The Curious Rise in Disability: How Changing Language Alters the Nature of Reality
By changing language, the state attempts to solve a metaphysical quandary, and something intangible changes about our reality. Our government’s rush toward one-size-fits-all solutions means the particularities of individual lives become lost in the maze of a bureaucratic process. Disability is a stark reminder of the human condition. It is more than a problem to be solved, although there are real problems for disabled people that need real solutions. Disability is a valuable teacher. It can catechize us on the nature of our humanity, and teach us about our mortality. We all can and should hope for redemption for our broken bodies.
My son is blind, immobile, nonverbal, and hearing-impaired, with multiple brain abnormalities and complex orofacial birth defects. Is he disabled? It depends on whom you ask.
According to Pew Research, thirteen percent of all Americans are disabled. However, the CDC considers more than twenty-five percent of all Americans as disabled, including seventeen percent of children. In contrast, the National Survey of Child Health considers just over four percent of American children to be disabled. These statistics represent alternate realities.
What is the reason for this wide disparity? Some definitions of disability are limited to activities of daily living, or ADLs, such as eating, walking, bathing, and toileting. Others are broader, including behavioral, mental health, and sensory impairments. While disabilities have increased for all Americans, children, in particular, have experienced a huge rise in disability. An NIH study uses the capacious “developmental disabilities” category for its analysis, incorporating recent rises in ADHD, autism, and learning disabilities, making up a majority of new inclusions. Under this definition, more than half of those children considered disabled have ADHD, with blindness by comparison only contributing to 0.16 percent of the total. More broadly still, one researcher defines disability in children as “activity limitations” including “anything that the parent identifies that their child isn’t able to do in the same way other children are able to do.” Perhaps unsurprisingly, this definition resulted in a twenty-eight percent relative increase in childhood disability within well-off households relative to those in poverty. This definitional morass has significant implications for politicians, educators, and parents, as state resources are allocated using widely disparate disability markers.
Changing definitions of disability create policy headaches and alter our perception of reality. By broadening the definition of disability, the state sets up a self-fulfilling prophecy. Driving the state’s changing standards of language is both political self-protection and political reward. Lumping complex social factors under one label is the state’s sleight of hand. By using such a broad understanding of disability, and therefore limiting conversation about other social, environmental, or economic factors, the state can both absolve itself of needing to provide real policy solutions and proclaim itself the protector of a victimized class.
As the state mediates our social interactions by adapting our language to fit its own ends, our social fabric frays and Christian charity weakens. The church has a unique responsibility to use precise language to describe the full range of human brokenness, particularly in children, allowing us to accurately attend to the real needs of others while offering true hope in the renewal of creation.
Three Models of Disability: Medical, Social, and Equity
Our government currently uses three models to define disability for both adults and children. The state categorizes human interactions and experiences of disability in definitions that both create and support a bureaucratic process. Language changes reality. These models, while emerging chronologically, are used simultaneously. The definition of disability has expanded under each subsequent model, moving from a limited definition under the medical model, to a more inclusive social definition, to finally a potentially unlimited definition of disability under the equity model.
First Wave: The Medical Model of Disability
The medical model, true to its name, views disability as a purely physiological issue to be handled within the bounds of the medical system. This is the oldest operative view of disability, with origins in the scientific model of medicine that began in the nineteenth century. Under the medical or pathological model, disability is primarily a disease, diagnosed by a physician, subsequently necessitating medical intervention to alleviate, manage, or cure. One cannot be both healthy and disabled. Under the medical model, disability is a function of the body, limited to the individual experience.
This paradigm views disability as purely a problem of the individual, disregarding quality of life concerns and communities of care outside of the medical system. Diagnostic terms and prognoses can be unnecessarily deterministic, potentially legitimizing social stigma against the disabled. The medical model is uninterested in the broader political and social milieu in which the disabled person finds himself. Naming disability as a disease implies a fixed reality to life with a disability that advocates adamantly protest. Interpreting disability through the medical model can seem like a life sentence to a diminished reality, one where the disabled individual is always diseased.
The medical model of disability is the original building block that has now given way to models that better fit current social values. However, vestiges of the medical model remain. The best example is the use of ADLs, or activities of daily living, to define disability. According to guidelines from the Health and Human Services Department, any survey form assessing disability must include six questions “representing a minimum standard.” These questions focus on an individual’s difficulty with vision, hearing, cognition, mobility, and self-care limited to dressing or bathing.
Using the medical model to define disability results in fewer disabled Americans when compared to other models. Under its definition, a 2019 report from the Census Bureau states only 4.3 percent of American children are disabled. A similar 2010 report from the Census Bureau found that 4.4 percent of those aged six and older needed assistance with one or more activities of daily living.
Second Wave: The Social Model of Disability
The social model of disability was introduced in the 1960s as advocates for the disabled preferred a more holistic approach to understanding disability. It stands in contrast to the limited medical model that many felt was discriminatory. Proponents of disability rights pushed back against the idea that disability was a disease to be cured, and instead advocated a definition of disability that recognized the relationships between individuals and society.
The social model distinguishes between “physical impairments” inherent to the body, and “disabilities” that advocates see as the limitations of society. As such, the disabling factor is not our biological reality, but society’s shortcomings. If we weren’t ableists, social model proponents claim, then impairments wouldn’t be disabling. The social model of disability discredits the medical model, claiming that health issues are not always disabling if the social environment is adequately accommodating.
To its credit, the social model introduced numerous benefits. It laid the groundwork for legally required accommodations in work and public life that are life-changing for many people, notably, through the passage of the Americans with Disabilities Act (ADA) in 1990. The ADA includes in its definition protection for a range of physical disabilities as well as mental and behavioral health conditions, including dyslexia, ADHD, and autism, among others. The broadening category of disability under the social model leads to an increase in disability. As a result, according to the Social Security Administration, since the 1970s, the number of disabled beneficiaries has increased from 1.8 million to 9.2 million in 2021.
The social model of disability centers on the individual’s relationship to society, not the individual himself or his biological reality. On one webpage, the CDC defines disability as an “interaction with various barriers [that] may hinder . . . full and effective participation in society on an equal basis with others.” Disability is now a function of one’s social environment, not just how one functions within one’s social environment.
Disability has moved from a biophysical to a psychosocial marker, increasing those under disability’s umbrella. And yet another change looms on the horizon, as a recent press release from the NIH has redefined disability yet again.
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How PCA Complaints Work: Against BCO Amendment Item 12
For the sake of argument, even if we grant that the lower court’s procedure should mirror that of the higher court, this amendment misses the mark. Instead of adding a filing deadline, chapter 43 of the BCO ought to be upended and rewritten, particularly adding the complainant’s right to appear and present an argument to the court. However, requiring the 10-day filing deadline does not provide any additional formal deliberation opportunity.
Amendments to the Book of Church Order are currently being debated by Presbyteries. Item 12 is an amendment to BCO 43 that would require complaints be filed 10 days before a meeting of the court alleged to be in error, otherwise the complaint need not be considered at that meeting and must wait before being taken to the higher court. There is no such time requirement currently.[1]
While this proposed amendment may sound reasonable on the surface, its true effect would impede the work of our courts and delay a hearing for anyone raising a complaint. This proposed amendment is based on a faulty understanding of the nature of the complaint process, fails to solve the supposed problem, and creates additional delay in our judicial process. Therefore, this amendment ought not be approved by our Presbyteries and the 50th GA in 2023.
A Faulty Premise
The amendment is based on the rationale that “Sessions have the same, analogous opportunities for due deliberation [of complaints] as the higher courts.” But this assertion is not correct under our BCO, as the lower court process of “considering” a complaint is fundamentally different from the higher court’s “hearing” process for complaints. Let’s look at this briefly.
The first step in the complaint process—the lower court’s considering—has minimal procedural requirements and limits how the court can handle the complaint (BCO 43-2). The person alleging error does not have a right to appear or to make arguments. The matter may not be referred to a study committee or postponed for additional deliberations. The BCO gives the lower court one meeting to think about and decide if it wants to reverse action—nothing more, and nothing less. If the lower court doesn’t remedy the situation to the satisfaction of the complainant, he can take his complaint to the next higher court (BCO 43-3).
The second step in the complaint process—the higher court’s hearing—has considerable procedural requirements (BCO 43-3–43-10). Notably, the complainant has a constitutional right to appear and be heard (BCO 43-8). A formal process is followed for the hearing of the arguments and the court coming to a decision (BCO 43-9).[3] There are no time constraints on the higher court fully deliberating and considering all parts of the case. In all, this higher court “hearing” process is the core of the complaint mechanism in Presbyterian polity. This hearing—and not the lower’s court’s considering—constitutes the complainant’s day in court to present his case for adjudication.
This asymmetric process—the lower court’s considering and the higher court’s hearing—is intentional. [4] This review by the higher court is essential to the well-being of the church because church courts “may err; and many have erred” (WCF 31.3). Assuming the lower court’s process is “the same” as the higher court’s radically departs from the logic of our current rules.
Adding this 10-day filing requirement hinders the primary goal of the complaint and is unnecessary to ensure judicial integrity in the PCA. This attempt to flatten the process is not helpful to our overall structure and misunderstands the main goal of the complaint.
The Supposed Problem Unresolved
For the sake of argument, even if we grant that the lower court’s procedure should mirror that of the higher court, this amendment misses the mark. Instead of adding a filing deadline, chapter 43 of the BCO ought to be upended and rewritten, particularly adding the complainant’s right to appear and present an argument to the court. However, requiring the 10-day filing deadline does not provide any additional formal deliberation opportunity. In the proposed amendment, the lower court must still reverse itself at that first meeting, otherwise the complaint may be elevated. Broader changes to the BCO must be made to achieve the drafter’s stated goal of making the lower court’s deliberations the same as the higher court’s.
Additional Delay
We all know the judicial process in our church courts takes a long time. This new requirement would routinely add weeks of delay to the complaint process, sometimes leading to even lengthier delays at the Presbytery level. In Presbyteries like mine that meet only three times a year, missing your Session’s April meeting means that the complaint won’t get to the Presbytery’s May meeting and that a complainant has to wait until October for the next stated meeting. Adding this ten-day requirement gums up an already protracted process.
In all, there is no benefit to this amendment if we understand a complaint the right way. In fact, it will only hurt complainants. For the well-being of the church, this amendment ought not be ratified by Presbyteries so that complainants can continue to have a route to the higher court’s review without this additional encumbrance.
Postscript
Despite all of this, I can agree with the drafters of the amendment that there is a potential weakness with the current complaint process. Specifically, someone could file a complaint with the lower court (especially those doing so in bad faith) moments before the meeting to catch the members flat footed and to force them to deal with the complaint then and there. However, this is less an issue of substantively considering a complaint, and more of an administrative issue of distribution and individual preparation. To remedy this narrow concern, I see merit to two better solutions:Remove the lower court consideration step altogether, like the RPCNA, and like the PCA prior to 1984. Let a complaint be a mechanism purely to take the issue to the higher court. Sessions and Presbyteries are no longer asked to reverse themselves as a necessary prerequisite to filing with the higher court. Instead, just file the complaint with the higher court.
Set an administrative deadline for filing a complaint with the lower court. This deadline is to provide opportunity to circulate the complaint and provide the members of the court the customary opportunity to prepare. The General Assembly, Presbyteries, and many Sessions have rules that require communications to the court to be filed so many days in advance of the meeting so it can be docketed, distributed, and reviewed by individuals before coming together in a deliberative body. The deadline for filing complaints ought to be this administrative deadline the court has already established. If no such rule exists, complaints must be filed 24 hours prior to the court’s meeting.Even if neither of these alternatives to Item 12 are ever presented or passed, the system we have is not fundamentally flawed. Even if a complaint is filed two minutes prior to a Session meeting and the Session feels unable to handle the matter right then and there, there is no harm in taking no action and letting the matter go to the higher court. That’s the point of a complaint, after all. So while it’s possible to improve our system, let’s make sure we do it in such a way that is consistent with the principles that we have preserved in our polity.
Jason Piland is a Minister in the Presbyterian Church in America and is Associate Pastor of Redeemer Church PCA in Hudson, Ohio.[1] See the full Item 12 amendment, available at https://www.pcaac.org/wp-content/uploads/2022/09/BCO-Amendments-Sent-Down-REVISED-9-27-22.pdf.
[2] Overture from the Northwest Georgia Presbytery to the 49th General Assembly, April 5, 2022, p. 1, ll. 31–32, available at https://pcaga.org/wp-content/uploads/2022/04/Overture-21-NW-GA-BCO-43-23-4-12-22-REV.-TITLE.pdf.
[3] Many other procedural requirements are included in the BCO. The lower court appoints a representative to argue its case (BCO 43-5). The lower court has to send up all papers related to the case (BCO 43-6). Parties may file written briefs if they so desire (BCO 43-8). The complainant has a constitutional right to appear and be heard (BCO 43-8). A full hearing is scheduled at the reasonable accommodation of the parties (BCO 43-8). Both parties appear and argue their case (BCO 43-9). The higher court sits in judgment and renders a decision (BCO 43-9). The higher court has significant latitude to order amends if the lower court is found to have erred (BCO 43-10). The process can become so complex that an entire Appendix to the BCO was inserted to assist Presbyteries in establishing a procedure for handling these matters (BCO Appendix H).
[4] Complaints in the PCA went straight to the higher court until the BCO was amended in 1984. Before then, only our sections 43-1, -4, -5, and -10 were included in the BCO, meaning that the complaint was not considered by the lower court before being heard by the higher court. To this day, the RPCNA still does not require a complaint to be presented to the lower court for consideration (RPCNA Book of Discipline II.4.3, .4), and neither does the EPC (EPC Book of Discipline 14).Related Posts:
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Leaving a Church Well
It is possible, in certain circumstances, to depart from a congregation in a loving way. Then there are ways one can depart from a congregation which leaves a wake of pain and suffering behind. One way honors the Lord and the other harms His people.
Today’s article is going to be difficult and could be painful for some. It may be controversial. How does one leave their local congregation? How does a Christian leave a congregation of people they love?
There are a myriad of reasons for a person to leave a congregation. Sometimes these reasons are good and sometimes these reasons are poor. The reality of the American church is that religion has been democratized. Members of a congregation may vote with their feet. Members may walk out and go to another church down the road or on the other side of town. Elders may attempt to shepherd well and encourage members to stay. However, there seems to be times in which the Lord’s people will do as they please.
What this article will not do is evaluate the plethora of reasons why one would leave their home church. This article is not about leaving a church in which there are moral failings or doctrinal errors. There are times in which, for the glory of God and care for one’s family, immediate departure should occur. That is not who this article is written for. Rather, this article is written for those who are considering a transfer to another congregation for non moral reasons.
The reader will find six principles to implement if you feel you must leave your present congregation.
There are ways in which one can leave the congregation well. It is possible, in certain circumstances, to depart from a congregation in a loving way. Then there are ways one can depart from a congregation which leaves a wake of pain and suffering behind. One way honors the Lord and the other harms His people.
Principle No. 1—Be clear why you are considering to leave.
For many who leave their home congregations the process starts as a subjective feeling that something is not right or is not working. It is important not to trust one’s feelings. The heart is deceitfully wicked and should not be trusted. Christians ought to question our feelings. We ought to stop and ask ourselves, “Why am I feeling this way.”
Too frequently Christians have vague ideas about why they feel as if they no longer belong in a congregation. Has there been a shift in the philosophy of ministry within the congregation? Have circumstances in your life changed in such a way that make travel an undue burden? Has there been a demographic change in the congregation that has left your family isolated? Have there been doctrinal shifts either in yourself or in the congregation? Has there been a lack of discipleship or a stagnation of spiritual growth?
Far too often many members have vague notions of why they feel they ought to leave. In the Reformed Presbyterian Church membership is formal and covenantal. Members make promises to God, the elders, and the congregation. The affirmations and promises which a member answers forms a binding relationship that ought to be taken with solemnity and sobriety. To break this relationship on opaque feelings is disingenuous and unloving.
You feeling that something is off may not be entirely incorrect. There may be things that need to change. There may be improvements that could occur in the local congregation. There may be ministries that need to be created to shepherd and disciple. There may be a reality to time, finances, family growth, job changes, and etc. that have caused a shift in one’s ability to continue to be a growing and active participant in their local congregation. Again, there are a myriad of practical and even biblical reasons why one may need to transfer their membership. Knowing exactly why you are considering a change is of the upmost importance. Have a concrete why.
Once you have your concrete why go and search the scriptures. Search out the Lord’s Word to see if there is Biblical warrant for your reasons. There may not be one proof text for your concern. However, you may search the Scriptures and find passages or themes that speak toward your concern. Maybe your why is that there has not been enough emphasis on evangelism. Maybe your why is that the congregation is growing but certain groups of people are being overlooked in discipleship and fellowship. Your why may be that there is plenty of doctrinal fidelity but there is a real lack of opportunity to fellowship and be in communion with other members. It could be that you have noticed the Scriptures time and again speaking of a care for the poor and orphans but you have not noticed that same emphasis in your present congregation.
Being crystal clear about why you are considering a change will help you in principle number two.
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Worship God as He Deserves
Envision worship in heaven. We’d never imagine poorly attired cherubim and seraphim imbibing some drink while worshiping God, would we? Nor any angel or host of angels responding to God in any type of lackadaisical manner. Neither should we. We should come to God in worship with our humblest attitude, appropriately attired, not distracted with earthly needs, and not sharing his glory with any human being. All who are present in our worship services should be overwhelmed by how we all are focused on the one true God and revere his majesty.
As a missionary to the Muslim world, I couldn’t be unimpressed with the reverence Muslims bring to their worship of Allah—standing, then on knees and touching their heads to the floor. In Christendom there are different approaches to the practice of worship. For example, Roman Catholic and Greek Orthodox churches bring a visible reverence to worshipping God, kneeling, sitting, and standing according to the liturgy taking place. Protestant churches, whether evangelical, reformed or progressive, traditionally show reverence in worship in their regular practice of sitting and standing. Lately, there have been some changes in some of the latter; a casual, less reverent ambiance appears to be growing in some churches.
What are some trends of lapsing down reverence of worship to Almighty God? One may have begun with clerics no longer wearing robes, which is neither right nor wrong. Yet it may have measurably diminished formality and authority (consider that judges wear robes as a sign of their authority). More formal or less formal attire doesn’t contradict Scripture—first century church leaders dressed as everyone else. Israelite priests wore specific apparel as commanded in the Law.
Another is casual dress. In the past, people attending worship dressed in their “Sunday best.” What people wore was intended to show respect for God; understandably, if we aren’t careful it could turn into making a fashion statement. The result was that whether rich or poor, the manner of dressing appropriately to the occasion made all more equal in appearance. It appears that in recent years our overall manner of dress has become more casual to the point that our clothing appears poorer with holes and such in them. It may mean that the unintended consequence of dressing down may result in a lack of respect toward God as we worship him, in contrast to the Psalmist exhortation, “Worship the Lord in holy attire” (Psalm 96: 9).
Can the approaches to worship over the centuries be called a lapsing-down of worship? By “lapsing-down” is a way to describe a lapse of awe, reverence, and worship of Almighty God as our Creator, Sustainer, Redeemer and Judge. Our worship is to be directed to God alone.
Now the practice is to applaud or clap after musical performances or testimonies. Why may this be disconcerting? Worship is to laud and honor God alone. Scripture refers to clapping to God, which clapping while singing may be appropriate. We don’t normally clap for the Scripture readings, prayers, or sermons, do we? These parts of worship may be more appropriate to receive such affirmation, more than applauding human performances. Children can be taught to sing to the Lord to bring attention to Him and not to themselves. Worship and entertainment are not the same.
Another trend current in our modern worship is bringing drinks into the sanctuary. Worship is not entertainment in a theater or a lecture in a classroom. Worship is other worldly; it’s spiritual. Sipping or drinking can be disrespectful in worship. What’s next, eating in worship? The time to eat and drink in worship is during the sacrament of Lord’s Supper. There is a certain decorum expected at formal events such as a presidential address. That is not the time or place to drink coffee or lemonade, which those attending don’t. Doesn’t God deserve better? Our entering into God’s presence is a call to humility, awe, and reverence.
Dr. Carl R. Trueman recently wrote, “God is a consuming fire and to be approached with awe and reverence.” Envision worship in heaven. We’d never imagine poorly attired cherubim and seraphim imbibing some drink while worshiping God, would we? Nor any angel or host of angels responding to God in any type of lackadaisical manner. Neither should we. We should come to God in worship with our humblest attitude, appropriately attired, not distracted with earthly needs, and not sharing his glory with any human being. All who are present in our worship services should be overwhelmed by how we all are focused on the one true God and revere his majesty. Instead of lapsing in our worship, rather let us acclaim in our worship the glory He deserves:
“Holy, Holy, Holy is the Lord God, The Almighty, Who was and Who is and Who is to come; Worthy are You, our Lord and our God to receive glory and honor and power” (Revelation 4: 8, 11).
Helen Louise Herndon is a member of Central Presbyterian Church (EPC) in St. Louis, Missouri. She is freelance writer and served as a missionary to the Arab/Muslim world in France and North Africa.
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