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To cite this article: Romel W. Mackelprang (2010): Disability Controversies: Past, Present, and Future,
Journal of Social Work in Disability & Rehabilitation, 9:2-3, 87-98
To link to this article: http://dx.doi.org/10.1080/1536710X.2010.493475
School of Social Work, Center for Disability Studies and Universal Access,
Eastern Washington University, Cheney, Washington, USA
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DEFINING DISABILITY
Disability Controversies
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The preceding discussion begs the question of how social work should
treat disability and people who have disabilities. Traditionally, the profession
has viewed disabled people as an at-risk population along with others such
as people in poverty, racial and ethnic minorities, women, and lesbian, gay,
bisexual and transgender (LGBT) populations. Because they are at risk in
society, these are populations that are most likely to be served by social
workers. However, in defining diverse groups that the profession embraces
as members and leaders, disabled people have not been embraced as have
people from the other at-risk populations (Gilson, DePoy, & MacDuffie,
2002). Therefore the profession is faced with the conundrum of whether
or not to embrace and fully integrate disabled people into the diverse tapestry of its membership and even its leadership. Or, does social work primarily treat the disability community as an at-risk group in need of its services
but not as a diverse group it embraces within its membership? The answer
lies, in part, in whether social work embraces the medical model in which
disabled peoples problems are primarily a result of individual pathology
or a result of ableism, devaluation, and lack of opportunity.
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culture, a unique subculture of a larger Disability culture. American Deaf culturalists differentiate Deaf American Culture (DAC) from Mainstream American Culture (MAC). People who belong to Deaf culture in which American
Sign Language is the primary language commonly capitalize Deaf when
referring to Deaf culture and to Deaf people as part of that culture (Wilcox,
1989). Some Disability advocates who embrace the idea of a culture of disability capitalize the D in Disability when referring to Disability culture,
and others use the moniker disAbility, thus emphasizing Ability.
Language use can present a conundrum for social workers, including
some social work scholars who adopt a social model approach to disability,
embrace disability as an identity, and adopt disability-first language. For
example, some social workers, steeped in person-first language as politically
correct language, might interpret disability-first language by colleagues
as offensive. For social work authors, peer-review journal panelists might
reject disability-first usage in an attempt to avoid pejorative language. Ironically, strict adherence to person-first language might limit progressive
dialogue relative to disability.
One approach to disability terminology is to use language that is context
specific. Disability-first language can be used to discuss disabled people and
the disability community. When referring to Disability culture, Disability or
disAbility might be used. Person-first language might also be used in some
contexts, especially in some social work settings. For example, people
who seek health care or social services might be referred to as persons with
schizophrenia or individuals with multiple sclerosis. Finally, as a component
of culturally competent practice, social workers who are unclear about
appropriate terminology should inquire of the people with whom they are
working for clarification (Mackelprang & Salsgiver, 2009).
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least a decade, disabled social workers have advocated for the NASW Board
of Directors to apply a diversity-based approach to disability. Yet, the NASW
Diversity and Equity Web site (NASW, 2009a) embraces sex, race and ethnicity, and sexual orientation, but not disability as diversity characteristics.
NASW supports commissions on sex, race and ethnicity, and sexual orientation, but disability continues to be absent.
The NASW (2008) Code of Ethics addresses disability stating, social
workers should not practice, condone, facilitate, or collaborate with any form
of discrimination on the basis of race, ethnicity, national origin, color, sex,
sexual orientation, age, marital status, political belief, religion, or mental or
physical disability (4.0.2., italics added). The designation of mental or physical disability is a term rejected by disability advocates, including the former
CSWE Disability Commission. It medicalizes disability into two diagnostic
categories rather than as an identity or characteristic. It addresses limited disability subgroups while excluding others such as those with hearing, visual,
and cognitive disabilities. It falsely distinguishes between mental and physical characteristics, although the two are highly interrelated. NASW (2006)
demonstrates indecisiveness in its Cultural Competence Indicators. It repeatedly uses terms such as physical or mental disability. One section excludes
disabled people from its definition of cultural competence; replacing disability with the euphemism physical and mental abilities (NASW, 2006,
p. 8). The 1992 CSWE disability task force soundly rejected this terminology
when CSWE proposed to include it in its curriculum and accreditation
documents.
On a positive note, a different section of the Indicators document states,
The term culture includes ways in which people with disabilities or people
from various religious backgrounds or people who are gay, lesbian, or transgender experience the world around them (NASW, 2006, p. 10). The latest
Social Work Speaks (NASW, 2009b) offers the most inclusive approach to disability to date in that it, advocates a national policy that ensures the rights of
people with disabilities to participate fully and equitably in society (p. 249),
and the inclusion of social workers with disabilities in all areas of the
professional organization (p. 250).
In summary, the third controversial issue addressed in this article, the
place of disability in social works professional organizations, is evolving.
Disability advocates, Disabled social workers, and allies advocate for fully
integrating disability into the diversity framework of the profession. NASW
continues to define disability as an at-risk group but displays ambivalence
about embracing disabled persons and the disability community as a diverse
population within the profession. In contrast, CSWE has made strides toward
adopting a social model of disability and welcoming disabled educators into
its structures and leadership.
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with IL so they can determine the fit between students and CIL practicum
placements. In addition, classroom faculty will need to educate about IL as
a practice modality. Concomitantly, NASW and state chapters will need to
grapple with the place of disability organizations and their employees who
have been educated as social workers. The connection between social
work and IL has been slowly evolving from the beginning of the IL movement and will likely continue for years to come.
NASW affirms the right of people to direct decisions at the end of life,
including in the states of Oregon and Washington that allow for assisted suicide for people with terminal illness. However, social works affirmation of
this right has limitations. For example, the profession has been actively
involved in suicide prevention, especially with youth, and it does not advocate for nonterminally ill peoples choice to end their lives. However, the
profession has remained silent on the practice of physically disabled persons
ending their lives. For example, in 1989, two young men, David Rivlin of
Michigan and Larry McAfee of Georgia, successfully sued the courts for the
right to end their lives. Both men had ventilator-dependent quadriplegia
and had been incarcerated in nursing facilities for years. In both cases the
courts determined that their physical conditions justified their decisions to
end their lives. In neither instance, nor in subsequent cases, have the courts
considered their unbearable living conditions in their decisions. People with
severe physical disabilities like Rivlin and McAfee are routinely incarcerated
in institutions, even though their physical care would be less expensive and
more humane if provided in the community. Rivlin completed his request by
having his ventilator turned off; however disability activists in Atlanta
arranged for McAfee to live in the community with physical attendant care.
Rivlin subsequently moved to the community and did not end his life
(Mackelprang & Mackelprang, 2005; Shapiro, 1994).
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CONCLUSIONS
What Is the Future for Disabled Social Workers and Their Allies?
In the late 1980s, the author, as a young educator attempting to develop a
scholarly agenda and achieve tenure, submitted an article to an NASW journal on including disabled persons in the social work profession. The article
was rejected with one reviewers comments, stating, Reject, reject, reject, do
you really think we want those people in our profession? The lesson learned
from this experience for disabled social work academics with invisible disabilities was to remain securely in the closet. For social work educators with
visible disabilities, the message was to minimize the impact of the disability
to the extent possible. Subsequently, as discussed in this article, social work
educators organized and have been instrumental in changing disability attitudes within the profession. Social workers with disabilities have become
active in promoting disability rights, and embracing the experiences that their
disability affords them. For example, one of the authors colleagues with a
physical disability from birth expresses his gratitude for his disability and
how it led him to his chosen profession, his life partner, and his life.
Mackelprang and Salsgiver (2009) provided numerous life stories of disabled
men and women who embrace their disabilities and revel in disability community and Disability culture. The profession, and especially CSWE, have
made strides in accepting the social model of disability. However, the social
model of disability is still far from being universally accepted as evidenced by
the current fact sheet item published by NASW: Social workers help
people overcome some of lifes most difficult challenges: poverty, discrimination, abuse, addiction, physical illness, divorce, loss, unemployment,
educational problems, disability, and mental illness (NASW, 2010).
Disabled social workers and allies who adopt a social model of disability
reject this NASW characterization of disability as one of lifes most difficult
challenges. Although many do not suggest that pathology be totally
removed from an examination of disability (Gilson et al., 2002, p. 3), they
aver that the primary challenges disabled social workers, including those
with mental health disabilities, need to overcome are externally imposed
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