Chronic Illness and Academic Accommodation: Meeting Disabled Students' "unique needs" and Preserving the Institutional Order of the University

People with disabilities are just one of the groups designated for special attention in relation to equity in postsecondary education. This paper explores the way in which policies that provide academic accommodation for students disabled by chronic illness unfold in practice. As part of the administrative regime of the university, these policies are typically designed to reconcile the interests and relevances of the law with the interests and relevances of the academy. When a disabled student "activates" the policy, regardless of whether or not services and assistance are provided or are useful, the student becomes situated within social relations that make disabled students' "needs" manageable in the organizational context. As applicants for the institution's privileges and services, students actively participate in the accomplishment of the institutional order of the university, i.e., they fulfil the university's legal obligation not to discriminate against students with disabilities. This, I will argue, constitutes an exercise of power and preserves the existing social organization of the university, although it is normally understood as the university acting "in the interests of students with disabilities." Specifically, I show how the individualization of accommodation--ostensibly to meet each student's unique needs--shifts the obligation for change to individual students and instructors and forecloses opportunities for the university to become more genuinely accessible and inclusive. ********** People with disabilities are just one of the designated groups that have been targeted for special attention in relation to educational equity (Fortin, 1987). At academic institutions across Canada this has entailed the creation of a social "disabilities apparatus" organized around the concepts of accessibility and accommodation. In postsecondary education, accessibility refers to the institution's legal obligation to create genuine opportunities for people with disabilities to participate in all aspects of university life. The duty to accommodate, as one aspect of the duty not to discriminate, requires the institution to take an active part in modifying those practices, facilities, or services that prevent the inclusion and participation of otherwise qualified students who are disabled (BCEADS, 1996). Improving accessibility includes making changes in the built environment and providing specialized adaptive equipment to disabled students. Accommodation usually involves procedural changes and modifications in teaching and academic evaluation practices that are individualized according to each disabled student's unique needs. Exactly what constitutes an accommodation is a matter of law: courts have the ultimate authority in Canada to define the meaning of the term and the extent of the responsibility of the institution to provide it (BCEADS, 1996). In this paper, I use an institutional ethnographic approach (Smith, 1987, 1999) to explore the more difficult procedures entailed by providing academic accommodation, especially in relation to students disabled by chronic illness. While chronic illness does not fit the more taken for granted understanding of disability--usually because it is less visible, or "invisible"--it still complies with the criteria set out by the United Nations definition of disability (Allbrecht, 1992; Wendell, 1996; Williams, 1998). In fact, people with chronic illnesses constitute a significant proportion of people with disabilities (Russell, 1989; Zola, 1994). And although many are reluctant to identify themselves as "disabled"(Charmaz, 1999; Gadacz, 1994; Gordon and Feldman, 1998; Linton, 1998; Russell, 1989; Wendell, 1996), most students with chronic illnesses depend on disability policies in order to take advantage of postsecondary educational opportunities. In this paper, I challenge the assertion that academic accommodation fulfils the university's moral and legal obligation to ensure the full inclusion of students disabled by chronic illness. …