On “Disability reconsidered: the paradox…” Roush SE, Sharby N. Phys Ther. 2011;91:1715–1727.

I was saddened by the comments of Roush and Sharby because they seemed to portray the word “charity” in a negative manner associated with a single philosophy. They state: “The medical model of disability can be linked to charity. If a disability cannot be eliminated, or significantly ameliorated, people with disabilities often are viewed as pitiful or helpless.”^1(p1717)

In fact, charity and pity are positive attributes. Here is a more typical definition of charity²:

1. Benevolent goodwill toward or love of humanity;

2. Generosity and helpfulness especially toward the needy or suffering; also: aid given to those in need.

It is easy to create a very long list of situations where an individual might be in need of support and services. Caring for people who are struggling because of social situations, natural disaster, war, reduced physical capacity, or a problem with mentation is difficult for all sorts of reasons. When an accountant does tax preparation for people in poverty or when a physical therapist provides pro bono care, these are acts of altruism, part of our professional codes.

Here is what answers.com says about pity. Synonyms for pity “signify kindly concern aroused by the misfortune, affliction, or suffering of another. Pity often implies a feeling of sorrow that inclines one to help or to show mercy…(and) denotes the act of or capacity for sharing in the sorrows or troubles of another.”³

Charity/benevolence, pity/empathy, and caring for people are not traits that can be slotted neatly into one philosophy. The authors must recognize that people in religious denominations and secular social programs are relevant to their discussion. The authors rightly point out that ethics play an important role in the successful interaction between people in need and those people providing care, but I am unsure why ethics are binned in the biopsychosocial model.

Many words can be construed one way or another, but like the philosophical approaches presented in this article, the positive aspects can sometimes be lost. I am sure we will go through many discussions about the definition and implications of words from the perspective of abstract concepts and philosophies. There are currently arguments for and against the label “patient.” Many people reject the word “disability,” but it might have a contextual relevance. In the current article, simplistic rhetoric does not help preserve valuable aspects of traditional philosophies and eliminate the hurtful parts. The authors could make the point that there are some shortcomings to our systems of providing needed resources and services. Yet it is inappropriate to demean all those involved in charitable acts. The worst and best human interactions span the philosophical approaches described by the authors. The authors warn us about stereotyping when, in fact, they seem to fall into this trap.

• © 2012 American Physical Therapy Association