“Metaphysical status”: the kind of thing we think disability is (its existential or ontological nature). Tremain means that most discussions assume that disability is: a real, biological fact about certain bodies; something that exists independently of culture, history, or power; a natural kind (like gravity or DNA) rather than a product of social processes. Tremain is questioning what kind of "reality" disability is said to have. 

"Metaphysical Status" 

“Epistemological character”: how we think we can know or understand what disability is; the methods, assumptions, and frameworks that shape knowledge about it. Tremain means that people assume: science and medicine are neutral, objective, and capable of giving us true knowledge about disability; disability can be accurately represented by scientific or medical categories (e.g., diagnosis, impairment type, cognitive score).

"Epistemological Character"

Tremain argues: Most feminist philosophers uncritically accept the aforementioned assumptions about what disability is, though they may not derive the same normative conclusions from this ontology that mainstream philosophers do (many feminist philosophers still treat disability as a biological fact- as something located in the individual body and described accurately by medicine. Even though feminist philosophers often challenge sexism, patriarchy, and other forms of power, they don’t always question the basic assumption that disability is a natural condition). 

Feminist Philosophers and Assumptions in Mainstream Philosophy

The group of assumptions that underlie these questions takes for granted the "metaphysical status" and "epistemological character" of the category of disability, casting disability as a self-evident (and thus philosophically uninteresting) designation that only science and medicine can accurately represent. 

Arizona State University

Discussions about disability are becoming more and more mainstream in philosophy. Many of the questions surrounding disability are things like: What (if anything) does society owe to disabled people? On what grounds is it justifiable to euthanize disabled people? Is it ethical to conduct research experiments on cognitively disabled subjects? Questions like these are based on a shared set of assumptions. 


Disability in Mainstream Philosophy

The medical model positions a disability as something that must be diagnosed and addressed with medical intervention. It views disabilities as something that reduces a person’s quality of life, curing the disability as the ultimate goal. Also, the medical model promotes the image of people with disabilities as needing health care or as “sick”. Many people with the philosophy of the medical model underestimate the human capacity to learn about the complexities of the human body, and thus to make safe decisions about one’s disability.

Medical Model of Disability

Tremain, S. L. (2017). Foucault and feminist philosophy of disability. University of Michigan Press.

Foucault and Feminist Philosophy of Disability Reference

Assumptions Underlying Questions in Mainstream Philosophy 

Attitudes toward deafness can be divided into two groups: the clinical and the cultural model.

1) The Clinical Model: Deafness is viewed as a handicap, a medical condition, or a deficiency. Deafness is viewed as something needing to be fixed, through such means as hearing aids and cochlear implants.

2) The Cultural Model: People with hearing difficulties are viewed as a linguistic and cultural minority group within a hearing society, marked by difference rather than limitation.

Attitudes Toward Deafness/ Two Conflicting Models

- Important Books in the Medical View of Disabilities

Important Literature in the Medical Model of Disabilities

Individuals who view disability in terms of the medical model may disrupt the potential for the people with a disability to form a positive disability identity by placing too much emphasis on ability and other internal factors.  

Disability Identity Development In Terms of the Medical Model 

'Making up people' is the concept that by studying and categorizing types of people, those classifications change to better reflect the societal views of the characteristics of individuals within that classification. By studying people we create kinds of people - ways people can be embodied - that did not exist prior to classification.

In this article, Sparti proposes that we can use the model of making up people to understand the formation of disabilities.

Making Up People - On Some Looping Effects of the Human Kind - Institutional Reflexivity of Social Control?

Self-help groups did not work within the medical model of disability and instead centered individuals as experts in their own experiences, and emphasized the need to address internalized oppression and create systems of community support rather than emphasizing eliminating or relieving someone from disability.

NBWHP's Self-Help Groups and Models of Disability

Higher education has historically used the  medical model of disability - systems like accommodations place the blame or site of of disability in the individual student for whom the environment needs to be changed to accomodate rather than locating disability in the system. Accomodations require students to disclose their disability status to recieve accomodations in ways that force them to pathologize their own being.

Models of Disability in Higher Education

Highlighting the role of essentialism and blame in disability stigma shows just how informed this stigma is by the medical model of disability.

Disability Stigma and the Medical Model of Disability

This refers to how human conditions and behaviors come to be defined and treated as medical illnesses requiring professional intervention. Medicalization leads to individualized diagnoses rather than social or cultural explanations for human differences. The process transforms social issues into medical problems amenable to clinical treatment. DP reveals how medicalization occurs through specific discursive practices in institutional settings.

Medicalization Process

When AI systems are designed through the lens of the medical model, disability is framed primarily as an individual deficit to be diagnosed, measured, or corrected. This drives the development of technologies such as diagnostic algorithms, assistive apps, or predictive screening tools that focus on “fixing” impairments rather than addressing the broader structural barriers that create disablement. While such tools can provide clinical benefits, they risk reinforcing a narrow view of disability as pathology and sidelining questions of justice, accessibility, and agency.

How Medical Model Shapes AI

Traditional special education roots itself in pathologization, intervention, and Eugenist philosophies. Students with disabilities are viewed through a deficit lens requiring them to be "fixed." The system demands students adapt to fit existing structures rather than questioning those structures. This approach perpetuates harm and dehumanization.

Special Education's Roots in the Medical Model

- By constructing the CI user as "abled" and the HA user as "disabled," the discourse reinforces the Medical Model of Disability.
- Disability is framed as a consumer choice between prostheses (choosing the "right" device) rather than a social or political issue.
- Ultimately, the formulation of CI satisfaction perpetuates audism by valuing human variation only as a deviation from "imagined perfection".

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