Ruth O’Brien's Crippled Justice performs this task with imagination and theoretical sophistication. Based on interviews, archival research, and secondary sources, the book examines the rise of the discipline of vocational rehabilitation in post–World War II America, and the challenge posed to this discipline's way of seeing people with disabilities by the emergence of the disability rights movement in the 1970s, a challenge that continues to this day. Chapters 1 and 2 offer a fascinating genealogy of the rehabilitation field, tracing its intellectual roots, the strategies of its creators and promoters, and the successful campaign to establish vocational rehabilitation as a major government program. Chapter 3 examines an ill-fated effort to extend the rehabilitation paradigm to the problems of poor people. Chapter 4 describes the beginnings of the disability rights movement, which reversed the basic premise of rehabilitation, that people with disabilities had to be taught to fit in to society: It was society itself, disability advocates argued, that had to change its prejudicial attitudes toward the disabled. The final two chapters and an afterword summarize the long line of court decisions based on the major disability rights statutes, Section 504 of the 1973 Rehabilitation Act and the 1990 Americans with Disabilities Act (ADA). O’Brien argues that these laws have been narrowed and thus “crippled” by federal judges still in the grips of the older vocational rehabilitation model of disability.

O’Brien's history of vocational rehabilitation, which occupies the first half of the book, highlights the influence of psychoanalysis, gestalt psychology, and theories of personality on the emerging discipline. Until World War II, medical rehabilitation was largely separated from vocational training and was dominated by orthopedists who treated their patients as a collection of medical problems (pp. 38–41). Howard Rusk and Henry Kessler, the progenitors of rehabilitation, argued that rather than focusing on the disabled person's injuries, rehabilitation clinicians must support the “whole man” in order to integrate him into society. The key to integration, they argued, was to build a healthy personality that could cope with the loss of one's capabilities. Borrowing from psychoanalytic theories of disability advanced by William Menninger, Rusk and Kessler believed that the “people with disabilities suffered from emotional adjustments more ‘crippling’ than their physical handicaps” and so had to be counseled out of their anger (p. 60). Thus, the goal of rehabilitation professionals was “normalization,” the attempt to refashion people with disabilities into average Americans, with psychological counseling a key component.

The enactment of Section 504 of the 1973 Rehabilitation Act, which barred entities receiving federal funds from discriminating against people with disabilities, presented a challenge to the hegemony of vocational rehabilitation in disability employment policy. The law catalyzed the disability rights movement, which reconceived disability unemployment as a matter of social discrimination, rather than individual adjustment. Employers, disability rights activists contend, must change their prejudicial ideas about the capabilities of people with disabilities and provide “reasonable accommodation” to allow them to flourish in the workplace. In theory, Section 504 and the ADA, which extended the ban on discrimination to most private employers, mandated these changes, but as O’Brien describes, federal courts have created formidable barriers to those seeking to enforce disability rights. Chief among these barriers is the necessity to prove that one is impaired enough to be counted as “disabled” by the law. Federal courts have decided that people with such maladies as arthritis, asthmatic bronchitis, epilepsy, and even cerebral palsy are not disabled and, hence, not entitled to sue under the ADA (pp. 179, 211–13). But ADA plaintiffs can also lose if they are considered too impaired to be productive employees. Indeed, in a recent Supreme Court case, a woman with carpal tunnel syndrome who was fired as a result of her impairments was nonetheless ruled nondisabled under the ADA. Perhaps most problematic for ADA plaintiffs are two Supreme Court decisions holding that the use of mitigating measures (eyeglasses in one case, medication in another) can make an impaired person nondisabled, a ruling that potentially makes every treatable disease a nondisability. Thus, in their ADA jurisprudence, federal judges have turned the logic of rehabilitation on its head: They look for ways in which individuals can mitigate their impairments, not in order to help them but to declare them nondisabled. As O’Brien suggests, in ruling this way, the judges are both reflecting and reinforcing the view that to be disabled is to be helpless and “un-whole” (pp. 207–09).

O’Brien's review of disability rights law is generally persuasive. But in building her argument that the disability rights movement has been thwarted at every turn, she sometimes overstates her case and in so doing inadvertently downplays the caginess demonstrated by disability activists, who have leveraged seemingly weak political resources into substantial policy gains. For example, she claims that a key 1970s federal court decision holding unconstitutional the exclusion of children with disabilities from public education, a great victory, became a defeat when the U.S. Supreme Court overturned the decision (p. 111). In fact, the decision, which was far from a clear resolution of the constitutional issue, was never overturned, and was used rather cannily by disability rights supporters to build support for the 1975 Education for All Handicapped Children Act, a federal law that guarantees all disabled children a “free, appropriate” education (R. Shep Melnick, Between the Lines 1994, pp. 146–59). More troublesome is O’Brien's statement that the ADA provides no “private right of action or punitive damages” but is enforced instead by the Equal Employment Opportunity Commission (EEOC) (p. 172). In fact, disability rights supporters wisely made a deal with the first Bush Administration that ties ADA employment remedies to those in Title VII of the 1964 Civil Rights Act, the main federal antidiscrimination law: Individuals using either statute must first file a complaint with the EEOC, but if dissatisfied with the EEOC's handling of the claim can commence a private lawsuit in federal court. After making the deal on remedies, disability rights supporters then worked with civil rights groups to enact the 1991 Civil Rights Act, which for the first time provided punitive and “pain and suffering” damages for both Civil Rights Act and ADA lawsuits. Thus, the story of ADA remedies does not fit O’Brien's despairing narrative. (See Thomas F. Burke, “On the Rights Track: The Americans with Disabilities Act,” in Pietro Nivola, ed., Comparative Disadvantages? Social Regulations and the Global Economy 1997, pp. 263–68.)

The deeper problem with O’Brien's theme of “rights crippled” is that it posits the ADA as a unique case, and thus leads her away from thinking carefully about the extent to which the story of disability rights compares to experiences with other rights laws. She complains, for example, that the text of the ADA leaves great discretion to federal judges, giving lower courts the freedom to interpret the ADA in diverse and problematic ways (p. 168). But these are features of all rights laws, not just the ADA. Similarly, she makes much of the fact that the ADA requires plaintiffs to prove they are qualified for a job, but as she acknowledges, this is a common requirement in civil rights litigation—the only difference is that the requirement is explicitly stated in the text of the ADA, which is much more detailed than that of other civil rights laws. Her analysis would have been strengthened by an engagement with critical scholarship on the implementation of other civil rights laws and on rights politics more generally. Within disability studies, for example, scholars have critically examined the basic assumptions of the disability rights model. (See Jerome E. Bickenbach, “Disability Human Rights, Law and Policy,” in Gary L. Albrecht, Katherine D. Seelman, and Michael Bury, eds., Handbook of Disability Studies 2001; and Richard Scotch and Kay Schriner, “Disability as Human Variation: Implications for Policy,” Annals of the American Academy of Political and Social Science 549 (1997): 148–59.) O’Brien's strategy, by contrast, is to imply an “uncrippled” version of disability rights that is unproblematically liberating for people with disabilities. One wishes that she had extended to disability rights the same critical, complex genealogical treatment she gives to rehabilitation. That said, O’Brien's book is packed with cogent and original observations about both rehabilitation and disability rights and thus makes a useful contribution to an emerging field.