According to a dominant view of stigma, a person is stigmatized within a community if sufficiently many people within that community hold a bad view of her. I call this the 'Bad View Model'. In this paper, I argue against the Bad View Model on the grounds that such beliefs are neither necessary nor sufficient for stigma, and that the account cannot explain the distinctive phenomenology of stigma, including certain vulnerabilities to shame. I then develop an alternative (...) that explains these features of stigma, which I call the 'Shaming Model'. On this view, a person is stigmatized within a community if she is shamed by members of that community, and this is explained by their belief that she has deviated from some social norm and/or standard. (shrink)

How should we interpret the popular objection that stigmatised subjects are not treated as individuals? The Eidelson View claims that stigma, because of its connection to stereotypes, violates an instance of the general requirement to respect autonomy. The Self-Presentation View claims that stigma inhibits the functioning of certain morally important capacities, notably the capacity for self-presentation. I argue that even if we are right to think that stigma violates a requirement to respect autonomy, this is insufficient to (...) account for the full weight of the charge that stigmatised subjects are not treated as individuals. We need the Self-Presentation View to explain a special threat to agency. I then address the worry that focusing on a concern with being treated as individuals opens the door to the suggestion that treating as superior can be just as morally troubling as stigma. This objection is fatal for the Eidelson View. But the Self-Presentation View has a number of resources for deflating the worry. We should not exclude the possibility of a moral symmetry between some cases of stigma and some cases of treating as superior. Rather, we should provide a nuanced account of the circumstances in which either phenomenon is detrimental for self-presentation. (shrink)

Would a just society or government absolutely refrain from shaming or humiliating any of its members? "No," says this essay. It describes morally acceptable uses of shame, stigma and disgust as tools of social control in a decent (just) society. These uses involve criminal law, tort law, and informal social norms. The standard of moral acceptability proposed for determining the line is a version of perfectionistic prioritarian consequenstialism. From this standpoint, criticism is developed against Martha Nussbaum's view that to (...) respect the dignity of each person, society absolutely must refrain from certain ways of shaming and humiliating its members and rendering them objects of communal disgust. (shrink)

Rawlsian liberals face the challenge of providing reasons to oppose stigma that do not appeal to a rejection of controversial stigmatic attitudes, but rather to political values that are undermined by stigma. One prominent strategy (the Self-Respect Strategy) appeals to the threat stigma poses to self-respect. Another strategy (the Hierarchy Strategy) appeals to the dependence of stigmas on social hierarchies, which are taken to be intrinsically problematic. I argue that the Self-Respect Strategy needs further resources in order (...) to answer important questions about which stigmas are most morally and politically urgent. The Hierarchy Strategy confronts the obstacle, for the purposes of political justification, of sustaining a highly contentious interpretation of the value of equality. In my view, Rawlsian liberals should jettison this underlying normative concern with hierarchy when making the case for opposing stigmas, and instead use considerations of hierarchy to identify some of the most pronounced threats that stigma poses to self-respect. In this way, considerations of hierarchy can help supply the explanatory resources that the Self-Respect Strategy needs. (shrink)

The stigma of reporting wrongdoing at work: When doing right is perceived as wrong The act of reporting unethical, illegal and illegitimate practices at work, whistleblowing, can be associated with a stigma for the individual in question (Banja, 1985). This article presents the stigmatizing position of reporting wrongdoing at work, types of wrongdoing and individual antecedents. Since empirical studies have shown very few systematic results regarding individual differences, one way to decrease societal stigma can be to relate (...) the act of reporting to other known acts that are perceived upon as more positive within society. We therefore also discuss similarities and differences between the idea of whistleblowing and other concepts such as Organizational Citizenship Behaviour (OCB), in-role, and extra-role behaviour before we make some concluding remarks. (shrink)

In this paper, I discuss stigma, understood as a category which includes acknowledged, enacted degradation, discreditation and discrimination. My discussion begins with an analysis of HIV stigma, as discussed in a social media post on Twitter. I then analyse a fictionalized clinical stigma scenario. These two analyses are undertaken to highlight aspects of the conceptual anatomy and interactional dynamics of stigma and by extension shame. Brief social media declarations and short, fictionalized clinical interactions are rich with (...) information which helps us understand how stigma—degradation, discreditation and discrimination—is operationalized in interaction. (shrink)

In this article, I address the question of the apportionment of the consequences of organizational misconduct to individual members of the organizational elite. I argue that this process can be best understood by marrying the behavioral aspects of stigma theory to the economic mechanisms of ex post settling up. Viewed in conjunction with stigmatization, ex post settling up following organizational misconduct can be seen as the result of attempts to avoid stigma by association. Efforts at stigma avoidance (...) on the parts of various stakeholders produce the diminished social interaction associated with ex post settling up: departure from the focal firm, and loss of seats on other boards. This also suggests that the process of stigmatization, and hence ex post settling up, can be influenced by characteristics of social interaction unrelated to the misconduct itself. (shrink)

This article examines the concepts of stigma and shame, their interrelationship, and their relevance to healthcare. It traces the intellectual genealogies of stigma and shame research, highlighting key debates and recent developments. The article argues for a praxeological approach to studying stigma and shame, focusing on how they are produced and made witnessable in interaction, rather than relying on theoretical abstractions. It explores the connections between stigma, shame, respect, and acknowledgement, emphasizing the importance of lived experience (...) and interactional dynamics. The article presents a fictional stigma scenario to illustrate how stigma can be enacted unintentionally and experienced differently based on past encounters. It concludes by advocating for case studies and scenarios over theories to build a picture of the praxeological logic of stigma and shame. This approach aims to avoid depicting stigmatized individuals as passive victims and instead recognizes their agency in anticipating, resisting, and managing potential degradation. (shrink)

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of (...) negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods. (shrink)

Hermeneutical injustice means being unjustly prevented from making sense of one’s experiences, identity or circumstances and/or communicating about them. The literature focusses almost exclusively on whether people have access to adequate conceptual resources. In this paper, we discuss a different kind of hermeneutical struggle caused by stigma. We argue that in some cases of hermeneutic injustice people have access to hermeneutical resources apt to understand their identity but reject employing these due to the stigma attached to the identity. (...) We begin with a reinterpretation of one of the cases discussed in the literature, Edmund White’s novel A Boy’s Own Story. We argue that in this case hermeneutic resources are available but are rejected due to the stigma attached to homosexuality. We then present two analogous kinds of cases: alcohol addiction and being the victim of intimate partner violence. Here, too, hermeneutic injustice occurs because of the stigma attached to an identity rather due to unavailability of resources. We close by suggesting that these cases may, additionally, involve the wrong of ‘Tightlacing’: by meddling with their self-conception, stigma can manipulate individuals into a view of themselves that licenses inappropriate demands on them and makes them complicit in the erasure of their identities. (shrink)

Scholars depict punishment as a dialogue. However, in the context of a life sentence the question emerges whether a penal dialogue is feasible. This paper seeks to explore the responsive work of life-sentenced prisoners during their parole hearings. Drawing on qualitative analysis of sentencing remarks and parole board hearings in Israel, the paper theorizes how these life prisoners negotiate their strict, exclusionary and stigmatizing sentencing communication, on the one hand, and the possibility of re-integration and inclusion, on the other. As (...) the findings suggest, the applicants responsively negotiate their flawed character, stigma and citizenship. The analysis reveals the intricate mechanism of penal dialogue in a case of a life sentence and sheds light upon the possibilities and limitations of communicative theory when considering the full meaning of the penal experience. (shrink)

The intersection of language, stigma, and neuropsychiatry is an integral area of concern for limited english proficiency (LEP) communities, demanding a greater focus in U.S. healthcare systems. Lan...

The consequences of stigma are preventable. We argue that individual attention should be provided to patients when dealing with stigma. Also, in order to deal with the impact of stigma on an individual basis, it needs to be assessed during routine clinical examinations, quantified and followed up to observe whether or not treatment can reduce its impact. A patient-centric anti-stigma programme that delivers the above is urgently needed. To this end, this review explores the experiences, treatment (...) barriers and consequences due to stigma. We also offer putative solutions to this problem. (shrink)

Addictions are commonly accompanied by a sense of shame or self-stigmatization. Self-stigmatization results from public stigmatization in a process leading to the internalization of the social opprobrium attaching to the negative stereotypes associated with addiction. We offer an account of how this process works in terms of a range of looping effects, and this leads to our main claim that for a significant range of cases public stigma figures in the social construction of addiction. This rests on a social (...) constructivist account in which those affected by public stigmatization internalize its norms. Stigma figures as part-constituent of the dynamic process in which addiction is formed. Our thesis is partly theoretical, partly empirical, as we source our claims about the process of internalization from interviews with people in treatment for substance use problems. (shrink)

Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, therapeutic revolutions in psychiatry have not yet been able to reduce stigma. Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. This review will discuss (...) the causes and consequences of stigma related to mental illness. (shrink)

Stigma has become an important concept in public health law. It is widely accepted that certain diseases are disfavored in society, leading to discrimination against people identified with them, which in turn has the tendency to drive an epidemic underground—i.e., to make it more difficult for voluntary public health programs to reach and succeed among populations bent on concealing their disease or risk status. The need to reduce stigma and its effects has been used to justify the passage (...) of privacy and antidiscrimination law to protect people with HIV. More recently, stigma has been part of the arsenal of justification for special genetic antidiscrimination and privacy law. Despite its importance, however, there is no single widely accepted definition of stigma in social science, and its relationship to law has been generally under-theorized and unsupported by data, reducing our ability to effectively deploy law and other tools in the anti-stigma cause. (shrink)

In addition to their conduct, organizations can be stigmatized for conduct they did not engage in. Advancing a conceptual foundation of illusory conduct stigma, I explain how it stems from a perceptional process that is distinct from the one underlying conduct stigma. I use conspiracy theory as an illustrative source of illusory conduct stigma and explain how the former evolves in the absence of evidence, differs from an official narrative, and incorporates organizations. The study proposes that organizations (...) are likely targets when they have higher status, larger size, and recent media coverage, and the targeting is persistent when organizations are complex, diversified, and carry strong emotional appeal. Moreover, organizations are at times participants in the production, facilitation, and forbearance of illusory conduct stigma. The study contributes by explicating how organizations are affected as well as how they participate in the development and propagation of illusory conduct stigma. (shrink)

Demand for healthcare chatbots has surged in recent years, with companies and governments actively investing in this technology. Drawing on care ethics and technology anthropomorphism literature, this research examines how businesses can design chatbots to provide more supportive healthcare services. Specifically, we explore how anthropomorphic features affect user perceptions and their willingness to adopt chatbots, particularly in the context of stigmatized health conditions. Across six experiments, including a Facebook advertising study, we find that, when consumers perceive the target health condition (...) as highly stigmatized, they are more likely to adopt a robot-like chatbot than a human-like one. This preference arises from the belief that human-like chatbots are more likely to make social judgments, which is undesirable for consumers facing stigma. Supporting this social judgment threat mechanism, we find that this effect diminishes when the human-like chatbot lacks facial features. Our findings advance technology anthropomorphism research by showing how design choices affect chatbot adoption in sensitive contexts. By integrating care ethics, we emphasize the need for empathetic, non-judgmental design in digital health technologies. This research also contributes to stigma research, showing how thoughtful chatbot design can reduce stigma-driven disengagement. Practically, we provide actionable guidance for designers and policymakers, urging them to tailor chatbot features to the needs of stigmatized users to ensure inclusivity. Our research highlights the ethical responsibility of marketers to design technologies that reduce, rather than reinforce, stigma, thus contributing to a broader discourse on business ethics in technology. (shrink)

Fat stigma is pervasive. Being fat is widely regarded a bad thing, and fat persons suffer numerous social and material disadvantages in virtue of their weight being regarded that way. Despite the seriousness of this problem, it has received relatively little attention from analytic philosophers. In this paper, I set out to explore whether there is a reasoned basis for stigmatizing fatness, and, if so, what forms of stigmatization could be justified. I consider two lines of reasoning that might (...) be advanced to defend fat stigma. The first is broadly consequentialist. It seeks to justify stigmatizing fatness based on the public health benefits that might be produced by doing so. The second argument takes stigmatizing fatness to be a warranted response to the morally blameworthy failure to slim down exhibited by fat persons. Clarifying and assessing each of these two lines of reasoning is the main task of this paper. I argue that, upon careful examination, both these attempts to justify the stigmatization of fatness fail. (shrink)

There is a stark knowledge gap on the sexual and reproductive health (SRH) of women experiencing homelessness. The limited research that does exist foregrounds the challenges that they face at every stage of their reproductive lives. However, this body of research is often theoretically underdeveloped. To address this gap, I propose utilising a reproductive justice framework to understand the constraints within which women experiencing homelessness navigate their SRH homeless. Reproductive justice draws attention to the connectedness of reproductive issues with other (...) social justice issues, and to the structural conditions which constrain the exercising of choice. This article focuses on one form of injustice, structural stigma, deploying a re-politicised theorisation of structural stigma as a mode of social control that is violently enacted upon women who experience homelessness. This conceptualisation of stigma, and its effects, holds the potential to underpin a future research agenda and provide a more nuanced understanding of the barriers that women who experience homelessness face throughout their reproductive lives. (shrink)

This paper proposes a theoretical framework for understanding fat stigma and its impact on people’s well-being. It argues that stigma should never be used as a tool to achieve public health ends. Drawing on Bruce Link and Jo Phelan’s 2001 conceptualization of stigma as well as the works of Hilde Lindemann, Paul Benson, and Margaret Urban Walker on identity, positionality, and agency, this paper clarifies the mechanisms by which stigmatizing, oppressive conceptions of overweight and obesity damage identities (...) and diminish moral agency, arguing that the use of obesity-related stigma for public health ends violates the bioethics principles of nonmaleficence, autonomy, and justice. (shrink)

This paper offers a critical analysis of the strategic use of biomedical models of mental illness as a means of challenging stigma. Likening mental illnesses to physical illnesses (1) reinforces notions that persons with mental illnesses are of a fundamentally “different kind,” (2) entrenches misperceptions that they are inherently more violent, and (3) promotes overreliance on diagnostic labeling and pharmaceutical treatments. I conclude that too much has been invested in the claim that the body is somehow morally neutral, and (...) that advocates of this approach oversimplify, misrepresent, and underestimate the personal and social costs of physical illness. (shrink)

Relational egalitarians oppose social hierarchy. Or, more precisely, they oppose intolerable social hierarchy. Stigma is often included among those unequal forms of relating that relational egalitarians ought to oppose, but there are circumstances in which stigmatizing behaviors or group identities might be strategically important for opposing social inequalities. Working through different responses to this puzzle, in this paper I advance the view that stigma is neutral, such that relational egalitarians should only oppose forms of it that are unwarranted.

IntroductionSelf-stigma arising from public stigma is a heavy burden for people suffering from mental health problems. Both public stigma and self-stigma encompass the same three elements: stereotype, prejudice, and discrimination. Public stigma has already been successfully explored by the Stereotype Content Model and the Behaviors from Intergroup Affect and Stereotypes map. However, this is not the case for self-stigma. Therefore, this is the first study that applies SCM and the BIAS map to self-stigma (...) by examining whether the effects of self-stereotypes on self-directed discrimination would be mediated by self-directed prejudices in people with mental health problems.MethodWithin a total sample of N = 823 participants, who took part in an online survey, n = 336 people reported mental health problems. Mental health and self-stereotypes, self-directed prejudice, and self-directed discrimination were assessed.ResultsStructural equation modeling supported the hypothesis that the stereotype dimensions warmth and competence negatively related to prejudice, while stronger prejudice was associated with more discrimination. Prejudice fully mediated the relationship between stereotypes and discrimination. The indirect effects of warmth and competence on active and passive self-harm were moderated by competence and warmth.DiscussionImplications for further research on self-stigma and the usage of SCM and BIAS map are discussed. (shrink)

The Stigma of Genius speaks to all of us - teachers, students, parents, citizens. In 1938 Einstein wrote "knowledge exists in two forms - lifeless, stored in books, and alive in the consciousness of men." This is a manifesto for an end to deadening convention, corporate bureaucracy, and standardized students in our public schools; and for a restoration of the flame of curiosity, diversity, and value systems, based not on a pre-ordained order, but in the heart and mind of (...) students with the freedom to think and question for themselves. (shrink)

The concept of self-stigmatization is guided by a representational account of selfhood that fails to accommodate for resilience against, and recovery from, stigma. Mainstream research on self-stigma has portrayed it only as a reified self, that is, as collectively shared stereotypes representing individuals’ identity. Self-stigma viewed phenomenologically, however, elucidates what facilitates a stigmatized self. A phenomenological analysis discloses the lived phenomenon of stigma as an act of self-objectification, as related to the experiential self, and therefore an (...) achievement of subjectivity. Following a phenomenological account, the stigmatized self can thus return to a state-of-being, similar to that Jean-Paul Sartre once referred to as bad faith. Regarding your identity as analogous to an inanimate thing is ultimately self-deceptive. Self-stigma is here phenomenologically illuminated as constituted by basic discretion, that is, as a minimal form of agency. The study found that basic discretion can uphold the possibility for emancipation from a stigmatized self. (shrink)

This article deals with the moral evaluation of stigma. I respond to Euan Allison's recent critique of stigma, calling into question his major arguments for its wrongness. Allison's foundational premise is that stigma is wrong because it fails to treat the stigmatized as individuals. He accepts that stigma denies the autonomy of those it attaches to but concludes that its distinctive wrongness lies in the harm it does to their agency by limiting their ability to self-present. (...) I challenge these criticisms, arguing that stigma can actually be quite congenial to acknowledging the individuality and autonomy of the stigmatized, and questioning whether limitations on one's ability to self-present are necessarily harms. I conclude by suggesting that stigma should be evaluated morally on different grounds than those Allison employs, such as the value of the ends it pursues and its ability to fulfill them. (shrink)

Purpose: There is a widespread recognition that biomedical explanations offer benefits to those diagnosed with a mental disorder. Recent research points out that such explanations may nevertheless have stigmatizing effects. In this study, this ‘mixed blessing’ account of biomedical explanations is investigated in a case of philosophical interest: Tourette Syndrome. Method: We conducted a vignette survey with 221 participants in which we first assessed quantitative attributions of blame as well as the desire for social distance for behavior associated with Tourette (...) Syndrome. Results: In our study, it is confirmed that in the case of biomedical explanations, less blame is attributed than in the case of psychosocial explanations. When presented with a mixed explanation stressing an entanglement of biological and psychosocial factors this did not increase blame attribution. The desire for social distance is unaffected by the type of explanation but the participants’ free text feedback indicates this might obfuscate an underlying dilemma between stigma and blame revealed in recent research. Conclusion: There seems to be potential for blame reduction in explanations where biological and psychosocial factors are entangled. However, dynamic, ‘epigenetic’, explanations require further qualitative research to be performed as well as a philosophical framework to account for the ‘mixed blessings’ account. (shrink)

As one of the best known science narratives about the consequences of creating life, Mary Shelley’s Frankenstein; or, The Modern Prometheus is an enduring tale that people know and understand with an almost instinctive familiarity. It has become a myth reflecting people’s ambivalent feelings about emerging science: they are curious about science, but they are also afraid of what science can do to them. In this essay, we argue that the Frankenstein myth has evolved into a stigma attached to (...) scientists that focalizes the public’s as well as the scientific community’s negative reactions towards certain sciences and scientific practices. This stigma produces ambivalent reactions towards scientific artifacts and it leads to negative connotations because it implies that some sciences are dangerous and harmful. We argue that understanding the Frankenstein stigma can empower scientists by helping them revisit their own biases as well as responding effectively to people’s expectations for, and attitudes towards, scientists and scientific artifacts. Debunking the Frankenstein stigma could also allow scientists to reshape their professional identities so they can better show the public what ethical and moral values guide their research enterprises. (shrink)

This article discusses the connections between William Shakespeare, the first person to use the word stigma seriously and consistently in English, and Erving Goffman and Leslie Fiedler, the first modern writers to theorize stigma. First, Shakespeare indirectly influenced Goffman’s theory and directly influenced Fiedler’s. Second, Goffman’s and Fiedler’s descriptions of stigma as a dramatic scene of social interaction illuminates how Shakespeare used dramatic expression to treat stigma as a social, rather than natural, phenomenon. Finally, Shakespeare’s treatment (...) of stigma as a rhetorically charged attack against those who represent difference clarifies an aspect of stigma unaddressed in Goffman’s and Fiedler’s theories. (shrink)

The primary claim of this paper is that COVID-19 stigma must be understood as a structural phenomenon. Doing so will inform the interventions we select and prioritize for the amelioration of such stigma. Thinking about stigma as a macrosocial determinant of health driven by structural factors suggests that downstream remedies are unlikely to be effective in significantly reducing stigma. This paper develops and defends this claim, setting up a recommendation to use a “bundle” of legal and (...) policy levers at meso- and macro- levels to reduce the adverse and inequitable impact of COVID-19 stigma.Historians of public health have long pointed out that outbreaks of communicable disease track social fault lines (Rosenberg... (shrink)

The effects of stigma and discrimination against people with lived experience of mental health conditions are common and profoundly socially excluding, and so constitute unethical barriers to full social participation. This chapter will discuss the ethical dimension of stigma by defining terms, discussing the existing literature on stigma related to mental health conditions, and considering global patterns of stigma, as well as summarising the evidence on stigma reduction.

This study uses an integrated model of resource conservation theory and social learning theory to explore the antecedents of hotel interns’ perceptions of occupational stigma and to explore the mechanisms inherent to retention willingness. This study first manipulated relevant subjects’ experimental materials through a contextual experiment and used a one-way ANOVA to test the effects of competence stereotypes and occupational stereotypes on hotel interns’ stigma perceptions, respectively, and then used partial least squares structural equation modeling as a statistical (...) tool and the SmartPLS 3.0 program to validate the model of hotel interns’ occupational stigma perceptions-intention. The effects of both competence stereotypes and occupational stereotypes on hotel interns’ perceptions of occupational stigma were significant. The results of the partial least squares structural equation model showed that hotel interns’ perceptions of occupational stigma significantly contributed to emotional exhaustion and that emotional exhaustion significantly influenced hotel interns’ retention willingness, hotel interns’ perceptions of occupational stigma had a significant effect on their retention willingness, while the role of emotional exhaustion as a mediating variable and occupational commitment as a moderator. The inner psychological and behavioral linkage mechanisms of hotel interns’ occupational stigma perceptions and their retention willingness under COVID-19 were explored, and the resource dynamics operating mechanism and professional commitment were also confirmed. (shrink)

ObjectivesThe breast cancer stigma affects Health-related quality of life, while general resilience resources, namely, sense of coherence, social support, and coping skills, are thought to alleviate this effect. The study aimed to explore the mediating/moderation role of GRRs in the relationship between stigma and HRQoL and its dimensions in Iranian patients with breast cancer.MethodsIn this cross-sectional study, Stigma Scale for Chronic Illness 8-item version, SOC-13, Medical Outcome Survey- Social Support Scale, Brief COPE, and Functional Assessment of Cancer (...) Therapy-Breast were investigated in a convenience sample of Iranian women with confirmed non-metastatic breast cancer. Following the establishment of correlations using Pearson’s correlation, single and parallel mediation analysis and moderation analysis were conducted to determine the extent to which each GRR might be impacted by stigma or decrease the adverse impact of stigma on HRQoL.ResultsAn analysis of 221 women with the mean age of 47.14 showed that stigma was negatively correlated to all HRQoL’s dimensions, SOC, social support, and the bulk of coping skills. In the single mediation analysis, stigma affected all facets of SOC, all subscales of social support, and positive reframing, which partially reduced breast cancer HRQoL. Stigma affects general HRQoL through damaging meaningfulness, social support, and positive reframing. Meaningfulness was marked as the most impacted GRR in terms of all domains of HRQoL. In parallel mediation, reduced meaningfulness, total social support, and positive reframing were highlighted as the pathways of diminished breast cancer HRQoL. Moderation analysis indicated the higher levels of humor, behavioral disengagement, and use of instrumental support behaviors to be functional in protecting different dimensions of HRQoL, while the results were mixed for venting, especially in patients with mastectomy surgery.ConclusionWhile GRRs may be impacted by stigma, they exert a relatively small protective effect against the impact of stigma on HRQoL. This study provides some novel findings, but longitudinal studies are needed to further verify these before any causal conclusion or recommendations for health policy can be drawn. (shrink)

In The Stigma of Genius: Einstein, Consciousness and Critical Education, we muse over ways in which to be, to become, to recognize uniqueness and different paths to genius. Understanding that there is no prescribed procedure, but only multiple actions, means, measures in which to recognize or teach to genius, we look at Einstein's life and knowledges to connect our pedagogies and students. Today's schools often exemplify an inability to stimulate and encourage students to find passion, goals, and reasons to (...) be educated. Our public school students are often not succeeding, many are failing and are discouraged. Teachers are exhausted, overworked, lacking respect and administrative support in districts controlled by local and national politics. Using Einstein as an example, but also a metaphor for educators, The Stigma of Genius is straight talk about the needs for schools/teachers/administrators/students to become critically and contextually aware. We argue for an education which is conscious of students' needs, and the nuances within each school and each classroom. Discussing cognition, classes, urban education, and diversity, we have attempted to circle back to Einstein and understand ways to support and encourage today's geniuses. (shrink)

BackgroundThe consent process for a genetic study is challenging when the research is conducted in a group stigmatized because of beliefs that the disease is familial. Podoconiosis, also known as 'mossy foot', is an example of such a disease. It is a condition resulting in swelling of the lower legs among people exposed to red clay soil. It is a very stigmatizing problem in endemic areas of Ethiopia because of the widely held opinion that the disease runs in families and (...) is untreatable. The aim of this study was to explore the impact of social stigma on the process of obtaining consent for a study on the genetics of podoconiosis in Southern Ethiopia.MethodsWe adapted a rapid assessment tool validated in The Gambia. The methodology was qualitative involving focus-group discussions (n = 4) and in-depth interviews (n = 25) with community members, fieldworkers, researchers and staff of the Mossy Foot Treatment and Prevention Association (MFTPA) working on prevention and treatment of podoconiosis.ResultsWe found that patients were afraid of participation in a genetic study for fear the study might aggravate stigmatization by publicizing the familial nature of the disease. The MFTPA was also concerned that discussion about the familial nature of podoconiosis would disappoint patients and would threaten the trust they have in the organization. In addition, participants of the rapid assessment stressed that the genetic study should be approved at family level before prospective participants are approached for consent. Based on this feedback, we developed and implemented a consent process involving community consensus and education of fieldworkers, community members and health workers. In addition, we utilized the experience and established trust of the MFTPA to diminish the perceived risk.ConclusionThe study showed that the consent process developed based on issues highlighted in the rapid assessment facilitated recruitment of participants and increased their confidence that the genetic research would not fuel stigma. Therefore, investigators must seek to assess and address risks of research from prospective participants' perspectives. This involves understanding the issues in the society, the culture, community dialogues and developing a consent process that takes all these into consideration. (shrink)

Drawing on fieldwork and interviews from South India, the author analyzes married women's experiences of stigma when they are childless and their everyday resistance practices. As stigma theory predicts, childless women deviate from the “ordinary and natural” life course and are deeply discredited, but contrary to Goffman's theory, South Indian women cannot “pass” or selectively disclose the “invisible” attribute, and they make serious attempts to destigmatize themselves. Social class and age mediate stigma and resistance processes: Poor village (...) women of childbearing age are devalued in ways affluent and professional women avoid; differently situated women challenge dominant definitions and ideologies of family in distinctive ways. South Indian women are creating spaces for childless marriages within the gendered margins of families and culturally prevalent definitions of womanhood. The findings contribute to rethinking Western assumptions in Goffman's theory and suggest new directions for research on power and everyday resistance. (shrink)

Alcohol use causes significant harms and is extensively regulated by governments, but alcohol-related questions are under-explored in public health ethics. To inform future work in this area, I conducted interviews with key informants from alcohol research and policy work in Australia. Thematic analysis of interviews identified a range of ethical issues that can be categorized under six themes: ethical issues in alcohol research; ethical issues raised by judgements about alcohol use; ethical issues raised by alcohol policies; ethical issues in policy (...) processes; ethical questions about policy aims; and ethical issues in how alcohol problems are defined. The study provides direction for future research on problems that are underexplored in the ethics literature. These include problems arising from the influence of industry in alcohol research and policy, the question of how to develop research and policy without generating stigma, and social justice issues connected to alcohol-related stereotypes and judgements. (shrink)

We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life. We recruited 430 dyads of elementary school children [mean age = 10.07 years; nboy = 241 ; noverweight = 138 ] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and (...) perceived weight stigma. Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations. (shrink)

The article dwells on the history of the formation of multiple stigmas of sick/poor people. The author describes medical and status characteristics that predetermine attitudes towards potential or real carriers of infectious diseases and poverty. Historical examples of the stigmatization of certain social groups in the era of the greatest epidemiological trouble until the middle of the 19th century are described.A content analysis of the discourse is carried out. It was based on the materials of a modern online publication and (...) included text-analyzes of the audience’ comments (n=133) to the news. The publication describes a conflict in a city cafe about the visitor who carries multiple stigmas. Statements that reflect the assessment of the identity of the stigmatized and the attitude of the audience towards him are given.Historical and cultural analysis made it possible to identify the continuity of discursive practices of stigmatization, the relevance for contemporaries of the historically established stereotypes of perception of a traditionally stigmatized category. (shrink)

Moving from the social and political arena to the choices we face in our own private lives, Claudia Mills asks how information about someones mental illness should be shared with others. Whileopen communication about mental illness works toward the important goal of reducing its unfair stigma, it can cause harm or embarrassment, violate privacy, and challenge an individuals ownpreferred self-representation. She offers tentative guidelines for how to proceed on this sensitive and morally charged issue.

Purpose: There is a widespread recognition that biomedical explanations offer benefits to those diagnosed with a mental disorder. Recent research points out that such explanations may nevertheless have stigmatizing effects. In this study, this ‘mixed blessing’ [2] account of biomedical explanations is investigated in a case of philosophical interest: Tourette Syndrome. Method: We conducted a vignette survey with 221 participants in which we first assessed quantitative attributions of blame as well as the desire for social distance for behavior associated with (...) Tourette Syndrome. Results: In our study, it is confirmed that in the case of biomedical explanations, less blame is attributed than in the case of psychosocial explanations. When presented with a mixed (or an epigenetic) explanation stressing an entanglement of biological and psychosocial factors this did not increase blame attribution. The desire for social distance is unaffected by the type of explanation but the participants’ free text feedback indicates this might obfuscate an underlying dilemma between stigma and blame revealed in recent research. Conclusion: There seems to be potential for blame reduction in explanations where biological and psychosocial factors are entangled. However, dynamic, ‘epigenetic’, explanations require further qualitative research to be performed as well as a philosophical framework to account for the ‘mixed blessings’ account. (shrink)

This article analyzes the relationship between the structure of federal Title IX investigations and the existing evidence addressing the emotional and mental health needs of sexual harassment and sexual assault victims. The article argues that federal requirements for investigating sexual harassment should be restructured so as to address the challenges stigma poses for the realization of Title IX's objectives.

In this article I read textual metaphors of ‘untouchability’ in ‘post-AIDS’ representation as an erasure of structures that condition HIV stigmatization in India. Throughout, my discussion is contextualised by the political economy of HIV and AIDS, which has been productive of particular modern sexual subjects. In the film My Brother…Nikhil, the stigmatization of Nikhil, a gay Indian man living with HIV, is constituted through visual and verbal caste metaphors, which draw on existing subject positions that are elided as ‘traditional’, residual, (...) and receding. This stigma is resolved textually through parental acceptance of the gay protagonist and his partner, projecting stigma as traditional and modernity as the resolution. Such metaphors of ‘untouchability’ prevent the representation of queer Dalit subjects in contexts of HIV and AIDS. Yet if addressing shame and social stigma are key to HIV treatment and prevention programmes, caste cannot be set aside simply as a metaphor. Expanding to include textual representations of queer Dalit subjectivity, the article reads a novel, The Boyfriend, and a poem, “Gandu Bagicha,” to show ways in which caste stigma and homophobia intersect in contexts of seroconversion risk. (shrink)

This chapter examines the concepts of stigma and shame, their interrelationship, and their relevance to healthcare. It traces the intellectual genealogies of stigma and shame research, highlighting key debates and recent developments. The chapter argues for a praxeological approach to studying stigma and shame, focusing on how they are produced and made witnessable in interaction, rather than relying on theoretical abstractions. It explores the connections between stigma, shame, respect, and acknowledgement, emphasizing the importance of lived experience (...) and interactional dynamics. The chapter presents a fictional stigma scenario to illustrate how stigma can be enacted unintentionally and experienced differently based on past encounters. It concludes by advocating for case studies and scenarios over theories to build a picture of the praxeological logic of stigma and shame. This approach aims to avoid depicting stigmatized individuals as passive victims and instead recognizes their agency in anticipating, resisting, and managing potential degradation. (shrink)

Public health law has focused primarily on combatting stigma through laws targeting discrimination based on attributes, when the reach of stigma extends far beyond mere appearances. By exploring the lived experience of stigmatized individuals, policy makers might more deeply understand public health problems, more appropriately create health policies, and more effectively promote positive health behaviors. Efforts to address stigma must focus on all aspects of stigma to be effective.

Public discussions of miscarriage in the UK frequently describe it as a stigmatised phenomenon that is ‘shrouded in silence’. And in turn, ‘breaking the silence’ is presented as the means of defeating the stigma. In this article, however, I argue that it is time to abandon the ‘breaking the silence’ frame. This is not only because it overstates the public silence it condemns, but also because it is rooted in an inadequate understanding of stigma, which keeps us stuck (...) in a cycle of talking more, rather than doing more, about miscarriage, and failing to connect miscarriage as a feminist issue with wider struggles for social justice. Drawing on critical sociologies of stigma developed by Imogen Tyler and others, I propose a paradigm shift: from a narrow liberal understanding of miscarriage stigma as a problem of social norms that can be alleviated through ‘breaking the silence’ and ‘awareness raising’, to a critical ‘stigma power’ approach which understands miscarriage stigma as a ‘machinery of inequality’ that fulfils a core function for patriarchal, racialised, neoliberal capitalist power structures, and hence requires transformative socioeconomic solutions. To this end, I call for a new research and activism agenda that fully incorporates miscarriage within the wider movement for Reproductive Justice. (shrink)

Since its foundation in 2010, the annual philosophy thematic edition of this journal has been a forum for authors from a wide range of disciplines and backgrounds, enabling contributors to raise questions of an urgent and fundamental nature regarding the most pressing problems facing the delivery and organization of healthcare. Authors have successfully exposed and challenged underlying assumptions that framed professional and policy discourse in diverse areas, generating productive and insightful dialogue regarding the relationship between evidence, value, clinical research and (...) practice. These lively debates continue in this thematic edition, which includes a special section on stigma, shame and respect in healthcare. Authors address the problems with identifying and overcoming stigma in the clinic, interactional, structural and phenomenological accounts of stigma and the ‘stigma-shame nexus’. Papers examine the lived experience of discreditation, discrimination and degradation in a range of contexts, from the labour room to mental healthcare and the treatment of ‘deviancy’ and ‘looked-after children’. Authors raise challenging questions about the development of our uses of language in the context of care, and the relationship between stigma, disrespect and important analyses of power asymmetry and epistemic injustice. The relationship between respect, autonomy and personhood is explored with reference to contributions from an important conference series, which includes analyses of shame in the context of medically unexplained illness, humour, humiliation and obstetric violence. (shrink)

Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. FASD is a spectrum of structural, functional, and neurodevelopmental problems with often lifelong implications, affecting communities worldwide. It is a leading preventable form of intellectual disabilities and therefore warrants effective prevention approaches. However, well-intended FASD prevention can increase stigmatization of individuals with FASD, women who consume or have consumed alcohol during pregnancy, and non-biological parents and guardians of individuals with FASD. This narrative review surveyed the literature on stigmatization related (...) to FASD. Public stigma appears to be the most common form of stigma studied. Less is known about FASD-related self-stigma, stigma by association, and structural stigma. Accordingly, the current literature on FASD-related stigma does not appear to provide sufficient guidance for effectively reducing FASD-related stigma. However, lessons can be learned from other related health topics and the use of a systematic approach for the development of health promotion programs, namely Intervention Mapping. (shrink)