Biomedical Engineering Reference
In-Depth Information
(WHO and World Bank 2011), it is possible to overcome the aporia of approaches radically
opposed:
As cultural differences are examples of environmental factors that are productive
of kinds and levels of disability it is essential to take them into account in practice.
A health practitioner cannot understand the nature and severity of the disability of a
client without understanding the client's environmental context, including his or her
cultural differences. Whether these differences actually make a difference in either the
nature or severity of the disability is a practical and empirical question that needs to be
answered on a case-by-case basis. (Bickenbach 2009, p. 1121)
In other words, the conflict is not in the contents (i.e., it does not concern the rightness of
both engaged positions), but rather in the political and/or ideological radicalism of both:
I argue that the conflict between universalism of rights and cultural sensitivity exist
only if these positions are expressed in extreme form: rights absolutism and cultural
relativity. If more sensibly spelled out—in the form of progressive realisation of rights
and situational sensitivity of difference—there is no conflict at all. Indeed, these more
reasonable positions are mutually supportive. (Bickenbach 2009, p. 1111)
It is now an unquestioned fact that the seriousness of a disability as well as the level of
an individual's functioning are largely determined by the context in which the individual
lives. The cultural sensitivity, given the universal foundation of human rights, is an opera-
tive horizon to which all professionals of rehabilitation should pay attention.
The necessity of better measurements of the effects of environmental factors, to improve
the rehabilitation outcome and, therefore, the well-being and satisfaction of a person with
a disability and the quality of life achieved, led to the implementation of more and more
accurate models of functioning. Concerning this, it is of a great importance that the 2002
American Association on Mental Retardation's (AAMR)
Definition, Classification, and System
of Supports
,
the 2002 System (Luckasson et al. 2002), aimed to pick out a shared assessment
model of assistive technologies. Beyond the specificity of the intellectual disability (pre-
ferred term to “mental retardation”) the relevance of the 2002 System's model lies in the
fact that “support” is considered a basic element of mediation between the multidimen-
sional features of disability (i.e., in this specific case, the intellectual one) and individual
functioning. The 2002 System recognizes as a common basis, as does the ICF, the biomedi-
cal, functional, and ecological aspects of disability. Both tools, by defining the disability in
terms of functional and ecological outlook, represent the raising of a new paradigm that
has “its focus on functional skills, personal well-being, the provision of individualized
supports, and the concept of personal competence (that is enhanced through skill acquisi-
tion, environmental modification, and/or use of prosthetics)” (Schalock and Luckasson
2004, p. 137).
In the 2002 System, the basic meanings are represented by human beings, the envi-
ronment, and supports. Such meanings explain the condition of disability and individ-
ual functioning. In particular, the dimensions by which human functioning is defined
are intellectual abilities; adaptive behavior; participation, interaction, and social roles;
health; and context. The supports, defined as “resources and strategies that aim to pro-
mote the development, education, interests, and personal well-being of a person and
that enhance individual functioning” (Schalock and Luckasson 2004, p. 142), are inte-
grated in the 2002 System relating four aspects: first, the individual functioning is the
