Between the ideal and the real: Reconsidering the International Classification of Functioning, Disability and Health

Abstract

Purpose. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) is a disability classification and framework that was endorsed in 2001. Despite its endorsement from WHO member states, some rehabilitation researchers have argued that the ICF has been used and requires further inquiry. The purpose of this article is to examine the ICF critically using a feminist theoretical perspective.

Method. In this commentary, I apply a feminist perspective to identify some of the assumptions that limit the ICF and to illustrate how the principles of feminist science could enhance the ICF.

Results. The analysis reveals that although the ICF is premised on the assumptions of biopsychosocial theory (BPS), there are aspects of the classification that contradict the tenets of BPS. Moreover, although the ICF is purported to represent a change in thinking about disability, the stated principles of rehabilitation medicine have the potential to limit the ICF in this regard.

Conclusion. The ICF has the potential to be a powerful tool for changing the way that we think about disability and to improve the lives of individuals of all abilities. Bringing the ICF into closer alignment with BPS theory is an important step in moving the ICF forward.

Keywords:

• ICF
• feminist perspectives
• standpoint theory
• biopsychosocial theory

Acknowledgements

I would like to thank Dr. Doreen Bartlett, Dr. Philip Doyle, Ms. Julie Gouweloos, Dr. Marilyn Kertoy, Dr. Anne Kinsella and Dr. J. B. Orange who provided comments on earlier drafts of this commentary. I would also like to acknowledge Sebastiano and Katherine Conti.