performances
only on tasks that are arbitrarily circumscribed from daily life. Disabilities are less
the property of persons than they are moments in a cultural focus. Everyone in any
culture is subject to being labeled and disabled.

EMPOWERMENT MODEL

The empowering model of disability allows for the person with a disability and
his/her family to decide the course of their treatment and what services they wish
to benefit from. This, in turn, turns the professional into a service provider whose
role is to offer guidance and carry out the client's decisions. In other words, this
model "empowers" the individual to pursue his/her own goals.

Under the Empowerment Model people with disabilities and their carers have a
right to fully understand the nature of that person’s disability/ies on any level;
where it is or isn’t experienced as their identity or selfhood, which parts the person
feels are strengths that need advocacy and appreciation and which parts the person
finds degenerative, painful or reducing their quality of life, which things they feel
require only acceptance, which require only advocacy, which they would prefer
some help managing or developing adaptations for, which parts they would like to
explore treatment for. The Empowerment model avoids emphasis on or direction
toward cure. It focuses not on their label/s but their personhood regardless of the
label/s that are experienced as integrated into, containing or constraining that
personhood. The only goal of the Empowerment model of disability is that of
empowering the individual. My Fruit Salad Model of autism is an example of the
Empowerment model. By having the ability to understand the ingredients in one’s
own disability/ies, one can choose to do with each part as one wishes. Embrace
what one wishes, advocate about what one wishes, or seek adaptations,
management or even treatment for what one finds overwhelmingly problematic.

Summary
●​ Definition and reframing: While disability is often defined as an impairment
that limits major life activities, it can also be seen as an alternative way of
 being with unique value (e.g., the Fukusuke legend), challenging
pathology-focused views.
●​ Charity model: Views disability as a personal tragedy; emphasizes pity,
dependency, and donations; keeps people separate from mainstream society
and as long-term welfare recipients.
●​ Medical model: Treats disability as an individual defect to be fixed or cured;
frames people as patients; relies on specialists; often costly and segregating;
policy focus is on healthcare reform.
●​ Social/Rights-based (Inclusive) model: Shifts the problem to societal
barriers; asserts equal rights and full inclusion; prioritizes removing
attitudinal, environmental, and institutional obstacles.
●​ Social/cultural insight: Labels can amplify disadvantage; “disability” is often
situational and culturally defined—everyone can be “disabled” depending on
context.
●​ Empowerment model: Centers self-determination; individuals and families
choose goals, supports, and treatments; professionals serve as guides;
emphasizes personhood over labels and prioritizes acceptance, advocacy,
adaptation, or treatment according to the person’s preferences—the core aim
is empowerment.
Designing Interventions: Legislations
Designing Interventions: Legislations

Designing interventions for people with disabilities often starts with a legal and
policy framework. In India, core legislations include:

●​ Rights of Persons with Disabilities (RPwD) Act, 2016: This ensures

equality, non-discrimination, accessibility, education, employment, and
social security for persons with disabilities. It mandates both central and
state governments to provide support measures, legal protections, and
rehabilitation opportunities, aiming for inclusion rather than just care or
charity.
●​ Other important acts: The Persons with Disabilities (Equal Opportunities,
Protection of Rights and Full Participation) Act, 1995, and the National
Trust Act, 1999, focus on equal opportunities and protections. There are also
schemes for aids, barrier-free environments, and incentives for employment.

Such laws don’t just provide rights—they shape how interventions (educational,
rehabilitative, economic, or psychological) are designed, ensuring respect for
autonomy and dignity.

Psychotherapeutic Approaches

Psychotherapy for individuals with disabilities should be adapted to their unique

needs and experiences. Key points include:

●​ Personalized Therapy: Approaches like Cognitive Behavioral Therapy

(CBT) and Exposure and Response Prevention (ERP) are found effective in
helping people cope with thoughts and emotions related to disability.
Techniques are modified by therapists to consider the specific challenges,
experiences, and strengths of each person.
●​ Inclusive and Strength-based: Therapy emphasizes understanding the
person's lived experience, respecting their knowledge about their disability,
and using inclusive language. Therapists help clients identify barriers,
leverage their strengths, and set realistic, adaptive goals.​
Overall, psychotherapeutic interventions should be flexible, individualized, and
respectful of the person’s context and preferences.

Appreciating Heterogeneity of Different Disabilities

Disabilities vary widely—not just from one category to another (e.g., physical,
sensory, intellectual, or psychiatric), but also within each group:

●​ Heterogeneity: Even people with the same diagnosis (like autism) may have
very different challenges, strengths, and needs. This diversity is due to
variations in symptoms, causes, and personal circumstances.
●​ Subgroups and Tailored Support: Recognizing heterogeneity means not
treating all individuals under a single label the same way. Instead,
interventions try to identify subgroups with similar needs to provide more
effective, targeted support.
●​ Practical Approach: Instead of a "one-size-fits-all" method, interventions
appreciate differences, foster individual assessment, and align supports with
each person’s unique capabilities and challenges.

Contemporary Debates: Euthanasia and Prenatal Selection

These debates highlight changing ethical, legal, and social attitudes in society:

●​ Euthanasia in India: Only passive euthanasia (withdrawal of life-sustaining

treatment in certain conditions) is legal under complex Supreme Court
guidelines. The debate focuses on autonomy (right to die with dignity)
versus ethical concerns (sanctity of life, risk of coercion, possible abuse),
especially among vulnerable groups like the disabled or elderly. Access is
often hindered by legal, cultural, and procedural obstacles.
●​ Prenatal Selection: In India, sex-selective abortion and prenatal selection
remain pressing issues, leading to a demographic imbalance. The debate
here is about the ethical implications of allowing parents to select certain
traits (such as gender), potentially increasing discrimination against
particular groups (e.g., girls or those with disabilities). These choices are
influenced by cultural, social, and economic pressures, and reflect
deep-rooted gender and ability biases.
Both these debates force society to confront questions about autonomy, dignity,
bias, and the value placed on different lives.

Types of euthanasia

Euthanasia, the act of deliberately ending a person's life to relieve suffering, can be
classified in several ways based on consent and the method used.

Based on Consent

●​ Voluntary Euthanasia: The person chooses and consents to end their life,
often with the help of a medical professional. This is usually at the explicit
request of the patient.
●​ Non-voluntary Euthanasia: The person is unable to give consent (for
example, they are in a coma or have a severe intellectual disability). Here, a
decision is made on their behalf, ideally following previous wishes or the
supposed best interest of the individual.
●​ Involuntary Euthanasia: The person is capable of giving consent but does
not do so, or is against it, and still, their life is ended; this is generally
considered murder or unethical killing.

Based on Method

●​ Active Euthanasia: This involves directly causing the person's death

through an action, such as administering a lethal injection or drug dose. The
death is a direct result of this intervention.
●​ Passive Euthanasia: This involves withholding or withdrawing treatments
that are necessary to sustain life, such as turning off life-support machines or
stopping medication, allowing the person to die naturally from their illness
or condition.

Other Types

●​ Indirect Euthanasia: This refers to providing treatments (like strong

painkillers) that relieve suffering but may also hasten death as an unintended
side effect. The primary intention is pain relief, not ending life, but death can
be an accepted consequence.
●​ Assisted Suicide: While not technically the same as euthanasia, this
involves a person intentionally providing someone with the means to end
their own life, typically by prescribing lethal medications the person takes
themselves.​