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Disability & Society, Vol. 18, No. 2, 2003, pp. 209–229
The Systems Theory Concept of
Disability: one is not born a
disabled person, one is observed to
be one
DIMITRIS MICHAILAKIS*
Associate Professor of Sociology, Department of Caring Sciences and Sociology,
University of Ga¨vle, SE-801 76 Ga¨vle, Sweden
ABSTRACT The article aims at the theoretical development of the concept of disability,
with particular reference to its integration with social systems theory. The concept of
disability is discussed by suggesting that the predominant models within disability research
cannot communicate with each other because they represent different observation points, all
of them describing disability from within a specific system. It is the thesis of this article that
the distinction between individual and society, which constitute the basis of the well-known
scheme of observed differences between impairment, disability and ‘handicap’, is a distinc-
tion based on naı¨ve realism and obscures the problems within disability research. In line
with a long tradition within sociology, social system theory rejects the belief that our concepts
are representations of reality: the categories and concepts we use are distinctions that are
system specific. It is through those distinctions that the phenomenon is observed. This implies
that observations are not absolute but relative to the observer’s perspective.
Three Conceptualisations in Disability Research
Focusing on Individuals’ Physical, Psychic and Intellectual ‘Defects’
A close look at the relevant literature within disability research shows that there is
no agreement on how the concept of disability should be defined; on the contrary,
there are several competing definitions within at least three different models. In the
following I will discuss these three models and thereafter propose a new, alternative
understanding.
The traditional view of disability focuses on the individual, which is thought
being incapable to perform certain activities due to one or more functional impair-
ments. Disability is thus an individual incapacity of medically verified facts. Disabil-
ity implies incapacities or failings, a defect or impairment. The individual is
*mdi@hig.se
ISSN 0968-7599 (print)/ISSN 1360-0508 (online)/03/020209-21
2003 Taylor & Francis Ltd
DOI: 10.1080/0968759032000044184
210 D. Michailakis
‘handicapped’, independently of the prevailing surroundings. This has been and still
is the medical point of departure. Thus, whether an individual is disabled or not
depends on his/her clinical status. Impairment is a phenomenon established through
a diagnosis, through a medical examination. The obstacles to participation on equal
terms are situated, accordingly, primarily in the individual, since it is the individual
who lacks certain capacities that are necessary to attain autonomy.
Impairment is consequently thought as something that could be treated by
different kinds of therapy of the body with the intention of curing it or at least
alleviating the physical, psychic or intellectual impairment. In the medical model
impairment is being viewed as a limitation of the individual, a limitation that is
thought to be compensated through rehabilitation. This model has under a long
period formed society’s understanding of disability. The distinctive trait of this
model is the assumption that all differences can be wiped out with prostheses,
exercises, medical interventions and by stimulating the handicapped individual’s
wish to adapt to the norm (Stiker, 1999). The medical model has been criticised
because it reduces the importance of political, economic and social factors. In a kind
of reductionist approach it assigns the individual’s physical, intellectual or mental
conditions as the primary factor, the only point of departure. It should be noticed,
though, that the distinctive trait of the medical model is the focusing on the body’s
malfunction and the needed therapy. The perspective is not to be regarded as
medical because, as many take for granted, the individual is in focus, but because it
is the individual’s physical–psychical defects that are examined and the purpose is a
medical diagnosis. Within disability research the medical perspective still hold a
position as, if not the only valid, at least the most fundamental in a hierarchic order
in relation to other perspectives.
Relativisation of Individual Preconditions
During the last decades, the medical model has been called into question. A more
complex approach to understand disability emerged. According to this, disability is
the effect of the relation between an individual’s physical, psychic or intellectual
conditions and the way the society is constructed. Disability emerges as an effect of
the obstacles that society raises. It is the result of the interaction between the
disabled individual and society. In an opposite way of reasoning compared with the
medical model, the demands and requirements from society determine whether an
injury or impairment becomes a handicap or not. Impairment becomes handicap-
ping through society that does not take the impairment into account, for instance by
architectonic hindrances, but also due to laws and attitudes prevailing in social
groups. The focus in this model shifts partially to society. It is society that must be
adapted in order to reduce–avoid the disabling effects. The solution, or the
remedy, could be given, not by medicine, but by law making, special education,
architectural considerations on persons outside the norm of the adult, able-bodied
male. Disabled persons’ organisations have supported this model because owing to
it many requirements and policy programs could be formulated. Basically that
society must be adapted as far as possible to meet the individual’s needs, rather than
Systems Theory Concept of Disability 211
simply rehabilitating the individual to live and work in a ‘normal’, i.e. a given
environment set up and developed with the non-disabled as norm. Impairment that
can lead to handicap is an important aspect, but is considered as the constant in the
relationship and society as the variable factor. Much of the limitations that are
inflicted upon individuals with impairments are neither natural nor inevitable
consequences of their capabilities, bur rather must be seen as the results of a failed
social policy or being the failures of social institutions to take into account certain
individuals’ particular conditions (So¨der, 1982; Moore et al., 1998; Lloyd, 2001).
The last decades of disability policy has been influenced by this model. The
advantage with this is that it has given rise to reforms in the field of disability policy.
Both the medical model and the individual–society model are obvious in the
WHO’s three level classification between impairments, disabilities and handicaps.
According to the WHO scheme, disability is a consequence of impairment in terms
of the individual’s performance and action capability. Handicap, on the contrary,
denotes the discrimination that the individual is exposed to as a consequence of
impairment or disability. Disabilities are seen as the result of impairments; they are
independent of context in the sense of not being dependent of the particular context
in which an individual finds him/herself. Disabilities are immanent in the individual,
while handicap is the effect of social factors (Edwards, 1997). According to the
WHO scheme neither impairment nor disability necessarily leads to handicap.
However, the reverse is taken for granted; there is a causal relationship between
handicap and impairment–disability where handicap always presuppose impairment
and disability.
The WHO has recently revised ICIDH and endorsed (resolution WHA 54.21)
the International Classification of Functioning, Disability and Health (ICF). The
terms functioning, disability and health replace the previously used terms impair-
ment, disability and handicap. The medical perspective prevails, as before, further,
the common denominator is as in all versions of WHO’s schemes the distinction
between the individual and the environment.[1]
Disregarding Individual Preconditions
In opposition to the prevalent way of thinking–conceptualising disability—i.e. the
medical model but also to the WHO scheme—a third model has evolved. The critics
mean that there is no causality between impairment (biology–organism) and ‘handi-
cap’, but on the contrary that ‘handicap’ is a particular form of discrimination and
that discrimination has social origins (To¨ssebro, 1997). The disadvantage is not an
effect of impairment. Disadvantages do not originate from some biological or
physiological determination. Disadvantage is culturally, socially, economically and
politically constructed. Disability becomes equivalent with oppression by social and
institutional structures within which certain physical, emotional and intellectual
differences are identified and treated in a certain way. From this perspective
economy, governmental policy, state authorities and institutions (e.g. educational
system) are key factors in the formation of structures that oppress disabled people
212 D. Michailakis
on a daily basis. Individuals have certain physical, emotional and intellectual
differences when compared with each other; some of them become disabling due to
social structures and organisation (Jones & Basser Marks, 1999). According to this
understanding ‘handicap’ is neither located in the impaired part of the body nor in
the relation between the individual’s inability and society’s demands—as in the
WHO scheme—but exclusively belongs to an excluding and oppressive society.
Oppression has its root in social structures, it must be institutionalised in order to
be oppression; it is not a simple effect of prejudiced individuals or accidents by
chance. Poverty, for instance, is an important factor in the distribution of impair-
ment among the population. Poor people are running greater risk of being injured
as a result of deficient working conditions, low standard in housing and sanitary
conditions, etc. This model points to the often forgotten fact that disability in a large
extent is ‘social creation’, following in the footsteps of war, famine and social
breakdowns. If human beings suffer from malnutrition and are exposed to major
risks of infection without access to medical care the frequency levels of disability rise
in great extent. We know that, eighty percent of people with disabilities live in
developing countries and ninety percent are living in rural areas. Disability as
understood in this model implies focusing on the social conditions and political
conditions that make people disabled, independently of their individual precondi-
tions. Many social scientists have made contributions in exploring this perspective of
disability in the last decades (Finkelstein, 1980; Oliver, 1990, 1996; Barnes, 1991;
Barnes & Mercer, 1996; Barton, 1996; Davis, 1995; Hales, 1996; Harris, 1996).
They consider the WHO scheme as a minor modification of the medical model.
They argue, that although the WHO scheme accepts that society modifies the
consequences of impairment, it regards—despite this fact—that the primary cause is
to be found in limitations of the individual organism.
Thus, in the medical model observations concern the body, its functions and
malfunctions, observations about health conditions and deviations from health
conditions, in the individual–society model observations concern the relation be-
tween disabled individuals and other individuals attitudes towards to the former
group, and in the social model observations concern social structures that are more
powerful than individuals and pay little attention to individuals different abilities and
inabilities. It is evident that different solutions are proposed depending on the
assumptions made to define the concept of disability. In the medical model the
proposed solutions concern therapies, rehabilitation, etc. The individual–society
model proposes both a change in attitudes and medical therapies, rehabilitation.
In the social model, focusing on institutional practices as being the main cause
for the occurrence of disability, the solution to the social oppression is to give
individuals with impairments citizenship rights. In the long run, society’s material
structure must change since the oppressive mechanisms that transform impairments
to disabilities are embedded in structures and not in ideas or attitudes among
non-disabled.
In the following I will present Niklas Luhmann’s theory on observation and in
relation to this discuss the disability concept and certain fundamental problems
connected with the models presented above.
Systems Theory Concept of Disability 213
Systems of Communications
Society is not a whole, organic and harmonious in its functions; it is compounded
of many different systems (or organisations, as some prefer to call them). A system
gets its distinctive trait when it identifies a particular modus operandi, which is
reproduced within the system and exclusively within the system. The reproduction
takes place on the basis of other operations of the same kind. This is the
self-generating mechanism that constitutes all systems according to the system
theory (Luhmann, following Maturana & Varela, uses the Greek word autopoiesis
that means self-creation). In analogy with the brain’s functioning (as observed by
Maturana & Varela), the self-creation is a constant operation going on in every
system: Thoughts that are reproduced from previous thoughts generating new
thoughts. From the connection and coherence of thoughts emerges the psychic
system, consciousness. There is no production of thought outside consciousness,
and consciousness exists only as far as it is able to produce new thoughts (that are
only its thoughts). A thought can neither be exported to another consciousness nor
imported from outside. It is inseparably connected to a series of operations that have
produced it. Therefore one cannot enter another individual’s brain and never know
his thoughts. (Therefore it is possible to lie.) What is possible is that an individual
coordinates his thoughts with another individual’s. It occurs by using the same
theme as an external ‘irritation’ and on that theme two individual consciousness may
coordinate their operations. By that way individuals can communicate, and com-
munication constitute another type of operation, namely that operation which give
rise to another kind of system: society. There is no communication that constitutes
itself as a communication outside society (Luhmann, 1995, Esposito, 1996). Com-
munications produce other communications in a reciprocal connection. The calcu-
lable and observed form of communication is action. But in making it accessible it
simplifies itself somehow. The cost for this is, of course, a reduction of its own
complexity. It is this reduction of complexity that the concept of action signifies.
The category communication, Luhmann (1995) maintains, is more fundamental
than the category action. Luhmann’s phenomenological based version of systems
theory can therefore be seen as an attempt to reconstruct actions as effects of
communications.
Social systems are characterised by communication, in contrast to biological
systems, for instance. System and environment are two separated parts in social
systems theory, but that does not imply any normative evaluation at all. As a matter
of fact both can exist only by reference to each other (Blu¨hdorn, 2000). Even when
the social system is exposed to irritations from the environment, it is neither steered
nor causally depended from it. The environment i.e. the ecological world and people
as individuals is only a context for the social system (Leydesdorff, 2000). [2]
Communication about people’s physical, psychic, mental, economic, etc. conditions
become part of society since society in Luhmann’s view operates only in terms of
meaning and not in terms of biological life.
From a sociological systems theory perspective, disability as a phenomenon
cannot be analysed other than in relation to the distinction system/environment
214 D. Michailakis
observing that individuals with disabilities—as well as other individuals—do not
belong to a system, but are part of the environment. The individual is linked up
to a specific system by means of that system’s specific codification ascribing a
certain meaning to the particular individual’s condition (health–illness, working
ability–inability, etc). The binary codification of the system becomes the attribute
that colours the perception of the entire person. All other aspects of the person are
ignored except those that fit the system-specific form of communication. Whatever
the medical or political system is able to communicate about disability will necess-
arily be medically or politically related. The medical system cannot communicate
political issues about disability and the reverse.
Different social systems communicate about phenomena in particular ways.
The economic system communicates about money, the value of commodities,
prices, exchange forms, etc. The political system communicates about power,
elections, what needs to be done in order to hold government, etc. The medical
system communicates about health–sickness, defects, the condition of different
organs, etc. Each social system aims at the reduction of complexity in the phenom-
ena observed by reducing the multiplicity of determinations constituting the
phenomenon (Luhmann, 1995). By focusing on specific aspects that are selected
through distinctions the reduction is made possible. Through those system-specific
distinctions, particular perspectives crystallise. Social systems are in one sense closed
worlds. No phenomenon can escape from becoming an object of knowledge, or to
be communicated in art, to be thought religiously, of being calculated economically,
etc. However the different kinds of communications cannot be mixed; they cannot
intertwine with each other.
A part of the world which has been distinguished through a certain category,
can be incorporated into another system, but then once again be treated as pure
stuff. In each of these systems works an internal logic, in a matter-of-fact-manner
which, while leaving place for great variability, binds communication together
through objective validity (Lee, 2000). As systems, these forms of thought have an
autonomous, internally coherent existence. A social system, for instance, economy,
is highly specialised and cannot be replaced by another system. (The specific
distinctions in a system are not applicable or translatable into another system.) The
distinctions are incommensurable, and it is this condition that guarantees the
autonomy of the system. Each function system orients itself through its own
distinctions and thereby by its own construction of reality; one can neither eliminate
nor override these distinctions (Luhmann, 1997).[3]
Each system uses occurrences, phenomena from the environment as a motiv-
ation to generate communication but the communication that is generated in each
system stands in opposition to the others. Science deals with phenomena according
to the scheme true–false, art according to beautiful–ugly, economy according to
pay–not pay, but the beautiful cannot be translated to economic beneficial or that
which is economic beneficial cannot be translated to beautiful or true. A conse-
quence of this is that it is impossible by economic terms to communicate medical
phenomena. This applies for all systems. What means, for instance, not paying in
medical terms? What means healthy or sick in legal terms? The terms pay–not
Systems Theory Concept of Disability 215
paying, healthy–sick are not confined within the legal system’s border, within the
legal system’s conceptual field. The distinctions are irreducible. Phenomena cannot
be formulated in a distinction common for all social systems or to be reduced to
something elementary that could be recognised by all systems.
Communication about individuals with impairments thus varies from system to
system and the system-specific communication about these individuals cannot be
transferred into another system. That is to say, the diagnose ‘Down’s syndrome’ is
a medical communication and this particular meaning attached to this observation
cannot be transferred directly in other social systems, for instance, being not
employable, legally incapacitated, economic beneficial, etc. A system does not
stretch its own boundary, but describes only itself. The usage of economic, legal or
medical language to communicate about individuals’ conditions—a common
theme—is not evidence that economy, law, medicine can transcend their
boundaries. What we are doing is to interpret the conditions of those individuals in
economic, legal or medical terms and thereby to try to force that which belongs
somewhere else into the system.
Observing Systems
There is a long tradition of critique of positivism within sociology. Luhmann is on
the same line with this criticism and carries it further. To observe by means of
systems theory implies to take the point of departure from distinctions and to strive
to map them further out; because it is through distinctions that we interpret the
world. The base for each observation, for each meaningful experience is to draw a
distinction between ‘this’ and ‘other’ or between ‘inside’ and ‘outside’. Through this
basic operation ‘something’ become distinct from ‘other’ and thereby comprehen-
sible. A distinction creates a difference. Systems theory suggest that before you do
an observation you must point out the system from which you want to observe the
world, then draw a distinction, differentiate yourself from that you want to observe,
while at the same time accepting the implication that the same also applies when you
observe yourself (Luhmann, 1995, 2000). [4]
Whatever is observed is observed by an observer who splits up reality in a
certain way in order to make it visible and observable (Luhmann, 1995). Whatever
distinction is used, it is only one of many possible. Each distinction illuminates only
certain aspects while concealing others. Without distinctions reality remains unob-
servable, but reality itself does not recognise any distinctions. Therefore reality
remains essentially inaccessible. Reality is the non-observable. There is no is–is not
in a universal and essentialist meaning. The theory of observation is an attempt to
undermine this distinction. From a certain point of observation, a certain perspec-
tive, which always implies particular distinctions, things are in a certain way but
when observed from another perspective they are in another way. Something has
been chosen, something has been focused in contrast to other possibilities (Arnold,
2001).
Each system observes its own operation and its environment, but that which is
observed is marked by the system’s unique perspective, by the particular distinctions
used by the system when it observes phenomena. The question one always has to
216 D. Michailakis
ask when reality is described the one way or the other is: Who is the observer
(remembering that there is no observer that cannot be observed) (Luhmann, 1992).
Which system uses a distinction such as impairment–not-impairment, able-bodied–
disabled, healthy–sick or productive–unproductive as a point of departure for its
observations? From which system is this or the other description of reality offered?
What is gained–lost by preserving this distinction? How is the distinction redefined
when one observes from other systems? Is it the same phenomenon, which is
observed when other distinctions are used? With the emphasis on the outer reality—
in relation between the object and the observer—the role of the observer becomes
insignificant, except for making sure of lack of bias (Bailey, 1994).
The observation of systems is itself the result of a distinction being made
between system and environment. The environment does not exist before systems
have been differentiated. It becomes visible only through the exclusion from the
system differentiated. A system’s environment is the whole world minus the system;
environment and system together is the whole world. Therefore, systems theory
starts with distinction—not with identity—and thereafter the system is defined
(Luhmann, 1995). In the reproduction of the system the distinction between system
and environment is continuously reproduced. The making of the system is the
drawing of the boundary between inside and outside, between belonging to and not
belonging to.
An observer is always within a system because the observer as a person belongs
to a system. The system in which the observer finds him/herself indicates his/her
position, his/her perspective. Questions and answers are communicated in a social
context, in a social system. We must observe how the particular system develops its
questions and answers, why one asks in this particular way and not in another. A
system cannot enforce its understanding about reality to other systems. The system
can only correct and re-evaluate its own understanding about reality and thereby
re-evaluate its relation to other systems and their understanding about reality.
Reality is always a particular system’s reality.
When we observe, we are using distinctions thereby distinguishing one of two
sides in a phenomenon perceived. When one side is marked something is indicated,
a reference is created, and this act of creating a reference becomes an observation
when the marked side is used in the following handling of the information. The
distinction used by the observer to indicate difference cannot be observed in itself.
The distinction remains invisible for the observer as long he is within that system.
He sees only the phenomenon which is marked, and if he wants to see what
distinction is employed for this particular marking he must use another distinction
through which he differentiates the first distinction from other distinctions (Teub-
ner, 1990). [5] From a system we can observe only that which is included by the
scope of the system. That which falls outside the scope of the system must be
observed from another system.
Consequently, instead of differentiating between working ability–disability,
impairment–not impairment, healthy–sick, disabled–non-disabled, etc. in an absol-
ute way as is the case in the ‘substantialistic’ and realist interpretation, with
Luhmann’s system theory it will be possible to distinguish different perspectives
Systems Theory Concept of Disability 217
from which different phenomena can be true–false, legal–illegal, profitable–
unprofitable, etc. Reality cannot be viewed as something absolute. The evaluation of
a theory can be done on the basis of the theory’s internal consistency, conceptual
sophistication and analytic usefulness, but not by testing how well it corresponds to
the outside world (Seva¨nen, 2001). Since concepts are not representations or
reflections of an extern reality; they cannot be regarded as true by assuming
correspondence with reality. Correspondence cannot be a criterion since our obser-
vations of reality start from the distinction we observer reality with. When an
observer observes a phenomenon as one side in a distinction, the observer makes a
second-order observation. The properties we ascribe to the object of analysis are
based on previous observations and descriptions, not on the objects themselves. If
the observer would be able to perceive the phenomena not as one side of a
distinction but that which is signified by the distinction, he becomes a first-order
observer (Jo¨nhill, 1997).
Today it is almost common place to state that the outside world is the brain’s
own construction which is treated by consciousness as if it was reality “out there”.
That observation is pre-structured by language is also well known (Luhmann,
2000). From this follows that facts are not reached primarily by means of percep-
tions, but by means of distinctions. Since concepts are not representations or
reflections of an extern reality; they cannot be regarded as true by assuming
correspondence with reality. Correspondence cannot be a criterion since our obser-
vations of reality start from the distinction we observe reality with. When we do
make an observation, we observe ‘something’—we see a mobility-impaired person
sitting on a wheel chair. This observation comes down to the use of particular
distinctions: we distinguish or differentiate or mark the wheel chair, the mobility
impaired person (‘something’) from other possible distinctions (‘from something
else’). Observing, then, is the selective processing of distinctions that refer to each
other (self-referentiality). Thus, an observation that makes use of the distinction
wheel chair/chair may identify an object as a wheel chair (Laermans & Verschraegen,
2001; Kirsch, 1998). [6] We do not see reality as it is, but according to our
distinctions and our distinctions are our means that create the content of our
observations (Jo¨nhill, 1997). Concepts in disability research are consequently con-
structions of really existing phenomena.
System Conditioned Observations
How is reality represented in our thought? Does cognition work with information
from the outside world? Is our thought determined from the outside world, or does
thought actively produce–construct the world? Since it is a central idea in auto-
poiesis theory that living systems of all kinds, irrespective of whether they are
biological, cognitive or social, observe themselves and regulate their functions by a
process which is almost analogue with that of thought, the same questions can be
posed with reference to system (Morgan, 1986). [7] How is the environment
represented in a system? Does the system communicate with the environment? Does
218 D. Michailakis
the environment determine communication within a system? Does systems con-
struct the world and make it visible?
Maturana and Varela’s epistemology rejects representation theory because it
assumes an external point of reference from which it could be possible to judge the
degree of conformity between the representation and reality. The implicit assump-
tion is that thought has the capacity to see and reflect the world from a reference
point outside it self. Maturana’s and Varela’s work identified this paradox and
proposed that thought creates conceptions–images about reality that express or describe its
own organisation,inturn resulting in a reciprocal influence between reflection and
images. In this reciprocal influence conceptions are modified (Morgan, 1986;
Maturana, 1981; Maturana & Varela, 1980; Varela, 1981). Luhmann (1995)
assumes, following Maturana and Varela, that the human psychic system is opera-
tionally closed. All contacts with the environment take place on the psychic systems
own conditions and specific internal operations. The operations that are specific for
the human psyche are thoughts, processes in consciousness through a succession of
thoughts, as stated above. Therefore Luhmann characterises the psychic system as
an autopoietic system. It reproduces consciousness through consciousness, thought
through thought. When the psychic system reproduces consciousness it does neither
import consciousness from the environment, nor export consciousness to the en-
vironment. In an analogous way, Luhmann explains the function of the social
system. As already stated, system theory rejects any form of realism. That is to say,
it rejects the epistemological premise, which assumes that thought perceives reality,
directly and free from any distortion and that our experiences are directly related to
reality. Everything that people observe, notice, think about or create is constructed
by themselves, even their self-understanding and identity (Pesch & Riegler, 1999;
Mariotti, 2001; King & Schu¨tz, 1994).
Phenomena mean something only within the context of a certain system.
Whatever is observed is different, dramatically different, from that existing ‘out
there’ before it has been observed. We can call the thing existing ‘out there’ as the
real thing, but this is not observable, because the very act of observation implies
choice of distinction and this necessarily transforms it, as have been pointed out
above. ‘Reality is what one does not perceive when one perceives it.’ (Rasch, 2000)
Regarding ‘reality-in-itself’ we cannot know anything about since there is rather a
multitude of ‘realities-for-us’. There are only our descriptions of the world that can
be true or false. The world as such i.e., independent of our descriptions, can neither
be true nor false. As a consequence the reliability of our descriptions cannot be
verified in relations to the real. Descriptions of reality can be discussed and
controlled, they can be rejected or accepted but in accordance to which reality? The
reality existing before our description, or the reality emerging simultaneously with
our description? Both of these realities exist, but it is only against the latter that our
descriptions and propositions can be verified. The reality existing before our descrip-
tion—that makes possible the observation of our man made reality—remains unob-
servable. Reality becomes what our distinctions differentiate. Whatever we can
observe is observations and whatever we can know is knowledge (Rasch & Knodt,
1994; Rasch, 2000).
Systems Theory Concept of Disability 219
Another aspect of the theory of observing systems is that meaning and com-
munication that is produced within a system is inaccessible for other systems.
When a phenomenon is included and communicated into a system—which implies
a linguistic codification by the system’s own distinctions—this act change its pre-
vious meaning. Since each system observes the environment through its own
distinctions, phenomena cannot be observed in the same way by all systems. When
systems communicate about each other the meaning of the phenomena is
reconstructed in the particular system. The process of reconstruction implies inter-
change between systems, but that does not result in one common view (Willke,
1997). Thus, different systems reconstruct the environment in their own terms and
provide us with different perspectives by means of which we can observe and
describe reality.
An observer observing unemployment among disabled persons from a medical
perspective sees something completely different compared with the observer
observing unemployment among disabled persons from the political system. They
do not observe the same phenomenon and they cannot see what the other observer
observes. A researcher though can see how the medical and the political
system observes the specific phenomenon, but the researcher cannot step outside
the scientific system as long as he is interested to observe from this particular
perspective. In order to understand what is said and why it is said, one has to make
clear who is the observer and from what position he describes that which is said.
An observation having a certain meaning carries with it distinctions producing
reality, the one or the other, depending on how one connects things from the
marked side.
From this follows, that there is no and can never exist a generally accepted
criterion of what constitutes handicap. The ambition of the ICF as being an
integrative model of the medical and the social models through a ‘biopsychosocial’
model is theoretically naı¨ve. There is no single observation position, no single
distinction, and no system from which one can observe the individual in relation to
all aspects: biological, psychic and social. There are biotic, psychic, and social
systems, or, in other words, organisms, consciousness and communication. But
there is no system unity, a super system that embraces all these. There is a dividing
line between organisms on one side and social and psychic systems on the other.
Organisms are integrated on the basis of life (in the biological sense), social and
psychic systems in contrast on the basis of meaning. If we can say that organisms are
living unities of body parts, organs, etc. it does not apply for social systems. The
ambition to construct a unity of all these (biopsychosocial) requires nothing less
than a new language theory. Systems are self-referential with no justifiable claim to
universality. All systems communications will refer back to the system, so whatever
law, for instance, is able to communicate about will necessarily be law-related.
Communications from different systems cannot be captured by a super code or
super model. Under conditions of functionally differentiated society hybrid dis-
courses are impossible, in Luhmann’s terms, a hybrid system of communication.
(This should not be interpreted as inability of lawyers and physicians, etc. to
cooperate with one another.)
220 D. Michailakis
Observing Individuals with Different Qualifications
Differences in individuals’ specific conditions are, to be sure, real but these differ-
ences cannot be observed by social systems without previously constructing a
distinction. Particular differences (e.g. physic, psychic or intellectual) are assumed
to exist, but for the social system and for the observer they do not exist before the
particular distinction is created through which one side of the phenomenon can be
marked. The observation of impairments has its origin in new distinctions identified
within social systems. For instance, before the industrial era working disabled people
were not observed as a particular category. They were undifferentiated within the
larger group of poor people (beggars, people with different impairments, criminals,
vagabonds, etc). The group disabled people was differentiated when the labour
market was constituted as a system through the distinction made between those
willing, but unable to work and those not willing to work (Foucault, 1973). In this
way communication about the group disabled people became differentiated and first
became the object for charity, successively communication types became differenti-
ated in the medical system, in the education system, the labour market system, etc.
In the period before, the disabled person was simply seen as an aberration compared
to others. Impairment was a phenomenon in the environment, a problem for the
individual concerned and possibly his/her family. But the communication about the
impaired individual in an extended group of disabled persons was not constructed.
We may sometimes read of an impaired individual, but there is no system-specific
communication constructed around disability. Without particular forms of com-
munication about disability, they were mainly seen as isolated deviations from a
norm. For disabled children, there were no special schools, no teachers, no dis-
course and in effect, no communication about disability within the education system
(Winzer, 1997; Michailakis, 2002).
The particular ways in which social systems observe and communicate about
disability determines exactly its meaning in the different systems, how the group is
treated and the problems they face. Just like archaic societies, organised into
segments; families, clans and tribes, the structure of stratified societies—that is,
societies structured in hierarchical layers—is governed by the principle of placing
people in different groups; in this case in different layers. In segmental as well as
hierarchical societies, the relationship between society and the individual is deter-
mined by total inclusion. Individuality and social position are identical. Belonging to
a tribe, family, corporation, or estate encompasses all aspects of an individual. Now
the central thesis of systems theory is that, with the formation of functionally
differentiated society, the very principle of social differentiation—placing individuals
in families or social layers—has become obsolete: it is no longer groups of people
that are distinguished but types of communication (Schwanitz, 1996).
Society’s functional differentiation and associated demands for inclusion in
social systems implied that disability became a social problem to be communicated
within functionally differentiated systems (e.g. special schools, asylums, rules for
distributive justice). In this process of becoming a part of social systems, new
distinctions are produced predisposing observers to new observations and the
Systems Theory Concept of Disability 221
construction of new realities. Thus, according to systems theory, disability is the
communication in functionally differentiated systems of the difference between
impairment/not impairment. Disability was not distinguished by types of communi-
cation prior to the functional differentiation of particular systems, even though
impairments were no doubt quite prevalent in the general population. Impairments
though was—as stated above—a problem for the individual, a problem in the social
systems’ environment. Without a codified notion of ‘working ability’ on the one
hand and ‘disability’ on the other—produced during the advent of the capitalist
society and the differentiation of the labour market system—individuals were not
automatically assigned to one category or the other on the basis of appearance.
The distinction constitutes within the system what is regarded as facts. [8] No
communication about impairments, disabilities, handicaps, working abilities, or
anti-discrimination laws exist outside the social systems. The statement that from
different systems, through system specific distinctions, individuals are observed in
different ways, is not an argument against the assumption that individuals with their
particular talents and limitations exist independently from distinctions, observers
and observation perspectives (see Ekegren, 1995). The argument is that there is no
communication about handicap and no communication about disabled persons
outside the social systems. In the environment individuals are neither ‘disabled’,
‘legal subject’, ‘subsidized workforce’, nor ‘professor’; these distinctions indicate
only different ways to communicate about man when he is included in different
systems. [9]
When individuals with disabilities are observed from particular systems, they
are described in a language specific for that system, e.g. as ‘functionally impaired’ in
the rehabilitation system; being ‘deaf’, ‘blind’, suffering from ‘paralysis’, ‘brain
damage’, etc., that is with specific illnesses, within the medical system; being ‘non-
employable’ or ‘less attractive work force’ in the labour market system; having
‘learning difficulties’ or with ‘special needs’ within the education system; declared
‘incapacitated’ in the legal system. As stated above, all the concepts we are using to
signify individual differences are distinctions that mark one side of a phenomenon
and thereby demarcate it in relation to other objects in the same category and make
possible the observation. The reality observed from each system becomes dependent
of the distinctions that guide observation.
A question that emerges is: How can we be sure that a system’s claim of being
able to differentiate between e.g. ability–inability, sick–healthy is a real difference?
The claim is raised on the system’s construction of reality. This construction implies
that the system is able to make judgments of working ability–inability, sick–healthy,
legal–illegal, etc., and these distinctions are subject to historic changes. (A historical
survey of the disability concept and awareness of the distinctions used through times
can convince even the most unwavering empiricist.) By this is not meant that
systems create the real; rather that it deals with the real by making distinctions; an
activity that is never per se but in connection to many other factors (e.g. the
definition of sight deficiency is dependent on needs; in order to have a driver’s
license or to perform a task demanding computer work all day put much higher
demands on sight than is required in an illiterate society, where people are living on
222 D. Michailakis
upbringing cattle; so even medical definitions are historical and cultural). Social
reality is constructed on the one or other way by means of distinctions. By that is not
meant that the observer in each single observation act creates social reality ex nihilo,
already differentiated systems and language leave its mark on how phenomena are
observed.
Disability has not always been observed and communicated in the same way. As
already stated, the first descriptions were developed within religious system and later
on became a theme in medical science (see Stiker, 1999; Foucault, 1975). The
struggles of individuals with disabilities and their organizations to be included in
other systems, e.g. the legal, labour market, education, social security, etc., implied
at the same time a challenge of the dominance of previous observations. [10]
A major problem in the models presented in the beginning of this article is their
claim to universality; they do not view distinctions as system specific. For instance,
the distinction working ability/inability refer to the labour market system since it
derives from the individual’s ability to support him/herself while the description
about functional impairment or diseases are observations from the medical system.
The medical system sorts out all information from the environment by means of its
binary code sickness–health. [11] Sickness is observed and interpreted within the
purview of physicians (medical system) alone since they are seen as uniquely
competent to perform such a judgement or function.
Observations’ Selectivity
Observation from a certain system implies inevitably a kind of enforced one-eyedness,
in the sense that a system must observe phenomena from its perspective with its
particular distinctions. Each system has been differentiated through the develop-
ment of an autonomous description of reality and by this particular description it has
been differentiated from the environment (Moe, 1996). From that follows that
modern society has no observation point or a super ordinate system from which the
entire society can be observed and this implies that it is almost impossible to reach
any form of consensus due to competing descriptions (Arnold, 2001). [12] There is
no point to observe the whole society, not even in an imaginary form, as a totality
constructed by parts, because in order to do that one needs another distinction,
another system–environment distinction and consequently another disparate world.
Systems form a world that is evaluated in terms of truth, beauty, profitability,
working ability or another property; these properties disappear when other systems
apply their distinctions and evaluate the world in their way. The description of
phenomena is mutually exclusive, incommensurable and cannot be reduced to each
other or be apprehended in a hierarchical relation, since no system can take over
another system’s function or to subordinate its function to another (Rasch, 2000).
In a functionally differentiated society the observations, descriptions and communi-
cations of phenomena have lost their unity. Both observation and communication
are always system specific and as such also relative to the point of observation. This
leads to conflicts and competing descriptions that can hardly be avoided in a modern
society (Muller, 1994; Seva¨nen, 2001). The implication of this is that individuals’
Systems Theory Concept of Disability 223
opportunities and qualifications cannot be observed and described from one per-
spective only, there are competing descriptions and no one can be said to be more
important than the other. The controversy between the medical and the social model
in disability research is an example of competing descriptions from two specifically
distinct systems.
Regarding communication of the theme disability, [13] it becomes clear that
there is no single distinction which can catch and express the phenomenon as a
totality. There are competing and mutually exclusive distinctions which disappear
when a system applies its distinctions and evaluate in its way. None of these
evaluations and descriptions of disability can be regarded as more important than
any other, or being reduced to another or be compared with each other. The
following table shows distinctions about handicap and are used within different
systems and they express different distinctions made:
PERSPECTIVES OBSERVATION OF DISABILITY AS:
Medical system Diseases, defects, malfunctions, impairments, treatment
Economic system Lack of economic resources, inability to pay, poverty
Labour market system Working disability, inability to engage in gainful activity
Legal system Legal incapacity, lack of rights/duties
Rehabilitation system Support/correction of functional incapacities
Education system Learning difficulties, low education level
Art system Ugliness, defective body
Social systems theory tries to make clear that an observer always chooses
perspective for his/her observations. Physicians, politicians, scientists et al., observe
a phenomenon from a certain perspective, although their role does not restrict the
choice of perspective (nowadays physicians are forced to observe patients also from
an economic perspective). Choice of distinction to observe a phenomenon deter-
mine the point of observation, it determines the system from which the phenomenon
shall be observed. Choosing the distinction impaired–not impaired leads to observa-
tions from the medical system. Choosing to relate the phenomenon to the distinc-
tion working ability–disability leads to observations from the labour market system
perspective. Thus, the choice of distinction in the case of disability means that the
identification of individuals as disabled persons necessarily takes place in relation to
a specific system. (Therefore one must always ask from which system is the
identification made.) It is not possible to identify persons having a disability in
general. This leads to the conclusion that we cannot discover a classification scheme
applying for all systems.
To apprehend a phenomenon is at the same time to construct it. The construc-
tion in turn implies both simplifying the phenomenon and choice among alternative
simplifications and that many versions of reality can exist side by side. For instance,
224 D. Michailakis
exclusion of persons with disabilities from the labour market is a moral issue; it
becomes a normative issue when the law declares discrimination illegal. The moral
issue becomes an economic issue when observed with respect to profit. Communica-
tions in a social system are exclusive to that system’s communications. It is both
functionally and operationally impossible for the legal system to incorporate politi-
cal, economic, religious or medical observations in its communication because
the legal system is forced to construct the environment according to the binary
legal–illegal (King & Schu¨tz, 1994).
The theory of observation can help understanding why we are living in multiple
realities, why we talk at cross-purposes and consequently why problems are so
difficult to solve (Moe, 1996). From this, it also becomes clear how valuable it is to
observe the phenomenon of disability from many different systems and being
conscious that the perspective is only one of many possible and to strive for better,
more subtle distinctions in order to observe deeper and more precise when providing
a description. Little is gained when the dominant medical model become replaced
by stressing the political observations’ dominance, as the proponents of the ‘social
model’ do.
Conclusion
Taking as point of departure the theory of observation, I have tried to show that
there are several descriptions of disability, as well as several system-conditioned
observations. Every system observes individuals in the environment as well as other
systems in its particular way; every distinction leads to a new description of the
phenomenon. Different phenomena are observed from different systems. Therefore
every attempt to a synthesis between a medical and a political observation are
condemned failing.
One of my points is that the distinction between individual and society by
means of which the WHO scheme describes the relation between impairment
and disability obscures rather than illuminates the problem. The epistemological
foundation of the scheme is naı¨ve realism. Observation theory assumes that we
cannot observe ‘das ting an sich’, i.e. reality as it is. From this follows that we can
reject all statements that man is something as such, i.e. all forms of essentialism.
Man as such is not handicapped, able-bodied, etc. People are observed as disabled,
able-bodied, etc., from certain systems, certain system requirements, by means
of certain distinctions. But functional impairments in the WHO schemes are viewed
as given facts, as something that can be perceived directly, an unmediated observa-
tion of reality. Impairments are although inaccessible for direct observation as
well as handicap or whatever phenomenon. From this naı¨ve realism the argumenta-
tion in the WHO schemes pass over to negate the medical observations relevance by
the assumption that impairment can be accentuated or be rendered insignificant
by society’s influence. The influence from social conditions can lead either to
render impairment insignificant or to transform impairment to disability. Thus, that
which was viewed as undeniable facts can be insignificant by appropriate social
Systems Theory Concept of Disability 225
organisation. One can imagine how realistic it is to accommodate society to all
individuals’ needs and qualifications (e.g. to adjust education to all children’s needs
and qualifications, to adjust the production process to all individuals’ preconditions,
etc.).
Communication about the individual is in the focus for several systems; in the
medical system for diagnosis and treatment, in the education system to examine
performances, in the labour market system to determine different abilities. In all
these systems the individual is observed and described by means of different
distinctions. [14] Interchange of specifically distinct perspectives takes quite often
place in disability research much due to the WHO schemes. This is expressed in
different ways. Special education, for instance, is often organised on the basis of a
medical diagnosis (So¨der, 1999). In this way the WHO schemes on the whole
reproduce the medical model within disability research. [15] The social model
suffers also of reductionism and reproduces the political perspective rendering
insignificant all other perspectives. Medical observations become insignificant since
everything is a question of power relations and the organisation of the capitalist
society.
Stone (1985) represents one of the few attempts made so far in disability
research to explain the category of disability and its origins in a systems theoretical
perspective. She sees the category disability as a solution for the social insurance
system to solve a distributive dilemma. The category is not reflecting an essential
property but is a social construction. Through this category, citizens are divided
according to certain criteria that establish their ability to work, and entitled to
certain benefits by including the unable to work within the social security system.
The category determines therefore who is included and it changes along with
technological, organisational, etc. factors. Thus, when individuals are observed from
the social security system disability is conceptualised as an administrative category
that determines the distribution of benefits. The concept, according to Stone,
signifies the legitimate reasons of no participation in the labour market. The history
of the concept is tightly related to power over work.
Functional differentiation forces the observer to observe individuals from a
certain perspective. There is no privileged position to observation. Nor can one use
a distinction that mixes several perspectives and codes since observations are system
depended and made with system specific distinctions. In a functionally differentiated
society there is no hybrid distinction that makes possible observation from several
systems simultaneously. System specific observations illuminate certain aspects at
the expense of others, they have an imperative and at the same time restrictive
power. Seeing one thing implies disregarding another thing. The fusion of different
perspectives, or the replacement of one perspective with another leads to less
knowledge about the reality, so difficult to grasp.
From each system one can observe everything, or rather relate the particular
code of the system to everything, but one chooses what should be observed and that
which is observed is marked by the system’s unique perspective. In an analogous
way, observations from the political, legal, educational or whatever system are as
partial as the medical system’s observations. None of these systems can create one
226 D. Michailakis
for the whole society binding description for persons with disabilities. The challenge
is to find new ways in order to get rid of the compulsory selectivity that characterizes
every observation and description in a functionally differentiated society (Luhmann,
1995).
NOTES
[1] I do not discuss the terminological differences between the previous versions of ICIDH
and ICF since the main distinction between individual and environment operates in all
versions.
[2] In Luhmann’s sociological systems theory the term environment is complex. It is the
correlate, the other side, of the system. A novelty in Luhmann’s theory is, as is indicated
in the following, that social systems are understood as communication systems, which
implies that man as an individual belongs to the social systems’ environment. By rendering
individuals and the ecological world to the environment Luhmann accentuates the auton-
omy of social systems. Man as a person is included in social systems. It is within social
systems that man acquires an identity.
[3] In ICF it is claimed that one of the goals is ‘to establish a common language for describing
health and health-related states’. (ICF Introduction) According to Luhmann, common
language can be established only within each particular function system. A common
language cannot be established between systems.
[4] Spencer Brown’s book Laws of Form, that has been of particular importance to Luhmann’s
work, opens with a recommendation that has become famous ‘draw a distinction’—for
otherwise you cannot observe anything. Without the use of a distinction, reality is an
undifferentiated whole in which you see nothing.
[5] The distinction that steers observation is that which the observation can never observe
without creating a paradox. Fundamental distinctions (binary codes) cannot be applied to
the system which itself identifies itself through them and marks its boundary against the
environment. For instance, when asking whether the distinction true–false itself is true or
false one creates a paradox.
[6] Positivism proceeds from a naı¨ve idea that concepts describe the real world. On the same
assumption is the WHO scheme based. For Luhmann neither concepts nor the world are
considered being solid entities. In order to understand the world we must mark differences.
In this sense knowledge is a construction. Luhmanns constructivism deals with construc-
tions of real operating systems and really existing phenomena.
[7] The most revolutionary trait in autopoiesis theory, which also is in agreement with
Maturana and Varela’s theory about the function of the brain is, according to Bailey, its
radical epistemology. The description of systems from a within perspective constitute the
basis for their epistemology (Bailey, 1994). This new epistemology implies—in contrast to
positivistic epistemology—that the emphasis is on the system’s–brain’s lack of direct
communication with the environment, their closeness (Bra˚ten, 1992).
[8] ‘Whatever we mean with reality, it reveals oneself to us solely through the active partici-
pation of its construction.’ (Prigogine & Stengers ur Jo¨ nhill, 1997)
[9] Thus, it is so difficult to communicate about those who are excluded from almost every
system; they are just bodies in the environment except for the religious system and for the
social sciences having society as its object. The psychiatric reform implied that a large part
of the patients became excluded from the medical system; within short they became
‘homeless people’, synonym with almost total exclusion from society.
[10] The observation which describes ‘handicap’ as environments inability to meet certain
individuals’ needs is a description from the political system, since implicit or explicit in
these observations there is a power relations perspective and a belief that through the
political system one can steer other systems.
Systems Theory Concept of Disability 227
[11] Health–sick is the medical systems binary code while its communication media is health.
Each system uses a leading distinction. Everything observed from the system is also related
to this distinction.
[12] Foucault has shown by examining the history of different discourses (clinic, prison,
sexuality) that there is no history of thought existing outside the history of specific systems
(Foucault, 1973, 1975, 1981).
[13] Disability is defined here as a general term signifying communication about individuals
with less opportunities due to physical, mental, intellectual qualifications. This difference
in opportunities–qualifications has been thematised in different ways by different systems.
[14] At this stage it is not the individual but the environment that is in focus. Not in an either/or
relationship as is the case in the WHO schemes and in the social model; where it is either
the individual or the environment. Systems in Luhmann’s theory do not make moral
judgements about the phenomena observed.
[15] Jones and Basser Marks (1999) mean that the very fact that in ICIDH the list over
impairments is so comprehensive and detailed in comparison to handicap reflects this fact.
It is also confirmed by the fact that WHO’s work focuses more in the prevention of
impairments than to abolish discrimination.
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