The Medicalization of Reasonable Accommodation

An older post, but a good one. Doesn't just apply to universities.....

http://goo.gl/xYX9ya

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.