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Family-Centred Care: A Critical Perspective

The following commentary is informed by my multiple perspectives as a parent of a 12-year-old girl with cerebral palsy, as a social worker, and as a critical disability advocate and activist. While I occupy these subject positions simultaneously, they are not necessarily always confluent with one another (Heron, 2005). I struggle with, and am, at times, conflicted by living, working, and parenting in a society that holds various views of disability and in particular how and where children with disabilities fit into the social tapestry. The foundation of some of these differing and conflicted views of disability stem from two dominant ideological perspectives, the medical model of disability and the social model of disability. The medical view is on the basis of historically hegemonic Eurocentric empiricism, where measurable standards of “normal” are the ideal (Jeffreys, 2002). From this standpoint, the human body that fails to measure up to these standards, in terms of body shape (the practice of counting the fingers and toes of a newborn reinforces this notion), how the body moves and how the body communicates is deemed deficient and not normal. The assessment of the “normality” of each individual continues from the moment they are born. A body determined to not meet the socially constructed standards of normalcy, is pathologized, diagnosed and defined as disabled, from temporary impairment to permanent, functionally “defective” (Swan, 2002). The important distinction here is that the process of assessment determines what the treatment of the body will be, in other words, how to “fix” the “problem” of this individual body toward a normalizing outcome. This may involve surgery, medicine, prosthetics, orthotics, rehabilitation, and any number of other interventions applied to attempt to correct the disabled body. Many medical and science-based professions are founded on this dominant western medical model. The social view of disability is a historically situated, political, and social response by people within disability communities to the oppression they have experienced by a society that structurally excludes the full participation and citizenship of people with disabilities (Siebers, 2002). This view challenges the notion of disability as an individual problem requiring it to be fixed. Instead, the social model locates the problem of disability in society through its promotion of rigid and categorically