In recent years, the notion of individual responsibility for one's health has been introduced into Swedish medico-political debate. Formerly expressed as a recommendation, it has now taken on the form of expectations. In a Swedish context, this shift from collective to individual responsibility is novel because it implies a break with well-established welfare state practice of comprehensive care for their citizens. Using a systems-theoretical approach, we interpret this shift of expectations as a political solution to the problem of legitimate allocation of scarce resources. A more inclusive medical conception of illness has facilitated the introduction of many new diagnoses that, in turn, have lead to a strong increase in claims for medical treatment and for compensation. This semantic change in medicine aggravates the budgetary situation of the welfare state. The political solution lies in a reorientation of the expectations the medical system can have on citizens as well as a shift of the expectations regarding the rights and obligations citizens can have on the medical system. Individuals are increasingly expected to live healthy lifestyles and to avoid hazardous habits. If they do not live up to these expectations, they have to face low prioritisation or denial of treatment.

Inclusive education is the attempt to educate persons with intellectual disabilities by integrating them as closely as possible into the normal structures of the educational system. As this necessitates various kinds of "inclusion through selective exclusion" (partial exemption from grades, special classes, special treatment by teachers, etc.), inclusive education is inherently faced by tensions. Drawing on sociological systems theory, we argue that these tensions can be assigned to three levels of the educational system - the level of the functional macrosystem of education, the level of the organization and the level of the individual (classroom) interaction. Analyzed in this way, it becomes possible to see that the dilemmas of inclusive education result from tensions between the three levels - e.g., inclusion into normal educational organizations requires exclusion from certain functions of the macrosystem of education and so on. The tensions themselves cannot be fully resolved, but they can certainly be addressed in ways that may be more satisfactory to individuals with special educational needs. © 2008 Association ALTER.

The article aims at exploring the relevance of Luhmann's sociological systems theory to understand disability as communication about impairments. The questions to be considered in the following are: What happens to interaction systems when confronted with individuals with psychical or physical impairments (deviating bodies, perception difficulties, difficulties to process information)? What are the essential characteristics of interaction where disabled people participate? Trying to answer these questions, a broader question is raised: In which ways does communication in interaction systems become strained or overloaded? I argue that from the viewpoint of systems theory, disability as a social phenomenon, as part of social systems ‐ historically evolved and intelligible only in a systems/environment relationship ‐ must be linked to communication. Individuals’ impairments strain interaction with respect to time, objectively and socially because interaction systems are a combination of perception and communication.