The debate between the medical and social models of disability continues to shape education, and daily life, according to a recent analysis by Luca Grecchi, professor of history of philosophy at the University of Milano-Bicocca, published in the Corriere della Sera blog InVisibili and explored in his book Filosofia, inclusione, comunità (Scholé, 2026). While the medical model focuses heavily on individual psychophysical deficits, the social model emphasizes environmental barriers, leaving experts to advocate for an integrated biopsicosocial approach.
Understanding the Medical and Social Paradigms
The medical model often leads to the "medicalization" of a condition, placing the challenge primarily on the individual. Conversely, the social model highlights how unaccommodating environments produce "disabilitization" by creating obstacles to participation.
In Italy, the medical model remains predominantly entrenched across major life stages. In educational settings, parents of students with disabilities are frequently required to provide medical certification upfront, placing the initial administrative hurdle on the student rather than the school environment. Similarly, entering the workforce often requires determining a strict percentage of invalidity to secure legally mandated corporate accommodations. Residential care facilities for adults similarly rely heavily on sanitary documentation, structuring daily life around activities labeled as therapeutic.
The Shift Toward Individualized Welfare and Consumer Models
The persistence of the medical model is driven partly by its alignment with modern socio-economic systems. According to the analysis, the medical framework promotes an individual relationship with services that can be delegated to private professionals, contrasting with the collective engagement demanded by a true social model. As public welfare systems transition toward individual consumer-based assistance—such as personal contributions, targeted cards, and specific aid packages tied strictly to medical certificates—institutions risk complicating access for individuals with intellectual disabilities.
Public structures designed for universal access would benefit the wider community while reducing the stigma associated with specialized care. However, individualized assistance models often minimize public spending while shifting reliance to private solutions.
The Biopsicosocial Approach and Neurodiversity
To bridge these contrasting frameworks, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), established in 2001, advocates for a biopsicosocial perspective. This integrated model combines attention to individual psychophysical traits with supportive community environments.
The debate is particularly prominent regarding autism. While some view autism strictly as a neurodevelopmental disorder requiring medical intervention, others characterize it as a natural neurodiversity best supported through social inclusion. Grecchi notes that while many behavioral challenges associated with autism diminish significantly within an accommodating environment, severe forms of autism still require specialized medical, pharmacological, speech, and physical therapy interventions regardless of the setting.
By synthesizing the medical and social paradigms, experts argue that society can better preserve the clinical support necessary for individuals while dismantling the environmental barriers that hinder true community participation.