The social model of disability posits that disability is caused by the systematic and social barriers that cause exclusion from daily living. This is in response (and contrast) to the traditional medical model, which views disability as inherent to the structures of a body.

The difference between the two, however, is not just a matter of optics. The medical model is a functional analysis, which insists that the solution to disability is to “fix” the biomechanistic “defects” of the disabled body. While the social model acknowledges impairment, it emphasizes that the inaccessible structures of environments, organizations, and interpersonal attitudes are in need of reform more than the individual body is in need of “treatment.” 

Illness as Disability

Though few doubt the efficacy of conventional biomedicine in treating illness, the social model can help us better understand illness as a social phenomena. Traditionally, illness is an anatomico-pathological fact; every disease has a causal entity that disrupts our physiological processes, manifesting as symptoms. This etiological agent can then be found, identified, and treated. 

Reading illness through the social model will tell us that sickness is functional, but not because of this structural change alone; rather, it disrupts our ability to interact regularly with our life worlds. A sore throat makes conversation onerous, a cough interrupts our sleep, or a headache stops us from reading. Health, in its many definitions, might be thought of as our un-self-conscious flow through daily life, operating smoothly and thus taken for granted. Illness, then, is the disruption (and sometimes total obstruction) of this flow. It brings to the fore the demands of our bodies, no longer in effortless unity with our sense of self. 

To illustrate, consider the case of a benign but foreign entity. Somehow, this invader has bypassed your body’s natural defenses, and permeates every cell of your body. Even if this doesn’t affect your daily functionings, going unnoticed in your ability to interact with your world as “symptomless,” a biomedical model might still want to hunt (and hope to destroy) this alien item. A keen observer might point out that the mitochondria, a structure shared by all of our cells, fits such a description; by the theory of endosymbiosis, the mitochondria may very well have been an independent bacterium that was engulfed by a host cell and now continues to live within us. Because the presence of mitochondria has been normalized, much of our functioning incorporates their effect. Scientific research is even being done on the role mitochondrial dysfunction has in the pathology of Chronic Fatigue Syndrome. 

Why the Social Model?

This is not to say that we should forget the medical model entirely; our most usual illnesses, such as the flu, coronavirus, and strep throat, all very much have causal agents which we should treat. Too often, however, the medical model focuses only on attacking this microscopic perpetrator, forgetting completely the human being who experiences the effects of this sickness. The social model reminds us to center the alleviation of suffering as the goal of healthcare, giving equal importance to the experience of sickness as to its source; it suggests, even, that the “source” is the phenomenological and social encounter of sickness itself. 

These two models don’t exist in contradiction, but in dialectic. Neither patient nor provider would suggest disallowing biomedical perspectives, but take no issue with being deprived of the humanistic side of medicine–and to grievous effect. Excluding the lived effects of illness may still allow treatment, but it precludes care.