top of page

A Journey through Time #4: The Medieval Roots of the Charity-Based approach to PwD

In recent decades, advocates who work on Persons with Disabilities (PwD) issues have championed a human rights-based approach, a perspective through which PwD are viewed as individuals who are entitled to inclusion, accommodation, and accessibility in order to fully exercise their human rights as equal citizens. This approach has become fairly widespread in most academic and professional circles after it was legally codified in the mid to late 2000s when most countries signed and ratified the Convention on the Rights of Persons with Disabilities.

The attitudes and practices of one of the previous models, the charity-based approach to PwD, continue to linger in many ways among the general public, however. An everyday example of this is the donation box one often sees at the local supermarket in the checkout queue, some of which are intended to help PwD meet their basic needs. These types of programmes are rooted in the charity-based approach, which took centuries to develop, and views PwD as passive victims who should be pitied and taken care of. Largely based on a religious point of view, believers were and continue to be encouraged to give charitable donations to PwD or to pray for them so they could be healed or ‘redeemed’, as their disability is implicitly understood to stem from causes such as a curse, demonic possession, punishment by God or a “test” of faith.

While we can see the patronising nature of the charity-based approach from a modern perspective, it represented a relative improvement when compared to the euthanistic approach taken by some hunter-gatherer groups, classical Antiquity, and medieval societies which I wrote about previously. Thankfully, the charity-based approach is waning as the human rights-based approach is now widely utilized by most practitioners in the field and has started to gain ground among the general public. Nevertheless, the charity-based approach is still prevalent among the general public and in certain religious circles. Indeed, inadequate funding both of public institutions and NGOs has led to a resurgence of fund-raising discourse intended to trigger pity and collect donations for the “deserving poor”. So, the question is; why does this limiting, problematic model continue to persist?

To better grasp the pervasiveness of the charitable model in our collective consciousness, we need to examine its history. In doing so, we can begin to understand why it has remained with us in the present, rather than fade away like other anachronistic ideas, as well as look at which aspects of the charity-based approach remain, and which have faded away.

While a human rights-based to PwD is relatively new historically, the charity-based approach has deep historical roots which can be traced back to the late ancient and early medieval periods, and the rise of monotheistic religions. In Judaism, disability was viewed as a form of punishment from God while for early Christians, persons with disabilities were thought to be cursed or possessed. In the Old Testament, there are numerous references to various disabilities which were thought to have come about due to an individual’s sin, or the sins of the forefathers. These references often put forward laws for how society should relate to PwD. For example, one law stated that visually impaired people should not be allowed into the home, while another referred to them as ‘unclean’ and restricted them from approaching the temple’s altar. Such examples, and similar ideas that are found in Hinduism for instance, demonstrate how the foundations of lingering discrimination and lack of accommodation PwD continue to face in the present are rooted in past beliefs.

At the same time, it was during the late ancient and early medieval period that more PwD managed to survive long enough into adulthood, largely due to the move away from euthanistic practices, as well as general life expectancy increases. Those who got a disability from an accident or war could sometimes survive via crude medical practices and charity. In part, religions such as Christianity and Islam place emphasis on treating those less fortunate with compassion, and therefore also played a role in this development. In order to obtain sustenance, PwD were often forced to beg for alms on the street, as it was difficult for them to farm or perform labour. Inversely, giving alms was seen as a way for the pious to gain merit or atone for their sins. This practice continues to this day in major cities across the globe.

The religious foundations of charitable approaches bring with them a legacy of moral judgment. Those that have a higher income, good health, and an able body believe that they are entitled to these privileges as a divine reward for their virtues. People who receive charity should demonstrate gratitude towards their benefactors. They should be content if they are allowed to survive but should not aspire to a life without suffering or deprivation. Importantly, they should not challenge the underlying principle of inequity. Charitable institutions are expected to offer their beneficiaries a marginally better life but by no means a good life. This stands in stark contrast to the rights-based approach, which draws on the principle of equal value of all members of the human family.

To understand another crucial aspect that persists from the charity-based approach, we have to understand the role monasteries and convents played during the medieval period in relation to PwD. Monasteries became centres of knowledge and a refuge for the vulnerable during dangerous periods after the fall of Rome in Western Europe. The religious orders who ran the monasteries often took care of PwD, combining spiritual methods for ‘healing’ with early medicinal practices, using plants and herbs, for instance. Similarly, in other parts of the world, religious orders also benefitted from charitable donations and endowments, while offering refuge to vulnerable groups. Such early practices thus constitute the beginnings both of giving responsibility for PwD to charitable religious institutions, and the institutionalization and segregation of PwD from the rest of society.

In closing, we can see the legacy of the charity-based approach in the ongoing discrimination and institutionalization that PwD still endure. At the same time, the historical development of this approach also positively impacted the lives of millions throughout history and has been a step towards more progressive models in the future.

Chavia Ali

69 views0 comments

Recent Posts

See All


bottom of page