Can you help me doctor?

The strange history of the strange relationship between the medical profession and people with learning disabilities

Simon Jarrett

This talk examines the different ways in which doctors and other members of the medical profession have been involved with people with learning disabilities over time.

We begin by looking at the emergence of a recognisable medical profession from the medieval period and into the 16th and 17th centuries. Physicians, surgeons and apothecaries (chemists) competed to meet the medical needs of individuals and communities both with each other and with a whole range of other practitioners – cunning men, wise women, bone setters, midwives, herbalists, quack doctors – who all offered their services. Over this period people who today would be recognised as having learning disabilities were not 'treated' or 'managed' by medical practitioners at all, unless they happened to be physically or mentally ill.

Why were medical practitioners not involved in this period? And if they were not involved, who did play a part in the lives of people with learning disabilities? Research from 'courts of the King's wards' records, parish records and the writings of contemporary observers can give us some idea of how learning disabled people lived, what others thought about them and who was involved in their lives.

Something started to change during the 18th century and by the 19th century doctors had become very involved in the lives of people with learning disabilities. The talk examines how these changes took place and why learning disability started to become a medical matter, with doctors and other practitioners claiming special knowledge and the authority to 'treat' and 'manage' it. Why did this happen, with a group of people who could not be considered 'ill' in any recognisable sense of the word? Why did people's lives change from being a matter for themselves, their families and their communities to become a matter for the intervention of the state and doctors? Why and how did the 'medicalisation' of learning disability happen?

Finally the talk looks at the implications of all this for people with learning disabilities today. To what extent is the medical view still the 'authoritative' view? How does this view stand against the 'social model' of disability we all talk about? The life expectancy of people with Down's syndrome has soared dramatically in the last 50 years and the medical profession has been at the forefront of making this happen. Yet at the same time some of the most abusive environments in which people with learning disabilities have found themselves have been medical environments. What makes the difference between 'good' and 'bad' medical intervention?