Concepts of Ill Health Disability and Impairment The words disability and impairment are used in a variety of different ways and can often be quite difficult to define clearly particularly the word disability. Tom Shakespeare (1998) a campaigner for disabled rights and writer on disability, genetics and bio-ethics who has achondroplasia, a form of dwarfism, formalized a distinction between the two words. Disability – Tom Shakespeare sees disability as being a problem which occurs when society does not take in to account the needs of a person who has a disability.
An example of this may be a young adult in a wheelchair is only disabled if the places that they want to go to do not have wheelchair access. In this context, writers may sometimes refer to it as a disabling environment which is an environment which does not have the adaptations and facilities to ensure that individuals with impairments are able to take full part in a social life. Impairment – An impairment sees the focus being put on the individual and the day to day restrictions that may happen as result of their long term physical or mental condition.From this point of view the patient has to co-operate with the health care professionals in order to limit the restrictions which are caused by their impairment – this is similar to one of the responsibilities of the sick role and as such they also have a similar role, to be let out of social obligations. An impairment could be for example the loss of a limp. Iatrogenesis Iatrogenesis can also be referred to as being a doctor-generated illness or illness which has been generated by medical activity or practice.
The term was introduced by Ivan Illich (1976) as a part of his criticism of the industrialised society and its large institutions. According to Illich there were three major types of Iatrogenesis. Clinical Iatrogenesis – clinical iatrogenesis refers to the unwanted side effects which may occur as the result of medical intervention. An example of this is the use of chemotherapy in the treatment of cancer.
This can cause nausea and vomiting, hair loss, anaemia and depression of the immune system which makes the person more vulnerable to illness.Social Iatrogenesis – social iatrogenesis refers to the fact that medicine has gained so much power and status so people very quickly and easily place themselves in to the hands of medical professionals and in turn become mass consumers of medical products. For example many people use anti-depressants to which people can become dependant on. Cultural Iatrogenesis – cultural iatrogenesis refers to when society becomes overly concerned with perfect health which makes it difficult to cope appropriately with death or too develop positive attitudes about impairment.This means is it really necessary to take medication for every illness. Another example could be anorexia and the way in which a perfect body shape is presented to people.
The Clinical Iceberg The clinical iceberg is what the official statistics of illness are occasionally called, this is because it is thought that the true levels are mostly concealed which is because many people are ill but they do not necessarily visit their doctor – this could happen for a wide reason.
