The importance of a disability/handicap distinction

This paper continues a discussion concerning the distinction between disability and handicap initiated in this volume by Steven D. Edwards. Edwards argues that the reasons advanced by the WHO for this distinction in its International Classification of Impairments, Disabilities and Handicaps (ICIDH) are not valid. Edwards also criticizes my own quite different grounds for distinguishing between the two concepts. His general conclusion is that the distinction is superfluous. In this paper I claim that Edwards's reasoning is invalid. I present five arguments for my case, viz., the arguments from: a) practical necessity, b) cost-effectiveness, c) clinical practice, d) the subject's vital goals, and e) the universal presence of some basic action. My own conclusion thus is that there is a need within health care for a distinction between disabilities and handicaps. I also indicate that there may be a need for further distinctions along the dimension of action-generation which is presented in the paper.