Comparación por cromatografía en capa delgada de V pavonii y V officinalis

Since the Second World War, there has been rapid and extensive social change in the world - economic, cultural and political. One important change has been the development of social movements initiated by groups of individuals who feel marginalised in society, e.g. civil rights movement, women’s rights movement, racial equality and the disabled people’s movement.

In Britain, the idea that disability was a form of social oppression rather than a medical or welfare issue began in the 1970s. One founding organisation of

disabled individuals was the Union of the Physically Impaired Against Segregation (UPIAS). UPIAS led the work on interpreting disability as one of oppression by society. In their Fundamental Principles of Disability they wrote:

“In our view, it is society which disables physically impaired people.

Disability is something imposed on top of our impairments by the way we are unnecessarily isolated and excluded from full participation in society. Disabled people are therefore an oppressed group in society” (1976, p14)

Impairment is the term used to describe a physical characteristic and disability is reconstructed as a social and political process. Oliver (1983) conceptualises UPlAS’s interpretation of disability into the ‘social model of disability’. This model describes disability as being created by societies organised around the needs of the non-disabled majority and which ignores the needs of the disabled minority. In

other words it suggests that disability is something that is done to the person rather than being something the person has. Swain et al (2003, p1) describe this paradigm shift from

“...thinking of disability as a condition of the individual, to understanding disability as a condition of a society in which people with impairments are discriminated against, segregated and denied full participative citizenship. It is a shift from ‘disabled’ being seen as a personal tragedy, to ‘disabled’ as a positive identity. It is a shift from dependency and passivity, to the rights of disabled people to control decision-making processes that shape their lives.’’

Swain et al’s definition is interesting in that it includes reference to disability as a ‘personal tragedy’, which they have coupled, albeit indirectly, with passivity and dependency, suggesting that it is an inappropriate response to disability. However, arguably in some cases it may be appropriate to talk of personal tragedy, for example, the actor Christopher Reeve, who became a quadriplegic after a riding accident, had his career and ultimately his life curtailed by the injury, which can be described as a personal tragedy for him and his family. His 'personal tragedy’ did not stop him becoming an ardent campaigner and activist. However, Swain et al’s assertion that being ‘disabled’ should be seen as a positive identity may not be accepted by all individuals, particularly those who have lost independence and mobility due to their disability.

Barnes et al (1999) observe the speed by which the social interpretation of disability has gained credibility and legitimacy. Their view of the social model is that it does not deny the significance of impairment to people’s lives but focuses attention on those social barriers that are constructed on top of impairment. The anti-discrimination element of the social model has been accepted at Government level and change is being initiated through legislation (see section 3.4 page 32).

Conceptually, the social model is strong. It is relatively easy to accept that a

disabled person can be constrained by their environment. However, as Lee (2002) points out, it is politically dangerous to dismiss a disabled person’s differences and simply adapt the environment because it could trivialise the social and medical care needs and accommodation the disabled person require. Lee also makes the

point that adopting the social model does not mean that every person with an impairment can be enabled to take on any role provided there are modifications to the person’s environment, as this would be unrealistic.

Although the emergence of the ‘social model of disability’ has challenged many to reconsider the issues around disability and impairment, the ‘medical model of disability’ still predominates in much of society, and is still accepted by many disabled people. The central focus of the ‘medical model’ is that disability is an individual problem related to the functional limitations of the body. The impairment is the disability, in other words. Biomedical science is focussed on eradicating or treating illness and disability with the goal of restoring ‘normal function’. Over the last century huge advances have been made in this area. In reality many disabled people need medical diagnoses and interventions as part of the ongoing

management of some disabling conditions and to access services and benefits.

In many ways the medical model reflects how Western culture values individuality and self-determination. Oliver (1990) and Gleeson (1997) argue that the origins of present day ‘disability’ are in industrialisation in the nineteenth century. New factory based production valued workers who were ‘able-bodied’, who could work quickly, efficiently and with minimal supervision. Anyone not fitting this norm was labelled sick or incapable and people with impairments were increasingly

separated out from the rest of society and housed in workhouses and other institutions. Thus the development of communities, in everything from transport to education, was not designed for people with impairments as it was expected their needs would be met elsewhere. It could be argued that the nursing profession as a deliverer of a service has this ethos of valuing ‘fit and able’ workers.

In 1878, Charles West, a fellow of the Royal College of Physicians, described nursing as:

“It entails on those who pursue it much fatigue of body, it calls for nimbleness of hand, as well as for gentleness and patience”. (Crowther

This view that nursing is a physical occupation requiring fit and healthy individuals is well entrenched within the nursing profession. During the twentieth century there were times when the nursing profession excluded individuals unless they were a certain height and weight, if they were married or became pregnant, if they had illnesses such as diabetes and epilepsy. While not being quite so draconian, current requirements of the Nursing and Midwifery Council (2004b) are for

individuals to make good health and good character declarations at the beginning of training and on entry to the professional register.

An example of the difficulties facing individuals who have a disability in gaining access to training is reported on the Disability Rights Council website (DRC, WWW, 2005). Here they report on Nikki Heazell who had her left arm amputated below the elbow as a baby, and the difficulty she had in persuading a school to take her on as a student nurse. She was ultimately successful and qualified as a nurse in 2002. The schools that rejected her felt she would be unable to carryout the role and functions of a nurse. This suggests that in many schools of nursing their selection decisions are grounded in the ‘individual’ or ‘medical model’ of disability. The advent of the Special Educational Needs and Disability Act (2001) regulations, which requires education institutions to make anticipatory

adjustments, has meant a shift towards the ‘social’ model of disability, as the focus moves to the learning environment and away from the individual.

It is interesting to note that while the nursing profession in respect of dealing with its members could be viewed from the ‘medical model’ perspective, care delivery by nurses is often approached from the ‘social model’ perspective. The biggest change can be seen in the approaches to care in the mental health and learning disability fields. Since the 1960s there has been a move away from

institutionalised, medically dominated care to community based services where the individual is helped to lead an independent life with support from the multi­

professional team. There is an acceptance that patients are not dependent

recipients of care but should, wherever possible, be active partners in determining what should happen to them.