Note and reflections on an article by Dimitris Michailakis.
The traditional view of disability focuses on the individual, which is thought being incapable to perform certain activities due to one or more functional impairments. Disability is thus an individual incapacity of medically verified facts. Disability implies incapacities or failings, a defect or impairment. The individual is ‘handicapped’, independently of the prevailing surroundings. This has been and still is the medical point of departure. Thus, whether an individual is disabled or not depends on his/her clinical status. Impairment is a phenomenon established throughDimitris Michailakis (February 2003) The Systems Theory Concept of Disability: One is not born a disabled person, one is observed to be one. Disability & Society 18(2):209-229
a diagnosis, through a medical examination. The obstacles to participation on equal terms are situated, accordingly, primarily in the individual, since it is the individual who lacks certain capacities that are necessary to attain autonomy.
So, I wear glasses because I am said to have been diagnosed with visual impairment–I am said to have a visual impairment; however, when I wear my glasses I don’t have a visual impairment. In other words, when my glasses join my body in an assemblage, I don’t have a visual impairment. These are different concepts of the self. I am not an individual, but rather an assemblage.
The perspective is not to be regarded as medical because, as many take for granted, the individual is in focus, but because it is the individual’s physical–psychical defects that are examined and the purpose is a medical diagnosis.Michailakis
The contrasting view is that disability is socially constructed, as when buildings are not made wheelchair accessible. The marginalization be corrected through law and architecture rather than medicine, because medicine in itself cannot make new laws or do anything about the architecture.
A given environment set up and developed with the non-disabled as norm.Michailakis
But we are still dealing with the individual-society model–that is, the view that society consist of individual persons. But for social systems theory, society consists of communication. The primary distinction is system/environment, not individual/society. The key issue is not how individuals fit into society, adjust to society, or find a place in society.
From a sociological systems theory perspective, disability as a phenomenon cannot be analysed other than in relation to the distinction system/environment observing that individuals with disabilities—as well as other individuals—do not belong to a system, but are part of the environment.Michailakis
Disability is, of course, one side of the dis/ability distinction, and this distinction is made by some system. It’s not a thing that exists outside of communication. That is to say, it’s a social construction. The bodies or brains that are to be disabled exist in the environment of society, the environment of communication. We must observe the observer:
Which system uses a distinction such as impairment–not-impairment, able-bodied– disabled, healthy–sick or productive–unproductive as a point of departure for its observations?Michailakis
I have a small disagreement with one thing Michailakis writes:
A system’s environment is the whole world minus the system; environment and system together is the whole world.Michailakis
I would say that a system’s environment only includes whatever can potentially irritate it or destroy it. If a system is oblivious of something and will always be oblivious of it, then whatever it is is not part of the system’s environment. For instance, there is a range of sounds and odors that dogs but not humans can detect. There is no “whole world” because the world cannot be observed from the outside.
Michailakis goes on to write,
From this follows, that there is no and can never exist a generally accepted criterion of what constitutes handicap. The ambition of the ICF as being an integrative model of the medical and the social models through a ‘biopsychosocial’ model is theoretically naive. There is no single observation position, no single distinction, and no system from which one can observe the individual in relation to all aspects: biological, psychic and social. There are biotic, psychic, and social systems, or, in other words, organisms, consciousness and communication. But there is no system unity, a super system that embraces all these.
Particular differences (e.g. physic, psychic or intellectual) are assumed to exist, but for the social system and for the observer they do not exist before the particular distinction is created through which one side of the phenomenon can be marked. The observation of impairments has its origin in new distinctions identified within social systems. For instance, before the industrial era working disabled people were not observed as a particular category. They were undifferentiated within the larger group of poor people (beggars, people with different impairments, criminals, vagabonds, etc). The group disabled people was differentiated when the labour market was constituted as a system through the distinction made between those willing, but unable to work and those not willing to work (Foucault, 1973). In this way communication about the group disabled people became differentiated and first became the object for charity, successively communication types became differentiated in the medical system, in the education system, the labour market system, etc. In the period before, the disabled person was simply seen as an aberration compared to others. Impairment was a phenomenon in the environment, a problem for the individual concerned and possibly his/her family. . . .
Society’s functional differentiation and associated demands for inclusion in social systems implied that disability became a social problem to be communicated within functionally differentiated systems (e.g. special schools, asylums, rules for distributive justice). . . Thus, according to systems theory, disability is the communication in functionally differentiated systems of the difference between impairment/not impairment. DiMichailakis
. . .
(Therefore one must always ask from which system is the identification made.) It is not possible to identify persons having a disability in general. This leads to the conclusion that we cannot discover a classification scheme applying for all systems.