Disability in Terms of Normal Human Functioning - Essay Example

Should We Understand Disability in Terms of Normal Human Functioning? Zahraa Almatrouk Institution MDSC 205 Disability in Terms of Normal Human Functioning The definition of disability is greatly contentious for many reasons. First, the term has historically been used to negatively depict a distinct category of people. Second, it has widely been deployed to depict a state of inability or to refer to legally imposed restrictions on powers and rights (Boorse, 1977). Arguing on the basis of these conflicting perspectives, it is critical to observe that settling on a proper meaning of the term “disability” calls for philosophical inquiry. Indeed, certain different aspects and features are regarded as disabilities, namely deafness, epilepsy, paraplegia, depression, autism, and diabetes. According to Jette (2006), the term covers varied conditions that signify congenital absence or an extrinsic loss of sensory function. It also refers to neurological conditions that are progressive, such as arteriosclerosis, and to the limited ability or inability to undertake such cognitive functions. Based on this definition, it is clear that there is little focus or emphasis on the functional status of individuals with these disablements to justify the idea that disability should be understood in terms of normal functioning. Therefore, this essay argues that disability should be understood in terms of normal human functioning. Standard definitions of disability offer contradictory concepts on disability. Anand and Hanson (1997) argued that an analysis of disease, based on disability, has to be broad enough to cover minor diseases such as eczema. Additionally, it must cover disabilities such as colour blindness and a cat’s ability to see in the dark. Further, it must count adults to be abnormal if they cannot walk, but not babies. The standard definitions for disability, however, do not meet these tests. Essentially, it is clear that disability should not be depicted as abnormal human functioning. Arguing on the basis of disease, aside from universal environmental injuries, diseases refer to internal conditions that inhibit functional abilities. On the other hand, health is depicted as freedom from disease, which therefore constitutes statistical normality of function. This implies that an individual has the capacity to perform all normal physiological functions with some distinctive efficiency. Disease is generally depicted as the absence of a health or anything that contradicts health. If this perspective should be taken, then disability could be understood in terms of normal functioning. However, an underlying problem in the philosophy of medicine is breaking from the norm with a substantial analysis of either health or disease. Disabilities cannot be generalised as conditions that require medical treatment. Arguing on the basis that value and disvalue in health denote occurrence of disease, Boorse (1977 defined health as something that is valuable or desirable. Hence, physical health is the state of physical welfare or well-being. Despite this, Boorse demonstrated that a wide range of undesirable physical conditions exists that limits an individual’s well-being and cannot be categorised as diseases within the medical context because they do not require medical attention, treatment, or intervention. To this end, it is critical to argue that just because it is generally undesirable to avoid being below average in any physical physiognomy or quality that is valued, this does not signify that lacking desirable qualities amounts to disability. Anand and Hanson (1997) argue that the attribute of undesirability alone does not justify the rationale that disability is a disease or abnormal body functioning. Hence, having physical disconformities or disabilities cannot be categorised as a lack of normal functioning or health. Burgdorf (1997) argued that doctors treat undesirable conditions, hence undesirable conditions or a lack of normal functioning require medical attention. Therefore, disabilities cannot be generalised as conditions that require medical treatment. As a result of broad variations, disability cannot be interpreted in statistical terms. Based on his argument, within the context of statistical normality, Boorse (1977) argued that in clinical terms, pathological conditions or diseases refer to conditions that are abnormal. Accordingly, because healthy conditions are normal conditions, several variables can be applied to explain them. For instance, while diseases or pathological conditions are interpreted statistically, disabilities are not. For instance, “normal,” or medical variables such as weight, height, blood pressure, and basal metabolism, consist of the variables whose statistical analysis depict particular ranges of normal variation. The concept of disability is wide enough and covers the field of disease. Because some diseases may cause physical suffering, some might also cause disability. According to Boorse (1977), disease consists of the aggregate of conditions that, based on their prevailing culture, are perceived to be disabling, painful, and which may simultaneously deviate from some idealised status or statistical norm. Aspects of interest, upon which this essay bases its argument, are “deviation from statistical norm and idealised status.” This essay, however, takes the perspective that health is normal functioning, and the condition of being normal is based on statistical biological functions. Based on the argument that pain, discomfort, and suffering denote the existence of a disease, it is impossible to argue on the basis that disability should be understood in terms of normal functioning. According to Boorse (1977), discomfort and pain contraindicate health. Boorse argued that, within the medical field of practice, patients who seek medical attention when they experience pain, discomfort, or suffering are often diagnosed with an illness. Based on Jette’s (2006) idea that, in medicine, health is defined as a total absence of distress that is subjective in nature, it cannot be argued that disability should be viewed in terms of health or normal functioning. The basis of this argument is that disability, pain, and suffering are not inherent characteristics of disability. Disability reduces an individual’s ability as a result of discrimination or stigma rather than personal homeostatic functioning. Boorse (1977) used the term homeostasis, which is excessively used within the medical field, to denote normal functioning or health. He observed that the positive functioning of a homeostatic regulating mechanism has been used increasingly in the medical field to depict good health. On the other hand, homeostatic failures indicate abnormal physiology. Homeostasis consists of processes used by living things to mina relatively stable internal conditions essential for survival. Somayaji (1994) explained that in homeostasis, individuals are able to maintain steady body temperature levels and other necessary conditions, such as sugar, water, pH, oxygen, fat and protein content of the blood motivations and stresses. Hence, all biological systems need to maintain an internal state that is relatively stable by responding to and tracking changes in the internal and external body environment. The process of self-monitoring describes homeostasis. Taking this into perspective, it is vital to observe that since individuals with disability such as deafness or lameness can still have the self-monitoring ability that ensures efficient operation of the various chemical and mechanical systems, they cannot be termed as suffering from ill health or a disease. Rodolfo (2000) explained that aside from health science, the term homeostasis has found extensive use in social sciences to describe how an individual who is under conflicting motivations and stresses is able to maintain stable psychological conditions. An individual who would not be able to maintain such conditions would be under the state of ill-health. In respect to persons with disability, it is generally agreeable that since they are able to maintain stable psychological conditions, they cannot be termed as having ill-health or a disease. Taking this perspective, it is convenient to argue that disability does not fit into the category of a disease or ill health. For instance, an individual with deafness may generally have properly functioning homeostatic processes. Hence, disability reduces the individual’s ability because of discrimination or stigma rather than personal homeostatic functioning. To this extent, the concept of disability can be viewed as race or gender within the context of philosophy, because it is concerned with the classification of individuals based on inferred or observable characteristics. Some philosophers have argued that the answer is the same as the questions of gender or race. Hence, it is discrimination and the stigma associated with the state of being disabled that reduces an individual’s well-being. If this perspective is taken then it should be argued that because people from a distinct race that is dominant cannot be perceived to be diseased on the basis of their uniqueness then disability cannot be understood in terms of normal human functioning. Because adaptation does not imply freedom from disease, an individual’s inability to adapt does not imply ill-health or existence of a disease. Based on the concept of adaptation, arguing that disability should not be understood on the basis of disability, Boorse (1977) noted that adaptation may be imposed by a positive ideal of maximum improvement of the abilities that are beneficial in each individual’s unique circumstances. According to Boorse, one may develop negative features that may have positive implications for others. Hence, disability cannot be understood in terms of normal functioning. To support this perspective, Anand and Hanson (1997) argued that all forms of abilities, such as running or tightrope walking, may improve an individual’s ability to live well in certain environments (Anand & Hanson, 1997). However, it does not imply that lacking such abilities would denote some pathological infection. There is no deficit in individuals with disabilities because nothing keeps the individual from being normal. This argument is based on the perspective that “normal” is a value-based perspective (Pfeiffer, 2002). Amundson (2000) offers an outstanding analysis of the concepts of “normal” and “abnormal.” According to Amundson, the two concepts form the foundation of the deficit model of disability. He argued that abnormal and normal consist of social judgments of what should and should not be considered acceptable biological functioning or variations. When individuals are classified as abnormal, the two value judgments are applied in justifying the disadvantages that confront individuals with disabilities. Disability should therefore not be used to refer to a certain deficit in a person. Pfeiffer (2002) argues that it should instead refer to value judgments that describe something not done in a certain acceptable way. The researcher used this perspective to demonstrate that, just as race is not a viable term biologically and has no scientific definition, so is the case with disability. Disability is therefore not based on health condition, normality, or functionality, but rather on value judgements concerning functioning, health, and normality. In this case, the term disability is based on social class and ideology. Amundson (2000) pointed to the conception that normal function has no basis in objective biological fact. The term “disability” is based on social construct, hence it has no objectivity. This perspective is also supported by critics such as Barton and Oliver (1997) and Davis (2002), who discredited the social—and medical—model, based on the duality between social limitations and biological impairment. According to Davis (2002), the argument of impairment does not hold because it is a social construction that classifies individuals based on the barriers they face. In addition, the biomedical rationale for categorising a variation on the basis of impairment is disputable because of the shifts in classification or the medicalisation of certain conditions, such as shyness, or the demedicalisation of conditions, such as lesbianism. By contrast, social environment plays an integral role in determining and creating certain impairments such as learning disabilities or dyslexia (Davis, 2002). Therefore, it can be argued that what is regarded as impairment to one may depend on the variation that appears to be unfavourable in a salient or familiar environment, or even on the variations susceptible to social prejudices. This perspective is developed by Silvers’ (2000) argument that less-than-average height is willingly classified as an impairment, compared to greater-than-average height, because the former is more unfavourable to individuals in environments that tend to favour individuals with average height. Based on this analysis, it is critical to argue that because adaptation does not imply freedom from disease, the inability to adapt is not a disability. On the other hand, if the arguments presented by Amundson (2000) hold, disability can still be understood in terms of normal human functioning. Amundson argued that disability is substantially different from gender or race because it reduces well-being and, to some extent, quality of life. According to Burgdorf (1997), even in an ideally perfect world where there is no discrimination, people with deafness, paraplegia, and blindness would be more disadvantaged than their able-bodied colleagues. Several models delineate the definition of disability. According to the medical model, disability should be perceived as an attribute or characteristic of an individual that has directly been triggered by trauma, disease, or some other health condition, and which needs certain types of intervention to correct or compensate for the problem (Jette, 2006). The social model of disability suggests that the fundamental problem results from an inflexible or unaccommodating environment because of the attitudes or features of the physical and social environment, hence calling for a philosophical response or solution. Lastly, the biopsychosocial model views disability as resulting from personal, biological, and social forces. Interactions between these underlying factors cause disablement (Jette, 2006). Amundson’s (2000) perspective is based on the medical and social model, where the disadvantages that disabled people experience are either assessed as normal or abnormal, terms derived from biology. Extensive empirical evidence has indicated that individuals with severe disabilities report a lower quality of life compared to those with normally functioning physical and mental features (Chen, 2007). Additionally, there are many differences among individuals with disabilities, regarding their bodily conditions and experiences, in the same way it is to people who lack disability. Some related studies have also indicated the question of biological normality and the relative quality of life among individuals with disability and those without (Chen, 2007). Amundson (2000) pointed out that individuals with disabilities experience reduced opportunities and relates them to the concept that the “abnormal are disadvantaged.” Conclusion To a greater extent, disability should be understood in terms of normal human functioning. Standard definitions of disability offer contradictory concepts of disability. Disabilities cannot be generalised as conditions that require medical treatment. Because of broad variation, disability cannot be interpreted in statistical terms. The concept of disability is wide enough and covers the field of disease. Based on the argument that pain, discomfort, and suffering denote the existence of disease, it is impossible to argue that disability should be understood in terms of normal functioning. Disability reduces an individual’s abilities because of discrimination or stigma rather than personal homeostatic functioning. Because adaptation does not imply freedom from disease, the inability to adapt is not a disability. There is no deficit in individuals with disability. The term disability is based on social constructs and thus offers no objectivity. References Amundson, R. (2000). Against Normal Function. Studies in History and Philosophy of Biological and Biomedical Sciences, 31(1), pp. 33–53 Anand, Sudhir; Hanson, Kara. (1997) Disability Adjusted Life Years: A Critical Review. Journal of Health Economics, 16(6): 685-702 Barton, L & Oliver, M. ed. (1997). Disability Studies: Past, Present and Future. Leeds: The University of Leeds Boorse, C. (1977). Health as a Theoretical Concept. Philosophy of Science, 44(4), 542-573 Burgdorf, Robert L. Jr. (1997). "Substantially Limited" Protection from Disability Discrimination: The Special Treatment Model and Misconstructions of the Definition of Disability. Villanova Law Review, 42: 409-585. Chen, J. (2007). Functional Capacity Evaluation & Disability. Iowa Orthop J. vol. 27, p.121–127 Davis, N. (2005). “Invisible Disability.” Ethics, 116(1): 153–213. Rodolfo, K. (2000). “What is homeostasis?” Scientific American. Retrieved: Jette, A. (2006). Toward a Common Language for Function, Disability, and Health. Physical Therapy 86(5), 726-734 Pfeiffer, D. (2002). The Philosophical Foundations of Disability Studies. Disability Studies Quarterly 22(2), 3-23 Silvers, A. (2000). Philosophy & Disability: an overview. Retrieved: Somayaji, A. (1994). Operating System Stability and Security through Process Homeostasis. Albuquerque: The University of New Mexico Read More