When presented with this sort of dichotomy, it is clear how the ADA is, in principle, closely aligned with the social model. After all, it understands the disadvantages of disability to be the unjust products of social arrangements and seeks to mitigate these disadvantages with civil rights protections that are quintessentially social fixes. In many instances, this is exactly how it plays out. The paradigmatic case is a description of how the disadvantage presented by using a wheelchair can be removed by architectural modifications of public space to make it wheelchair accessible with ramps, elevators, lifts, and so on. Thus, the wheelchair user is not excluded from goods like employment, education, commerce, leisure, and the rest. In the language of the ADA, such social fixes to socially constructed disadvantage are referred to as reasonable accommodations. In sum, these reasonable accommodations are intended to account for atypical modes of functioning and remove any disadvantage these modes would present in a typically inaccessible social environment.

First, I will briefly lay some conceptual groundwork. It is widely noted that the ADA is a civil rights law grounded in and justified by the social model of disability. Roughly, the social model maintains that a person’s biological differences – or perhaps impairments – become disabling only within a particular social context in which there is a mismatch between the mode in which she functions and the mode for which the social environment has been constructed. Thus, most of the disadvantages of disability are socially constructed, according to this model. In contrast, the medical model says that the disadvantages of disability are inevitable because disability is, ontologically speaking, a biological deviation from the norm that is, by definition, disadvantageous.

In the U.S., much is being made of the 25 year anniversary of the Americans with Disabilities Act. In activist circles, commemoration has meant celebration of the progress that has been made alongside calls to action regarding systemic disadvantages that remain. It is fortuitous that the launch of this blog coincides with this anniversary, both inviting reflection on how this policy has made an impact on higher education.

Yet, when we start to examine how higher education has operationalized the provision of reasonable accommodations for students, faculty, and staff, we see how easy it is to revert back to the medical model and all of the disadvantages it presents. Indeed, higher-ed offers an interesting case study of how the reasonable accommodations of the ADA can simultaneously be conceptually based in the social model but procedurally reliant on the medical model. It seems that the best practice of most major university disability services offices is to only consider requests for accommodations, no matter how minimal, after there is a confirmed medical diagnosis from a health practitioner that has documented the “functional limitations” of the disabled person. For a person starting a new job or new course schedule, this requirement of getting a medical evaluation poses a significant barrier to success that is not presented to a non-disabled academic or student.

Clearly, it would be a mistake to think of this medicalized procedure for enforcing the ADA as only a conceptual contradiction or confusion. The problem is not just that the practice of using medical professionals as the gatekeepers of civil rights reinforces a questionable ontology of disability, but that it also reproduces exactly the sort of concrete disadvantage the ADA is meant to relieve. Amidst the chaotic processes of setting up your email account and getting your University ID, adding doctor visits to the list of tasks that need to be achieved before you can even request access to your office or dormitory is a significant disadvantage indeed.

Further, this practice is even more troubling when you put it in the context of similar procedures for verifying the “validity” of disability, which have been a historic double-bind for many disabled people. The political historian of disability, Paul Longmore, devoted much of his most widely read work Why I Burned My Book and Other Essays on Disability to describing how it is that disabled people are systematically forced to occupy a political space of incompetence to get the basic supports and services they need to attain any measure of competence. For example, Longmore highlights how he and other disabled people must first be declared by a physician as unfit to work in order to get the sort of homecare they need so they can seek or maintain employment.

While medically validating disability for the purposes of attaining reasonable accommodations does not present this sort of tragic choice, we can reasonably assume that these procedures for validating disability are similar in their motivation. Using medical experts as the gatekeepers of both social safety net benefits and civil rights is an attempt to avoid instances of “fraud.” Of course, like other attempts to combat fraudulent claims on civil rights (i.e. voter disenfranchisement), this amounts to a disincentive for an already marginalized group to claim what is theirs. In effect, through their medicalization, the reasonable accommodations of the ADA have, at least partially, become barriers to the inclusion of disabled people in the academy.

--Joseph Stramondo

(Acknowledgment: The author would like to thank Dr. David Perry for motivating him to think about how the ADA has become increasingly medicalized via personal correspondence, social media, and Dr Perry’s personal blog found at: http://www.thismess.net/2015/01/seattle-museum-turns-down-lights-for.html)