The Pathic Model of Disability: Identity, Moral Force and the Politics of Pain

ABSTRACT

Critics of the ‘strong social model’ of disability developed in the U.K. commonly claim that it focuses too one-sidedly on social oppression, thereby neglecting the role of individual impairment. In this theoretical article, we contrast that model with what we call the ‘pathic model’ of disability, which we characterise through the case of people living with chronic pain in the U.S.A. We argue that the difference between these two models is due to differing socio-political contexts and national policies concerning welfare and addiction as well as normative assumptions regarding the moral force of focusing on individual pain. We conclude that the political goals of proponents of the ‘pathic model’ present a challenge to the presumption that the ‘strong social model’ is the most or only politically effective way to rectify disability-related social oppression.

KEYWORDS:

• British social model
• comparative and international disability studies
• disability politics
• ethics
• impairment
• pain
• philosophy of disability
• social movements

Notes

1. Some scholars argue that the social model as a whole is outdated or simply unhelpful. For example, see (Davis, 2013).

2. As Melzack and Wall (2003) put it,

The impact of the pain revolution is revealed by the contents of this handbook. The further we move from a stimulus-driven concept of pain, the better we recognize the validity of baffling pain syndromes that often have no obvious pathology to explain the presence of pain or its terrible intensity. They include neuropathic pains, backache, fibromyalgia, pelvic, urogenital, and other pains, which become increasingly comprehensible when we extend our diagnostic search to consider multiple causal mechanisms.

3. What is more, as Don Gustafson nicely summarises, ‘Not even acute pain examples (a burn of the hand or blow to the thumb, etc.) cited by philosophers and others are conceived as simple sensations in current pain sciences’. Don Gustafson, ‘Categorizing Pain’, in (Aydede, 2005, p. 237).

4. For example, see the websites of the American Chronic Pain Association, the U.S. Pain Foundation, and the Chronic Pain Support Group on +SupportGroups (ACPA, 2017; +SupportGroups, 2017; U.S. Pain Foundation [USPF], 2017). This is also a common refrain among memoirs, histories, and other writings about pain in the U.S.A. e.g. see (Thernstrom, 2010; esp. pp. 159–162; Wailoo, 2014; esp. pp. 168–201). For a perspective on the context in the U.S.A. from a person living with chronic pain in Canada, see (Heshusius, 2009, esp. Chapter 5).

5. The fact that the category of the ‘addict’ is used in this way is deeply problematic in and of itself, of course, but we do not have space to address that issue here.