Appendix 1: Concepts and definitions
Impairment and disability
In anticipation of the International Year of the
Disabled in 1981 and the start of the Decade of the Disabled in
1982,[14,15] the World Health Organization (WHO) commissioned a
study to define and classify "disability." This study
led to the International Classification of Impairment, Disability
and Handicap. Within this model, diseases may result in "impairment,"
the outward expression of deficits in the function of organs and
organ systems.[16,17] Impairment may lead to "disability,"
which is defined as a reduced ability to perform activities of
daily living, to move about or to interact with one's environment.[16,17]
Handicap
According to the original WHO definitions, a disability
may lead to a "handicap," which is a limitation of a
person's social role in regard to family, society or economic
independence.[16,17]
In recent years, various groups have tried to refine
these definitions.[18] In particular, many groups representing persons
with disabilities have argued against the notion that disability
leads to handicap. The Canadian Society for the International
Classification of Impairment, Disease, and Handicap recently proposed
a change to the classification of handicap. It argued that handicap
is a situational result of the interaction between the characteristics
of a person=s impairments or disabilities and those of his or
her environment; it is the interaction that results in social
or environmental obstacles in a given situation. Thus, it is acknowledged
that persons with disabilities may be influenced not only by medical
and functional factors but also by environmental factors affecting
accessibility, accommodation, resource availability, social support
and equality; these may result in a handicap.[19]
Accessibility
There have been no formal attempts to define the
term "accessible" as there have been to define "disability."
The Oxford dictionary defines "accessible" as "capable
of being used, entered or reached" and as "open to the
influence of." Some have interpreted this definition in a
broad sense to imply not only to "enter and use facilities,
but also to be dealt with in an equable, reasonable, and accommodating
manner."[20] In this definition, accessibility refers not only
to structural access but also to "attitudinal access."[20]
The diverse challenges involved in accommodation,
the increasing strength of the disability movement and the research
showing that persons without disabilities can make use of many
accessible-design features have led to a new philosophy termed
"universal accessibility." This philosophy represents
a departure from traditional approaches to accommodation. Instead
of special aids, facilities or structural elements being added
or implemented specifically for persons with disabilities, the
design eliminates obstacles and provides an environment that is
barrier-free to all.[21] Barrier-free design takes into account
the wide range of potential users of a building, including persons
with permanent or temporary disabilities, elderly people, children
and other persons without disabilities engaging in a variety of
activities.[22]
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