Making disability known: medicalisation of disability and the development of the International Classification of Functioning

Historically medical paradigms and diagnostic criteria have dominated disability policy content and operation, but, paradoxically, neglect of the health needs of people with disability was and still is a common experience. Medical-focused frameworks are generally also individually focused and seek to identify, fix or prevent impairment or difference in people’s bodies. The impact of this frame is a policy focus on disability being an essential and diagnosable state in an individual, with the onus then on either sequestering people from society or assisting the individual to adapt and accommodate to the majority environment. Attempts to bring together medicalised understandings of disability with the social models of disability and human rights have resulted in categorisation systems such as the ICF (International Classification of Functioning, Disability and Health), being applied at the person and population level. The ICF approach, or parts of the ICF model, remains the dominant framework for most Global South disability policy. This chapter maps the history of practices which led to the development of the ICF in parallel with the Convention on the Rights of Persons with Disabilities, examining each to understand what they represent and how they might be put to work in disability policy.