Comment Paper

French, Sally and John Swain (2001). The Relationship between Disabled People and Health and Welfare Professionals, Chapter 32 (pp 734-753) in Handbook of Disability Studies (Thousand Oaks, CA: Sage).

In this article, the relationship between disabled people and health and welfare professionals is examined and discussed. It focuses largely on the gross imbalance of power between the disabled and professionals. The professionals are very much in control of the disabled people’s lives, while the disabled people seemingly have little say in making choices regarding their own lives.
French and Swain give accounts of how the professionals assert their role as one of being in control or in power. The professionals define disability as an individual personal tragedy, giving it a negative connotation, as in something to be avoided at all costs. By being the ones that define it, they also gave themselves the role of being the only ones that would appear to know how to fix it and have any chance of controlling disabilities. I found it disturbing how the disabled people were treated, particularly during any sort of assessment procedure, where they would be treated as if they were completely ignorant to their own needs. French and Swain go on to describe how the professionals use defining and other methods as a way of preserving their own power. I am immediately apprehensive about trusting any group that has self-preservation as their foremost concern when their purpose is supposed to be helping others that need it. Also mentioned is how doctors have somehow transcended the boundaries of their medical world and are involved in the decision-making process in areas such as housing, education and employment of the disabled. I can only imagine how it would be received if a real estate agent and a teacher came into a doctor’s office to assist in diagnosing and advising medical conditions. The authors do concede that the medical profession is not without merit, as survival rates and life expectancy rates have increased. But, not content with that assessment of their own achievements, the medical professionals also credit themselves with reducing disease and impairments, while not considering that perhaps economic and social development had something to do with it. This fact helps underline the recurring idea that maybe these people have been taking themselves a little too seriously and still do.
The notion of dependency comes up; as an enforced dependency of the disabled being dependent on the medical professionals as well as the fact that the professionals rely on the disabled to maintain their own employment or organization. This helps one understand how the professionals would want or need to cling on to their position of power.
Disabled people’s experiences of being diagnosed and put through physiotherapy are given. They were treated like objects, and were given about as much dignity and respect as a circus animal. The needs that the disabled people felt that should have been addressed, such as emotional support rather than just physical training, were completely overlooked. I cannot imagine the devastating effect it would have on a person to be suddenly unable to walk, to have no consolation, but be expected to not be a burden on society by getting up and suddenly being independent.
Institutional discrimination is described in the chapter as treating disabled individuals unfairly or unequally in institutional organizations. There are different levels of this kind of discrimination that intermingle and rest on each other; attitudinal, environmental, and structural barriers. The authors examine a GP practice in a building that, although built recently enough in the 1990s, is ridiculously inadequate for anyone with any sort of disability, be they patient or employee. This is a good example of how disabled people can be kept out of being employed in the professional’s realm. In the next section, I found it sad that some educational institutions had actual policies that discriminated against disabled people to keep them out of certain professions. It was noted that there were advantages to having disabled people in these professions as they could empathize with patients better than a non-disabled person. When investigating the GP practice, the alternative of treating disabled people at home is mentioned but not seen as viable as it would deny disabled people the opportunity to participate fully in society. Although not stated here in the article, one might imagine that treating people at home could exacerbate the problem of institutional discrimination. If the disabled people are not coming to the institutions anymore, there would be no need to be concerned for their welfare when designing buildings and training staff.
Changes have come slowly. Discrimination had hampered the ability of the disabled to organize into a collective force. This changed greatly after one initial group introduced the social model of disability, which was based on the collective experiences of oppression of actual disabled people. This contrasted and spoke against how the disabled people were defined by the medical profession as individual tragedies. The social model greatly helped disabled people form organizations of all sizes around the world. There is still a tone of condescension from the professionals in that they are judging these organizations and their worth.
The centers for integrated, or independent, living show how disabled people are able to make more of their own choices. By having more control over their own lives, they feel less disabled. Although they may have more control over their lives here, overall, they still do not have control over the medical professionals.
The recurring theme I noticed in this chapter was consultation of disabled people is the key to solving any problems disabled people may have. Maybe the professionals will allow this some day.