Comment Paper Week 8, Independent Living

October 30, 2007

French, S. and Swain, J. (2000). “The Relationships between Disabled People and Health and Welfare Professionals”. Handbook of Disability Studies by Albrecht, G. L. Thousand Oaks, California: Sage Publications.

The article, "The Relationships between Disabled People and Health and Welfare Professionals", concerns itself with the issue of independent living and examines the relationship development between disabled people and professionals, as stated in the title. Power structures and relations within the medical and social professions, and the production of disability through institutional discrimination are also addressed.

Discussion begins with the awareness that the emergence and redefinition of disability as a human and civil rights issue has underpinned fundamental challenges to professional ideologies and models (French & Swain, 2000). Of most importance are the establishment of centers for independent living and the provision of services for disabled people by disabled people (French & Swain, 2000). Disability, according to French and Swain, is defined as a form of oppression and institutionalized discrimination. Thompson suggests that, “an understanding of the workings of power is an essential part of challenging inequality, discrimination and oppression” (French & Swain, 2000).

Three associated elements of professional power have been identified. The power of individual professionals to access disabled people, define their problems and needs, specify solutions and evaluate their effectiveness is one such element. McKnight states, “Therefore, if the client is to have the benefit of the professional remedy, he must also understand that the professional not only knows what he needs but also how the need is to be met“ (French & Swain, 2000). This is not always the case as has been discussed in previous comment papers. Every disabled individual’s situation is unique. This is an example of professional dominance where medical observations are viewed as objective, whereas the patient’s perceptions are subjective (Coates and King, 1982).

Secondly, power involves professionals as powerful groups within society, in a pursuit of self-interest, with the mystification, defining, and control of expertise (French & Swain, 2000). As Hugman (1991) states, this might serve as “basis for defining the boundaries of the profession with other professions, and it provides the foundations for power exercised by the professionals in relation to the users of their services”.

Thirdly, the aspect of professional power is seen in the agents or representatives of the economic and political elite. Of importance to professional-disabled people relations is the maintenance of the status quo by pathologizing and individualizing problems that have been socially and economically created (French & Swain, 2000). Segregation and institutionalization create dependency of disabled people and facilitate the development of the medical profession to medicalize areas of disabled people’s lives that had little to do with medicine. Although the medicalization of disability has had some positive effects, it has also played a crucial role in the maintenance and justification of the individual tragedy model of disability and the enforced dependency of disabled people. In contrast, the implications of the social model are to promote the collective struggle for social change. This is the aim of the disabled people’s movement. As a result of discrimination, however, they have been rendered relatively powerless.

A large number of British Council of Organizations of Disabled People (BCODP) organizations comprise coalitions of disabled people and centers for integrated and independent living, CILs. The concept of integrated living evolved from the social model and provides a challenge to the dominance of professionals in relation to disabled people. The argument is that people that are disabled by societies terms, physical, intellectual, sensory, have the right to assert control over their lives (French & Swain, 2000).

In another case, The Derbyshire Centre for Integrated Living attempts to remove barriers and provide basic needs of information, technical aids, transport, counseling, housing, personal assistance and access. Every aspect of their work is geared towards the fulfillment of disabled people on their own terms and in viewing disabled people as active, capable citizens who are restricted not by impairment but by a disabling society (French & Swain, 2000). As stated by French, “Disabled people define independence, not in physical terms, but in terms of control”. They are still independent of thought and action, enabling them to take control of their lives.

Despite the potential for a change in the relationship between professionals and disabled people, there is little evidence of any shift in power. It can be argued that only the rise of the disabled people’s movement, along with the relinquishing of health and welfare professional’s power will rectify the problem as professionals and disabled people become allies.

This form of writing gains strength through the disability activist movement. The activists arguing societal issues draw in supporting arguments, similar opinions, from other activists who have written similar literature. This helps to strengthen the case, forming a basis or proof that the ideas are representative of the disabled population as a whole. Two contrasting case studies were offered to support the relationships between disabled people and health and welfare professionals. This put matters of discrimination and attempts to rectify the problem, by regaining a sense of independence through choice of care for disabled people, into perspective.