Defining Disability Conceptual Issues

The idea of disability and these related concepts are tricky to define. The conditions that often are referred to as disabilities are varied, including sensory losses, learning difficulties, chronic systemic illnesses and their effects (such as constant fatigue and pulmonary insufficiency), mental illnesses, lack of limbs, and lack of mobility. Do all these conditions have a common feature? Does every biological abnormality qualify as a disability? Does the availability of technological aids play a role in determining whether a bodily state is a disability? To what extent does being disabled depend on the environment in which a person lives? The very definition of disability is controversial; there is no single accepted definition.

The World Health Organization (WHO) of the United Nations offered the following definitions, which have been highly influential:

Impairment: Any loss or abnormality of psychological, physiological, or anatomical structure or function.

Disability: Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.

Handicap: A disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal, depending on age, sex, social and cultural factors for that individual. (United Nations, 1983, quoted in Wendell)

Those definitions provide a good starting point but require fine-tuning. The distinction between impairments and disabilities is useful even though in some cases the distinction may be strained. The term impairment best captures a loss of or a defect in psychological, physiological, or anatomic features. Thus, paralysis of an arm muscle is an impairment, and inability to throw something is a disability brought about by that impairment, because it is a lack of the ability to perform an activity (throwing). Inability to throw a baseball is not an impairment or a disability; instead, in a person who would be expected to be able to throw a baseball it may be a handicap: a disadvantageous inability to perform a socially defined activity that is caused by an impairment and a disability.

Thus, not every impairment is disabling. An abnormal shape of the eyeball that prevents light from focusing properly on the lens is an impairment, but if the afflicted person can see perfectly well with glasses or contact lenses and carry out the same activities that other people can, that impairment is not disabling. One also can ask whether a disability is a handicap. Franklin Delano Roosevelt had a disability (he could not walk) that no doubt prevented him from fulfilling some social roles, but it did not prevent him from fulfilling the role of president of the United States, and so in that respect it was not a handicap.

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