Book Review

Disabling Laws, Enabling Acts: Disability rights in Britain and America

N Engl J Med 1995; 332:1798June 29, 1995

Article

Disabling Laws, Enabling Acts: Disability rights in Britain and America
(Law and Social Theory.) By Caroline Gooding. 219 pp. Boulder, Colo., Pluto Press, 1994. $16.95. ISBN: 0-7453-0771-X

Comparing and contrasting the development and current status of disability legislation in the United States and Britain is an effective way to highlight the major issues. It also adds dramatic impact to a scholarly work. Gooding starts with the premise that disability is to a great extent a concept based on social, political, and historical factors. These factors have a greater role in defining the personal and legal status of someone with a physical or mental impairment than the impairment itself. The medicalization of physical and mental impairments and the paternalism of the welfare state — the dominant philosophies until the early 1970s — combined to establish a status quo that worked against the entry of people with disabilities into society at large. The author demonstrates how activists in the disability movement, patterning their strategy on the approach of the Black Power, feminist, and other social movements, began working toward legislative remedies, which 20 years later culminated in the passage of the Americans with Disabilities Act.

The book then provides an easily followed analysis of the structure and effectiveness of American disability laws, with an emphasis on the tactical and strategic uses of social and political activism. The scene shifts next to Britain, and the author recounts a struggle that has achieved little progress and is marked by the virtual absence of effective enforcement of the few laws that have been passed. People with disabilities have not been able to match even the small gains achieved by women and ethnic minorities, and little change seems likely in the near future. The inability of the European Union to pass meaningful social legislation is documented. Even in this venue, Britain has refused to sign any agreement that might commit the nation to binding social legislation.

The author clearly brings the perspective of an activist for civil rights for the disabled to her book. She can, however, keep rhetoric in check and document her arguments with relevant citations. As an added fringe benefit, the book provides Americans with a brief but interesting primer on the British parliamentary and legal systems.

The United States almost always comes off badly when compared with other industrial nations. Examples such as infant mortality, violent deaths of the young, and teenage pregnancy are well known. We have excelled, however, in developing and implementing legislation that facilitates the entry of people with disabilities into mainstream life and gainful employment. Anyone frustrated by the seeming “excesses” of the Americans with Disabilities Act and related legislation, especially at a time of frontal assault on all social programs, should read this book, compare our situation with that in Britain, and be reminded of what life in this country was like not too many years ago for 36 million Americans with disabilities.

Gerald S. Golden, M.D.
National Board of Medical Examiners, Philadelphia, PA 19104