A book is about social policy that focuses on hardware

Engineering Disability

Public Policy and Compensatory Technology

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Sandra J. Tanenbaum

The use of the Boston Elbow—a sophisticated prosthesis designed to replace the human arm—provides a dramatic example of how social and political policy affects the distribution of an unusual, expensive, and highly desirable compensatory device to the disabled. Engineering Disability examines the conditions under which these devices are dispensed, to whom they are given, and why they are withheld. Like the field of biomedical engineering, this book is about social policy, but it focuses on hardware.

Based on interviews and extensive research, this study identifies the users of the Boston Elbow and considers the psychological dimensions of needing, getting, and using this device. Veterans, workers covered by private and public worker insurance plans, Medicaid recipients, and privately insured individuals are the "customers" for this technology. Sandra Tanenbaum shows how their disabilities become a public problem as well as a deeply personal one with its attendant anxieties and expectations.

The findings that apply to the distribution of the Boston Elbow can be generalized to include other prosthetic devices as well as disability policies as a whole. The underlying premise of Engineering Disability is that disability is a loss of function, and correspondingly of mobility, employability, etc.; and that disability policy, in distributing compensation for these losses, redistributes loss itself. The author concludes from her research that the public diffusion of all health technologies is likely to be inequitable and discriminatory, based on society’s assumptions about what is and what is not important.


About the Author(s)

Sandra J. Tanenbaum holds an MSW from Bryn Mawr College and a Ph.D. in Political Science from MIT. She is currently employed as a policy analyst, Division of Long-Term Care, Ohio Medicaid.

Subject Categories

Disability Studies

In the series

Health, Society, and Policy, edited by Sheryl Ruzek and Irving Kenneth Zola.

No longer active.

Health, Society and Policy, edited by Sheryl Ruzek and Irving Kenneth Zola, takes a critical stance with regard to health policy and medical practice, ranging broadly in subject matter. Backlist titles include books on the legal and professional status of midwifery, the experience and regulation of kidney transplants, the evolution of federal law on architectural access, and a political/ethical argument for making the community responsible for universal access to health care.



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