Introduction
I found a poster on LinkedIn today that argued for a shift in thinking about disability – from ‘fixing people’ to ‘fixing systems’. The sentiment is familiar but this rigid binary that distinguishes between the medical model [bad] and the social model [good] reveals a perspective I would be concerned to find in a person representing themselves as a disability inclusion expert today.
To me this is ‘old hat’ thinking that isn’t helpful now. Below I want to reflect on why the medical/social model of disability is dated and no longer useful. It is still asserted by people who have limited exposure to the spectrum of disabilities and who haven’t updated their ideas.
Why the medical model is so unfairly disliked
There was a time when disability was seen as a kind of offence against the normal, the ideal. If you had lost the capability to walk up stairs it was on you to find a way to get up the stairs, not on the community to create an alternative – like a ramp.
I have observed previously that even after World War One there was no motivation to include veterans by making public spaces more accessible. They may have risked or given their lives or body parts in service of the nation, but there would be no accommodation of impaired mobility until the 1960s when the disability rights movement changed public policy.
In a sense the medical model of disability is a red herring that attracts an emotional response to a complex set of issues. For example, one of my former colleagues, who is an ardent advocate for disability inclusion, has bilateral below-knee amputations. He is remarkably active, holding records for ascending stairways the height of tall buildings, precisely because he has prosthetics – a ‘medical’ solution.
My brother has relied on an electric wheelchair for about 8 years following a diagnosis for a rare genetic condition that makes it very hard for him to recover from physical exertion [a medical insight]. The wheelchair was effectively prescribed as a solution to a medical problem. Where he can get to in his wheelchair is, however, a social issue.
I rely on Canadian crutches to make it possible for me to walk. I contracted GBS in 2008 and it took 18 months of medical care and rehab to be able to walk again. My health fund significantly covers the cost of replacement crutches. But how accessible public spaces are to me is another matter. That’s why I volunteer as a member of my local council’s Access Reference Group – so we can mesh essential ‘medical’ solutions with ‘social’ solutions.
So, my point is that ‘medical’ responses to disability are still vital, and with advances in technology even more important now than they were 50 years ago.
I love medical responses to disability. They are essential and, in many cases, make it unnecessary to rely on the social model. My former colleague with his prosthetic feet doesn’t need the accommodations I need with my original feet and crutches.
Talking about the medical model of disability in such a negative way in 2026 strikes me as either anachronistic or manipulative.
We need to re-imagine the social model
The poster is right in asserting that there is a need to change laws and rules. Legislation is in place. It is fair enough to ask whether it should be updated. There are policies in place too. They should be reviewed as well.
But in Australia I don’t think the issue is the adequacy of law or policy but how they are interpreted and implemented. This is an entirely different matter.
The social model of disability has been serving us well in the sense that it has required changes to policy, practice and funding, and those changes have resulted in significant improvements to the level of accessibility and inclusivity for many people with disabilities in our communities. But by no means has this resulted in universal accessibility and inclusivity.
The social model must continue to evolve, and it must do so in concert with the medical model. That terminology is now out of date, so let me suggest that we think in terms of personal and communal – what the individual needs and must be responsible for getting, and how the community must adapt away from universal ablism as the template for design and toward universal capability and need.
Cochlear implants are ‘medical’ interventions that transform people’s lives. I have seen videos on YouTube showing a person using a prosthetic robotic hand controlled by ‘thinking’. In fact, considerable funding has gone into high tech ‘medical’. It is nothing to dismiss as a response in isolation. These more sophisticated technologies exist because there has been a profound change in the way we think and feel about disability as a community, and as a culture.
So, we can understand that disability has a personal dimension and a communal dimension. In the past the communal dimension hasn’t been as responsive as it could have been. But now both dimensions have grown and are closer to a balance. Still so much more to be done, though.
The critical consideration of culture
Having laws, rules and policies is one thing. Creating a culture of enthusiastic compliance and conformity that includes prioritisation of resources and attention is something else entirely. And this is where a lot of advocates for inclusion fall down. Movement away from moral admonition and re-litigating battles already won is vital. But the Disability Inclusion movement is addicted to the emotionally appealing role of being an advocate rather than being a skilled guide on how to make changes happen – and then stick.
This is what struck me about the poster. It seemed like a call to action but offered no guidance on how to make any action effective and successful. For instance, there’s a speech bubble that says, “Create Equitable Opportunities”. Fair enough, but how?
This is a fundamental problem with Disability Inclusion advocacy. It stops at the ‘good idea’ stage that has a strong moral valency but does not progress into offering genuine skill and insight into how ‘good ideas’ can become sustainable realities. This suggests to me a perpetuation of a ‘victim mentality’ which allows people with disability come up with the problem and leave it to others to find the solution.
That’s so old hat. It is so unempowered. There is a lot of sentimental blather about people with disabilities not standing for being excluded and ‘demanding’ their rights to be included. It’s like the only ‘empowerment’ is a right to demand inclusion. Victim status is locked in.
True inclusivity, in our cultural context, is a stretch, an evolution. It is where we are headed and nobody has a playbook on how to make it happen – yet. The critical insights on how to make it happen are available in our understanding of evolutionary, social and organisational psychology. They are available also in texts on leadership, management, communication and relationship building.
Empowerment is a good feeling word, but it is something earned rather than granted. We can ‘grant’ a right, but it still has to be exercised competently. The alternative is to fall back onto notions of victimhood and powerlessness with nothing to do but demand rights.
There are many people with disability who are powerless and who rely on effective advocates to speak and act for them. My focus is on workplace access and inclusion. My passion for effective Disability ERGs is grounded in my experience of effective advocacy.
I am not going to intentionally shame the source of the poster that set off this piece. But I will say that it is a disservice to many when the primary qualifying attribute of an advocate for Disability Inclusion is thought to be the experience of living with a disability. That makes as much sense as insisting your defence lawyer has committed a similar offence.
Conclusion
Our world is changing/has changed in fundamental ways. The old politics of moral persuasion are gone. They did the job that got us the legislation and policy changes that we now rely on. But the next step is a shared need to become more self-aware and self-responsible – mutually evolving our culture toward intentional inclusion.
The idea that a Disability Inclusion advocate can think that moral guilt tripping is still going to work is sad. The person with a disability with unmet inclusion needs isn’t a child and their organisation or community isn’t a parent. We are peers. It’s just that some are more able than others to make things happen.
There is a tendency to imagine that effective advocates for Disability Inclusion must have a disability themselves. This is nonsense. Many of the people with disability who style themselves as advocates are not any good at that role at all in my experience. It has often been the parents, siblings, friends, allies, carers and champions of people with disability who have driven the essential changes.
This isn’t a ‘them without disability versus an us with disability’ affair. It is a shared concern about problems we need to tackle together. I have been a member of my local government’s Access Reference Group for 5 years. It is an extraordinary demonstration of a shared community commitment to inclusion. I led a Disability ERG for 3.25 years and we were able to drive significant changes. This is peer-to-peer, not victim to controller.
Effective advocacy takes skill as well as passion. It takes a sophisticated capacity for insight, for communicating and for working with others to create a momentum for steady progress. Passion without skill has ruined so many things – art, food, sex etc.
Dragging up the old medical model versus social model binary seems to me to reflect a disconnect with the reality of now.
Contemporary research into the roll out of AI tells us something vital. Those who engage with AI with high metacognition capabilities benefit far more than those who use AI as a shortcut to getting stuff done. The clue is in understanding what metacognition is and how to employ it.
This applies to any system or environment. An organisation or a community is a form of intelligence. If we want to influence its behaviour and have it act to our benefit, we must develop metacognitive skills. If we don’t, we will be disempowered and without influence. This isn’t a novel insight. But summing it up so succinctly is novel, thanks to AI research.
This is the transitional insight that effective Disability Inclusion advocates need to be successful now. No posters reliving the medical versus social model.
Now and then living with a disability and having the competence to be an effective Disability Inclusion advocate coincide in one person. But not often.
My transformation into a highly effective ERG lead was because of Kate Nash, founding CEO of PurpleSpace. I may have gotten there eventually, but Kate’s influence supercharged me. Kate lives with disability, as I do. But disability didn’t make Kate great, it was the avenue of the expression of her considerable capability for insight and action.
I have seen on LinkedIn, and elsewhere, people parlaying their lived experience of disability into a qualification to be a paid Disability Advocate. I understand the impulse to make the best of your situation, and I do not criticise those who do this. But I do caution those who might employ them to be aware of what you are purchasing. Lived experience of disability does not equal competence in Disability Inclusion advocacy any more than liking cakes makes you competent to cook them.
I have worked in disability related roles for over 30 years in everything from hands on personal care, monitoring compliance with care standards, coordinating delivery of support services, monitoring compliance with service delivery contract requirements, addressing more complex care services and coordinating responses to emergency accommodation and care needs. I also had extensive paid time to run a Disability ERG as well as coordinate my employer’s other action to address Disability Inclusion in the workplace as an overall fulltime job.
In addition, I have Masters and Masters Honours degrees with majors in Social Ecology. I have been reading in management, leadership and organizational behaviour for around 30 years. And I have a modest Associate Certificate of Applied Management which apparently cost my employer around $10k.
The point I am making here is that while I acquired significant mobility and grip disabilities [I can now type only with one finger] those disabilities are the least of the attributes that made me very good in my role as Disability ERG lead.
So, I want to close here making two key points:
• While they said once that “Clothes maketh the man.” disability does not.
• If you are serious about fostering Disability Inclusion in your organisation, demand advocates who actually do know what they are talking about.
Disability Inclusion advocacy is not what it seems. Organisations have lazily indulged in magical thinking as well. It’s not just the advocates who are at fault. If organisations better understood how complex and difficult Disability Inclusion can be, they’d be way more discerning about who they hire to assist or advise them.
I have noted previously that Disability ERGs should be professional grade collaborators and partners with their organisations as peers helping them meet their legal and moral responsibilities. They are not voluntary ‘staff-led’ amateur versions of a social club. They are part of an organisation’s core business. That means everyone involved has a professional responsibility to ensure effectiveness and success. That way staff with disability have their access, equity and inclusion needs met competently and promptly. How is there any other way to do this?
Seeing awful posters like the one that started me off is a sign of how much we still have to do to get it right.