title: Disablement and the ideological crisis in health care.
abstract: Disablement from chronic illness presents medicine with a constant reminder of the limits to its therapeutic effectiveness, and challenges the political legitimacy of Welfare States. In this regard, chronic illness forms a crucial component of the 'crisis' in health care. In this paper I look at the different ways in which disablement stimulates this crisis--for medicine, for political economy, and for disabled people themselves. In looking at responses to the crisis I detect a certain reluctance, or inability, to move away from an atomistic perspective which underpins much of our thinking on health and social policy, and much else besides. I conclude by arguing, against post-modern cynics, that a reasoned defence of the Welfare State requires a broader concept of self-sufficiency and a perspective which both acknowledges the need for help, and recognizes the extent to which the provision of help may further disempower the disadvantaged.
authors.affiliation: ARC Epidemiology Research Unit, Medical School, University of Manchester, England.
authors.forename: G H
authors.initials: GH
authors.lastname: Williams
mesh_terms: D002908:Chronic Disease; D003695:Delivery of Health Care; D006233:Persons with Disabilities; D006801:Humans; D010684:Philosophy; D011056:Political Systems; D006113:United Kingdom