Picture of man welding

Medical model? Social model? No, I follow the Hacker model of disability.

Picture of man welding

This is possibly the most manly picture ever used in this blog… normal service to resume shortly ( http://commons.wikimedia.org/wiki/File:GMAW.welding.af.ncs.jpg)

I do not follow the social model of disability.

…and before you get preemptively angry. I’m not a medical model person either.

A couple of weekends ago I met a lovely man. He was telling me about the difficulty that his daughter had with plane seats – she needed support to sit up and almost all the products that would help were banned by airlines or where both massively unsuitable or prohibitively expensive.

This was after a fairly long group discussion on the topic which mostly focused on the (important and noble) goals of getting the airlines to agree official policy and make sensible exceptions. I utterly support this approach – I think that airlines (and similar setups involving seating) should be all over this and I think pressure should be applied to make it so. It’s a very classic social model approach and I have no doubt that in several years (hopefully much less) it will bear fruit.

However, a couple of years is a long time not to take your daughter on holiday, and so the solution turned out to be that she was supported by a big roll of toilet tissue on either side of her during the flight. I loved that approach so much because it was so close to how I think. Today – you solve the problem in front of you. It might not work tomorrow, but you’ll deal with that tomorrow. It might not work for anyone else, but family comes first.

I think that this is a different model. And the internet has really made it flourish. Some of my favorite examples are video games, sweet measures, and Kindle page turners.

This is the ‘hacker model’. It’s not technology limited either – it’s the mindset you often find in service users, social workers, SLTs, elder brothers and sisters, care staff. They are not trying to ‘fix’ anyone, and they are not trying to change the world today.

At the risk of overplaying the point I think the difference is this:

Medical Model: With advances in stem cell research I think we can find a way that we can make that man able to swim.

Social Model: If we reduced the depth of the water, even in just one section of the swimming pool then that man would be able to enjoy the swimming pool without restriction.

Hacker’s Model: My friend is drowning, I’m throwing them a rope.

Yes I believe in long term social change, yes I support it. I also support medical research. But my heart and my instincts belong to the people who make life better with duct tape or an afternoon welding something in a shed. These are temporary measures but, as the great Pratchett has said “life was no more than a series of temporary measures strung together”. And I think it’s an important distinction: there is a space between medical and social and a lot of good is done there.


EDIT: relevant Twitter conversation…








8 thoughts on “Medical model? Social model? No, I follow the Hacker model of disability.

  1. I emailed this to my bosses. They loved it. I work in a children’s respite, and because their needs change so often, the hacker model is our model. The OHS team would be horrified about how much more inclusive we have made the children’s weekends. But let’s just say that if an organisation risk assesses a day at the beach, it just won’t happen.

  2. Hi Joe, I have to say I disagree! It sounds to me like you are actually talking about the medical model. The medical model isn’t just about clinical treatments. If you’re taking the ICF definition of disability (impairments interacting with environmental barriers), medical means focussing on the impairments, social means focussing on the environmental barriers.

    So yes, designing a more inclusive plane would come under social. But any form of treatment applied to an individual, be it gene therapy or toilet rolls, comes under medical. The concept of assistive technology, from glasses to white sticks, powered wheelchairs to toilet rolls, all comes from the medical model.

  3. For me, it’s not about one model Vs another, it’s about using three different models together wherever they’re most appropriate. So medical & social, plus economic too. So economic meaning thinking of people as a figure on a balance sheet. But not in the traditional sense of local authorities assessing people with disabilities solely as a negative financial value, but the opposite – spending power, profit, business cases.

    So social model as the first port of call, wherever there’s a totally unnecessary barrier that can be removed/avoided (eg. configurable controls, using symbols as well as colour), medical for where social just can’t cut it, the situations where access cannot be achieved simply through environmental/product design (eg. custom controller, screenreader), both backed up by economic for where altruism isn’t enough justification (eg. 14% of players chose to configure their controls on this other game).

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