The Evolution of Disability Perspectives: From Charity to Human Rights

How we understand disability shapes how we treat people with disabilities – and that understanding has changed dramatically over the past century. What was once seen as a matter of pity, divine punishment, or medical deficiency is now recognized in international law as a human rights issue. This journey – from charity to rights – is not just historical context. It explains why inclusive education, accessible infrastructure, and anti-discrimination laws exist today, and why they matter.

The charity model: pity as a framework 🔗

For much of recorded history, disability was treated primarily as a matter of charity and medical intervention, with persons with disabilities viewed as objects of pity rather than active members of society. The charity model, dominant through the 19th and early 20th centuries, framed disability as an inherent personal tragedy – a burden to be managed through the goodwill of non-disabled people.

The charity model positions non-disabled people as “saviours” and disabled people as passive recipients of that generosity. This framing is deeply embedded in cultural and religious ideas: in some traditions, disability has been linked to divine punishment or bad karma – a moral failing either of the individual or their family. The result is a worldview in which a person with a disability is seen as deserving pity but not dignity, sympathy but not agency.

In practical terms, the charity model produced welfare institutions, donation-driven relief programs, and telethons – well-intentioned but ultimately disempowering. The charity model is a profoundly damaging way of understanding disability because it creates dependency, suppresses the potential for contribution, and treats disability as something inherently negative rather than as a natural variation of human experience. Critically, it centers the giver’s generosity – not the rights or needs of the person receiving charity.

In contexts shaped by notions of karma or divine will, this model has been especially persistent. When disability is understood as cosmic consequence, society feels absolved of its responsibility to create accessible, inclusive environments. The “problem” lies with the individual, not with society’s design.

The medical model: the problem is in the person 🔗

As modern medicine developed in the 20th century, the charity model evolved into what is now called the medical model of disability. This model defined disability through three key terms: impairment (the functional limitation in a person’s body or mind), disability (the restriction caused by that impairment), and handicap (the social disadvantage resulting from it). Under the medical model, people with disabilities were treated as sick and in need of cure, fixing, and care through medical intervention and therapy, and the experts on disability were considered to be medical professionals – doctors, nurses, therapists – not disabled people themselves.

The logic of this model is straightforward: if the problem lies within the individual’s body or mind, then the solution is rehabilitation – changing the person to fit into a world designed for non-disabled people. This meant cochlear implants over sign language recognition, standing wheelchairs over accessible sidewalks, and behavioral therapy over structural reform.

The core limitation of the medical model 🔗

The medical model’s most significant flaw is what it leaves out: the role of the environment and society. Consider a simple example. Wheelchairs may be provided, but the streets remain inaccessible. The model addresses the individual while ignoring the barrier. A person who uses a wheelchair is not disabled by their inability to walk – they are disabled by the absence of a ramp. A person who is blind is not disabled by their visual impairment – they are disabled by a world that defaults to visual-only information.

By locating the “problem” exclusively in the individual, the medical model redirects responsibility away from society. It can also lead to what disability scholars call medicalisation – treating every aspect of a disabled person’s life as a clinical problem to be managed, rather than a life to be lived. The medical model considers disability to be an individual characteristic; assistive technology is used to fix the disability and allow the person to have a more “normal” life – with the definition of “normal” never being questioned.

This model does have practical utility. Medical expertise matters enormously in diagnosing conditions, providing treatment, and managing health. The limitation is not medicine itself, but the use of a medical lens to explain and respond to all disability-related questions, including questions that are fundamentally social and political.

The social model: society creates disability 🔗

The social model emerged from the disability rights movement in the 1970s and represents a fundamental shift in thinking. The social model sees disability as created by the social environment, which excludes people with impairments from full participation in society as a result of attitudinal, environmental, and institutional barriers. The model makes a clear distinction between impairment – the physical, sensory, or cognitive difference a person has – and disability – the restriction imposed by a society that fails to account for that difference.

According to the social model, it is not the impairment that disables people, but rather the barriers put in place by society. If those barriers were removed – if spaces were accessible, attitudes were inclusive, and systems were designed for diversity – then disabled people could participate equally. Disability as a form of exclusion would, in large part, cease to exist.

This is not a theoretical abstraction. It is a practical design principle. A lecture hall without a hearing loop excludes people with hearing impairments. A website without alt text excludes screen-reader users. A job interview that requires an in-person visit to an inaccessible building excludes wheelchair users. The social model says: fix the building, fix the website, fix the system – not the person.

The social model places the responsibility for change squarely on society – on institutions, governments, employers, and designers. It places emphasis on society adapting to include people with disabilities by changing attitudes, practices, and policies to remove barriers to participation. This reframing is the intellectual foundation of everything that follows in disability rights law and policy.

The human rights approach: from barriers to entitlements 🔗

The social model explains how disability is created. The human rights approach goes a step further and establishes what must be done about it – legally and politically. The human rights model builds upon the foundations laid by the social model and the Universal Declaration of Human Rights, viewing the individual with a disability as a human first, entitled to the same rights as everyone else, with those rights protected and enforced by law.

The human rights approach also recognizes that disability is not a fixed category. The UNCRPD recognizes that “disability is an evolving concept” that arises when a person with an impairment interacts with barriers in their environment. This framing is inclusive – it covers physical, sensory, intellectual, and psychosocial disabilities – and it resists the reductive idea that disabled people are a uniform group with identical needs.

The disability rights movement and “nothing for us without us” 🔗

The shift to the human rights framework was not handed down from above. It was fought for. The concept embedded in the slogan “nothing about us without us” emerged in the 1980s and grew in popularity in the 1990s among disability rights activists, who demanded that disabled people be at the centre of decisions affecting their lives. This principle challenged every institution – medical, governmental, educational – that had historically treated disabled people as passive subjects of expert management.

In the United States, this movement produced the Americans with Disabilities Act (ADA) of 1990 – the world’s first comprehensive civil rights law for people with disabilities, signed into law by President George H.W. Bush on July 26, 1990. The ADA prohibits discrimination based on disability in employment, public services, transportation, and public accommodation. Its passage was hard-won: in March 1990, protesters abandoned their wheelchairs and crawled the 83 stone steps of the U.S. Capitol to demand the bill’s passage – an act that powerfully illustrated the physical barriers disabled Americans faced every day.

The UN Convention on the Rights of Persons with Disabilities (UNCRPD) 🔗

On the global stage, the most significant expression of the human rights approach is the UN Convention on the Rights of Persons with Disabilities (UNCRPD), adopted on 13 December 2006. It entered into force on 3 May 2008 and has since been ratified by 193 countries – the largest number of signatories to a UN Convention on its opening day in history.

The UNCRPD marks a decisive shift from viewing persons with disabilities as “objects” of charity, medical treatment, and social protection, toward viewing them as “subjects” with rights – rights to make their own decisions, participate in society, and hold governments accountable. The CRPD was the first human rights treaty to be developed by disabled people, for disabled people, embodying the principle of “nothing about us without us” from its very inception.

The UNCRPD does not create new rights – it clarifies how existing human rights apply to persons with disabilities. Article 3 of the CRPD establishes as its first general principle: “Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons.” Other principles include equality, non-discrimination, full inclusion, and accessibility. Signatory states are required to pass legislation, remove barriers, and ensure that disabled people can participate fully in political, civil, social, cultural, and economic life.

The human rights model takes the UNCRPD as its main reference point and sees people with disabilities as the “central actors in their own lives as decision makers, citizens, and rights holders.” This is the sharpest possible contrast to the charity model, in which disabled people were passive recipients of others’ goodwill.

Why this evolution matters in education and practice 🔗

Understanding how these perspectives have shifted is not merely academic. Each model produces a different kind of response. The charity model produces telethons and pity-driven fundraising. The medical model produces rehabilitation programs that ask disabled people to conform to a non-disabled norm. The social model produces ramp-building and policy reform. The human rights approach produces legal entitlements, enforceable protections, and a seat at the table for disabled people themselves.

For educators, policymakers, and anyone working in social or development sectors, this progression is a reminder that how we frame a problem determines what solutions we reach for. Even though there have been great achievements in the emancipation of disabled people, we still live in an ableist world where outdated models and attitudes continue to persist. The language we use, the systems we design, and the assumptions we carry into classrooms and workplaces all reflect – consciously or not – one or more of these models.

The shift from charity to human rights is not complete. It is ongoing. And it requires not just structural changes to infrastructure and law, but a genuine transformation in how every institution, and every individual, understands what disability is and where the problem actually lies.

What do you think? If a school provides a wheelchair to a student but fails to make its classrooms and corridors accessible, which model of disability is it operating from – and what would a human rights approach require it to do differently? And how might the persistence of charity-based thinking in everyday language and institutional culture slow down the full implementation of rights-based frameworks like the UNCRPD?

References

1. https://social.desa.un.org/issues/disability/crpd/convention-on-the-rights-of-persons-with-disabilities-crpd
2. https://www.drakemusic.org/blog/nim-ralph/understanding-disability-part-4-the-charity-model/
3. https://disabilityphilanthropy.org/resource/dismantling-the-charity-model-of-disability-within-philanthropy/
4. https://miusa.org/resource/tip-sheets/disabilitymodels/
5. http://oah.olin.edu/node/61
6. https://gsdrc.org/topic-guides/disability-inclusion/background/definition-of-disability/
7. https://enil.eu/conceptual-models-of-disability-throughout-history/
8. https://sites.uab.edu/humanrights/2023/03/06/part-three-the-different-approaches-to-disabilities-and-the-future-of-disability-rights/
9. https://www.nps.gov/articles/disability-history-series-introduction.htm
10. https://www.archives.gov/research/americans-with-disabilities
11. https://disabilities.temple.edu/resources/disability-rights-timeline
12. https://www.ncbi.nlm.nih.gov/books/NBK558160/