UN to decide what “disability” means
An intriguing comment on what we mean when we talk of a disability appears in The Lancet of October 7. We are assured that the United Nations
General Assembly will shortly consider the precise definition that
should be applied to the term. The outcome will affect the treatment
that must be awarded to individuals who are pronounced disabled. This
will mean increased attention to
non-fatal health outcomes, including the onslaught of the ageing process.
A definition of disability should be applicable to all people, without
segregation into groups such as “the visually impaired”.
Comparisons need to be made of severity across different types of disability,
recognising the effect of environment on their degree. Stipulations about
the cause of the condition should not be involved in the definition.
The current definition includes long-term physical, mental, intellectual
or sensory impairments, which in interaction with various barriers in
living may hinder full and effective participation in society. The proposed
new definition means difficulty at the levels of body, person or society
in one or more domains of life experienced by an individual whose health
condition interacts with factors existing in social living. Only on such
a basis can the concept of disability be accepted.
It is noteworthy that whatever a person’s health problems may be
from the medical angle, the feature of his or her immediate environment
must also be taken into account. Disability is therefore a state of decreased
functioning that is associated with disease, disorder, injury or other
health condition, which in the context of one’s environment is
experienced as impairment, limitation of activity or restriction in social
participation. Unless fully recognised, no remedy is possible.
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