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Disability

Impairments, activity limitations, and participation restrictions

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long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder [a person's] full and effective participation in society on an equal basis with others.

Disabilities have been perceived differently throughout history, through a variety of different theoretical lenses. There are two main models that attempt to explain disability in our society: the medical model and the social model. The medical model serves as a theoretical framework that considers disability as an undesirable medical condition that requires specialized treatment. Those who ascribe to the medical model tend to focus on finding the root causes of disabilities, as well as any cures—such as assistive technology. The social model centers disability as a societally-created limitation on individuals who do not have the same ability as the majority of the population. Those who ascribe to the social model tend to focus on accessibility and social/cultural attitudes toward disability. Although the medical model and social model are the most common frames for disability, there are a multitude of other models that theorize disability.

Like many social categories, the concept of "disability" is under heavy discussion amongst academia, the medical and legal worlds, and the disability community. There are many terms that explain aspects of disability. While some terms solely exist to describe phenomena pertaining to disability, others have been centered around stigmatizing and ostracizing those with disabilities. Some terms have such a negative connotation that they are considered to be slurs. A point of contention is whether it is appropriate to use person-first language (i.e. a person who is disabled) or identity-first language (i.e. a disabled person) when referring to disability and an individual.

Due to the marginalization of disabled people, there have been several activist causes that push for equitable treatment and access in society. Disability activists have fought to receive equal and equitable rights under the law—though there are still political issues that enable or advance the oppression of disabled people. Although disability activism serves to dismantle ableist systems, social norms relating to the perception of disabilities are often reinforced by tropes used by the media. Since negative perceptions of disability are pervasive in modern society, disabled people have turned to self-advocacy in an attempt to push back against their marginalization. The recognition of disability as an identity that is experienced differently based on the other multi-faceted identities of the individual is one often pointed out by disabled self-advocates. The ostracization of disability from mainstream society has created the opportunity for a disability culture to emerge. While disabled activists still promote the integration of disabled people into mainstream society, several disabled-only spaces have been created to foster a disability community—such as with art, social media, and sports.

History

Contemporary understandings of disability derive from concepts that arose during the scientific Enlightenment in the West. Prior to the Enlightenment, physical differences were viewed through a different lens.

Antiquity

Historically, scholars have often assumed that disabled individuals were unsupported and marginalized within their communities, based on the belief that ancient agricultural societies had to be strategic with their limited resources for survival. For instance, some historians argue that ancient Greeks actively practiced ableism through infanticide, as suggested in the writings of Plutarch, Plato, and Aristotle. Despite this, ancient Greeks demonstrated notable empathy and acceptance toward their disabled peers, contrary to the views presented in the writings of Plato and Aristotle. Literary accounts from Hippocratic physicians and archaeological evidence support the idea that the Greeks made efforts to cure and assist disabled individuals, including deformed infants, whom Plutarch claimed were promptly killed in Sparta. Since disability was not uncommon, it was frequently mentioned in literature and poetry. Disabled individuals, regardless of social rank, were largely integrated into society thanks to the variety of roles and duties available in personal life, the economy, and the military. As a result, these writings represent the philosophical ideals of Greek thinkers and do not necessarily reflect the actual practices of ancient Greece, as neither work was intended to serve as factual records.

In "The Life of Lycurgus" of Parallel Lives, Plutarch's describes infanticide as a common practice in Sparta, where the lawgiver decreed that newborn infants be taken to the lesche, likely a public building, for examination by elders. If an infant was "ill-bred and deformed", it would be sent to the apothetai, meaning "exposure places", a pit beneath Mount Taygetus. Plutarch suggested this practice occurred because a deformed infant would be seen as a liability to Sparta, a city-state known for its strict martial ethos. While Plutarch's account provides valuable insights into Spartan society, its reliability is questionable, as he lived 700 years after the events he described. Even Plutarch acknowledged that his accounts were open to dispute for this very reason. In Republic, Plato argues that in an ideal state rulers must ensure the breeding of the best men and women while discouraging those deemed inferior from reproducing. He asserts that if the children of inferior parents, or any other parents, were deformed, they should be "hidden away in a secret and unknown place, as is fitting." In Politics, Aristotle advocates that "the bodies of offspring should conform to the wishes of the lawgiver", ideally being healthy and strong, which implies a similarly ableist stance to that of Plato. He further proposes that a law should exist to prevent the raising of deformed infants, implying his endorsement of killing disabled infants.

There is considerable evidence suggesting that individuals with deformities were well cared for in antiquity. At the Windover Archeological Site, one of the skeletons was a male about 15 years old who had spina bifida. The condition meant that the boy, probably paralyzed below the waist, was taken care of in a hunter-gatherer community. Disability was not viewed as a means of divine punishment and therefore disabled individuals were neither exterminated nor discriminated against for their impairments. Many were instead employed in different levels of Mesopotamian society including working in religious temples as servants of the gods. In Ancient Egypt, staffs were frequently used in society. A common usage for them was for disabled people there to help them walk.

In Ancient Greece, regardless of gender, age, or rank, deformed citizens were largely acknowledged, embraced, and accommodated in various aspects of society. This is illustrated in the Hippocratic Corpus, a collection of treatises written by physicians during the late 5th and 4th centuries BCE as a practical manual. Therefore, it offers a more accurate depiction of how the Greeks treated disabled people. For instance, many of the treatises describe the conditions and treatments for infants with congenital anomalies or impairments, such as weasel-arm, clubfoot, and cleft conditions. Ironically, among these, the practice of infanticide or the harming of deformed infants is never mentioned. In fact, these Hippocratic physicians treated a wide range of patients throughout the Greek-speaking world from the 5th century BCE onwards. This suggests that it may not have been normal in ancient Greece to kill deformed infants, presenting a reality that contrasts with the views of Plato, Aristotle, and other ancient philosophers. Many of them expressed neutrality, if not optimism, toward deformed infants, striving to cure them while documenting their conditions.

The depiction of disabled adults or gods was common in the literature of ancient Greece. In Homer's Iliad and Odyssey, Hephaistos, a god and renowned craftsman, is described as being "lame in both legs", and he is mentioned 41 times in the Iliad and 19 times in the Odyssey. In Book 2 of the Iliad, Homer provides a detailed description of Thersites' deformity, including his bandy legs, lame foot, hunched shoulders, and balding pate, calling him "the ugliest man who came beneath Ilion". This suggests that ancient Greeks acknowledged disabled adult civilians, as disability, whether congenital or acquired, was common due to the harsh realities of ancient life and warfare. In addition to literary evidence, archaeological evidence is crucial in unfolding ancient Greeks' attitude towards deformed individuals. One that is most related to the discussion of infanticide in Ancient Greece is the Agora Bone Well, in which archaeologists found a large number of skeletons, including those of infants. Since the median age at death for these infants was only eight days old, it gives rise to the assumption that infanticide could be a possible explanation; however, scholars cannot determine whether the infants were intentionally killed or whether they died of natural causes, which was particularly common, especially during the first eight days after birth.

Archaeologists have discovered a significant number of feeding bottles throughout the Hellenic world, dating back to the Late Bronze Age. Many of these were found in the tombs of infants and young children. While scholars debate whether these bottles were used as aids for weaning infants or as symbols of condolence with no practical purpose, the shape of the bottles is particularly suited for feeding infants with cleft conditions. Depending on the severity, such infants would have had difficulty extracting milk from a nipple. This suggests that the ancient Greeks may have invested extra care and resources in raising disabled infants, rather than killing them. Contrary to previous beliefs, Greek men with disabilities or physical infirmities were generally exempt from military campaigns and battles. In Memorabilia, Xenophon suggests that men with bodily weakness or illness were considered liabilities in battle. Additionally, during the Battle of Thermopylae, the Spartan king and commander Leonidas excused Eurytus and Aristodemus from fighting, as both of them were suffering from severe eye sickness, demonstrating that men unfit for war were not forced to participate. In exceptional cases, disabled or injured men might be called upon to take on suitable roles that would contribute to the war effort.

In terms of personal life, there is no evidence to suggest that disabled Greeks were barred from marriage or reproduction. This likely stemmed from the belief that deformed parents did not necessarily produce deformed offspring; however, disabled individuals may have faced greater challenges in finding a suitable partner, as they were sometimes rejected by the family of a potential spouse. Regarding their economic situation, disabled Greeks—regardless of gender or social rank—worked in a variety of positions and professions. According to Lysias, a disabled man who uses two canes to walk "plies a craft" and runs a shop, demonstrating that disabled individuals were not deprived of the ability to support themselves. In On Joints, Hippocrates describes people with arm disabilities also being engaged in "handiwork", provided they were still able to operate tools. Plato also mentions in Laws that slaves who acquired disabilities later in life could be reassigned to other suitable roles, a principle that logically should also apply to free individuals in Greece.

Ancient Greeks were subjected to a wide range of physical consequences of aging, causing impairments and disabilities. Therefore, ancient Greeks put great effort into assisting elderly people in their communities. In some Greek states, children were legally required to care for their elderly parents, which might have included parents who were physically or mentally impaired. According to Aristotle, people who failed to do so would be imprisoned. Provisions that enabled individuals with impaired mobility to access temples and healing sanctuaries were made in ancient Greece. Specifically, by 370 BC, at the most important healing sanctuary in the wider area, the Sanctuary of Asclepius at Epidaurus, there were at least 11 permanent stone ramps that provided access to mobility-impaired visitors to nine different structures. On top of this, disabled Athenians who were unable to support themselves received monetary assistance from the state, sufficient to cover their basic needs. This indicates that some forms of charity and social welfare existed in Athens. Disability was also common among individuals of high status in ancient Greece. In the 6th century BCE, Croesus, the King of Lydia, had two sons, one of whom was either deaf or mute. He spent a considerable amount of wealth in an unsuccessful attempt to cure this son, even consulting the oracle of Apollo at Delphi. Eventually, Croesus rejected the disabled son, choosing to favor only his able-bodied son, Atys, instead. Similarly, Agesilaus, a Spartan king in the 4th century BCE, was lame in one leg but still became a general and fought in major battles. The Macedonian king, Philip II, also suffered from multiple physical impairments during his conquests; he lost one eye, fractured his collarbone, and shattered one hand and leg.

Middle Ages and After

During the Middle Ages, madness and other conditions were thought to be caused by demons. They were also thought to be part of the natural order, especially during and in the fallout of the Black Death, which wrought impairments throughout the general population. In the early modern period there was a shift to seeking biological causes for physical and mental differences, as well as heightened interest in demarcating categories: for example, Ambroise Pare, in the sixteenth century, wrote of "monsters", "prodigies", and "the maimed". The European Enlightenment's emphases on knowledge derived from reason and on the value of natural science to human progress helped spawn the birth of institutions and associated knowledge systems that observed and categorized human beings; among these, the ones significant to the development of today's concepts of disability were asylums, clinics, and prisons.

Contemporary concepts of disability are rooted in eighteenth- and nineteenth-century developments. Foremost among these was the development of clinical medical discourse, which made the human body visible as a thing to be manipulated, studied, and transformed. These worked in tandem with scientific discourses that sought to classify and categorize and, in so doing, became methods of normalization. The concept of the "norm" developed in this time period, and is signaled in the work of the Belgian statistician, sociologist, mathematician, and astronomer Adolphe Quetelet, who wrote in the 1830s of l'homme moyen – the average man. Quetelet postulated that one could take the sum of all people's attributes in a given population (such as their height or weight) and find their average and that this figure should serve as a statistical norm toward which all should aspire. This idea of the statistical norm threads through the rapid take-up of statistics gathering by Britain, the United States, and the Western European states during this time period, and it is tied to the rise of eugenics. Disability, as well as the concepts of abnormal, non-normal, and normalcy, came from this. The circulation of these concepts is evident in the popularity of the freak show, where showmen profited from exhibiting people who deviated from those norms.

With the rise of eugenics in the latter part of the nineteenth century, such deviations were viewed as dangerous to the health of entire populations. With disability viewed as part of a person's biological make-up and thus their genetic inheritance, scientists turned their attention to notions of weeding such as "deviations" out of the gene pool. Various metrics for assessing a person's genetic fitness were determined and were then used to deport, sterilize, or institutionalize those deemed unfit. People with disabilities were one of the groups targeted by the Nazi regime in Germany, resulting in approximately 250,000 disabled people being killed during the Holocaust. At the end of the Second World War, with the example of Nazi eugenics, eugenics faded from public discourse, and increasingly disability cohered into a set of attributes to which medicine could attend – whether through augmentation, rehabilitation, or treatment. In both contemporary and modern history, disability was often viewed as a by-product of incest between first-degree relatives or second-degree relatives.

Disability scholars have also pointed to the Industrial Revolution, along with the economic shift from feudalism to capitalism, as prominent historical moments in the understanding of disability. Although there was a certain amount of religious superstition surrounding disability during the Middle Ages, disabled people were still able to play significant roles in the rural production based economy, allowing them to make genuine contributions to daily economic life. The Industrial Revolution and the advent of capitalism made it so that people were no longer tied to the land and were then forced to find work that would pay a wage in order to survive. The wage system, in combination with industrialized production, transformed the way bodies were viewed as people were increasingly valued for their ability to produce like machines.

In the early 1970s, the disability rights movement became established, when disability activists began to challenge how society treated disabled people and the medical approach to disability. Due to this work, physical barriers to access were identified. These conditions functionally disabled them, and what is now known as the social model of disability emerged. Coined by Mike Oliver in 1983, this phrase distinguishes between the medical model of disability – under which an impairment needs to be fixed – and the social model of disability – under which the society that limits a person needs to be fixed.

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