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The most commonly cited
definition is that of the World Health Organisation in 1976(1),
which draws a three-fold distinction between impairment, disability
and handicap, defined as follows. 'An impairment is any loss or
abnormality of psychological, physiological or anatomical structure
or function; a disability is 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; a handicap
is a disadvantage for a given individual, resulting from an impairment
or a disability, that prevents the fulfilment of a role that is
considered normal (depending on age, sex and social and cultural
factors) for that individual'.
According to activists in the disability movement,
the World Health Organisation has confused between the terms 'disability'
and 'impairment'. They maintain that impairment refers to physical
or cognitive limitations that an individual may have, such as the
inability to walk or speak. In contrast, disability refers to socially
imposed restrictions, that is, the system of social constraints
that are imposed on those with impairments by the discriminatory
practices of society. Thus, the Union of the Physically Impaired
Against Segregation defined impairment and disability in the following
manner. An 'impairment [is] lacking part of or all of a limb, or
having a defective limb, organism or mechanism of the body'. 'disability
[is] the disadvantage or restriction of activity caused by contemporary
organisation which takes no or little account of people who have
physical impairments and thus excludes them from the mainstream
of social activities'(2).
According to the United Nations Standard Rules on the equalization of Opportunities for Persons with disabilities:
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The term "disability" summarizes a great
number of different functional limitations occurring in any
population in any country, of the world. People may be disabled
by physical, intellectual or sensory impairment, medical conditions
or mental illness. Such impairments, conditions or illnesses
may be permanent or transitory in nature.
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The term "handicap" means the loss or limitation
of opportunities to take part in the life of the community on
an equal level with others. It describes the encounter between
the person with a disability and the environment. The purpose
of this term is to emphasize the focus on the shortcomings in
the environment and in many organized activities in society,
for example, information, communication and education, which
prevent persons with disabilities from participating on equal
terms.
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The use of the two terms "disability" and
"handicap", as defined in the two paragraphs above, should be
seen in the light of modern disability history. During the 1970s
there was a strong reaction among representatives of organizations
of persons with disabilities and professionals in the field
of disability against the terminology of the time. The terms
"disability" and "handicap" were often used in an unclear and
confusing way, which gave poor guidance for policy-making and
for political action. The terminology reflected a medical and
diagnostic approach, which ignored the imperfections and deficiencies
of the surrounding society.
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In 1980, the World Health Organization adopted
an international classification of impairments, disabilities
and handicaps, which suggested a more precise and at the same
time relativistic approach. The International Classification
of Impairments, Disabilities, and Handicaps(3) makes a clear
distinction between "impairment", "disability" and "handicap".
It has been extensively used in areas such as rehabilitation,
education, statistics, policy, legislation, demography, sociology,
economics and anthropology. Some users have expressed concern
that the Classification, in its definition of the term "handicap",
may still be considered too medical and too centred on the individual,
and may not adequately clarify the interaction between societal
conditions or expectations and the abilities of the individual.
Those concerns, and others expressed by users during the 12
years since its publication, will be addressed in forthcoming
revisions of the Classification.
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As a result of experience gained in the implementation
of the World Programme of Action and of the general discussion
that took place during the United Nations Decade of Disabled
Persons, there was a deepening of knowledge and extension of
understanding concerning disability issues and the terminology
used. Current terminology recognizes the necessity of addressing
both the individual needs (such as rehabilitation and technical
aids) and the shortcomings of the society (various obstacles
for participation).
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(1)World
Health Organisation. Document A29/INFDOCI/1, Geneva, Switzerland,
1976.
(2)Union of the Physically Impaired Against Segregation. Fundamental
Principles of Disability, London, 1976.
(3) World Health Organization, International Classification of Impairments,
Disabilities, and Handicaps: A manual of classification relating
to the consequences of disease (Geneva, 1980). |