Background: Fetal alcohol spectrum disorder (FASD), a complex diagnosis that includes a wide range of neurodevelopmental disabilities, results from exposure to alcohol in the womb. FASD remains poorly understood by Canadians, which could contribute to reported stigma faced by both people with FASD and women who drink alcohol while pregnant. Methods: To better understand how information about FASD is presented in the public sphere, we conducted content analysis of 286 articles from ten major English-language Canadian newspapers (2002-2015). We used inductive (...) coding to derive a coding guide from the data, and then iteratively applied identified codes back onto the sample, checking inter-coder reliability. Results: We identified six major themes related to clinical and scientific media content: 1) prevalence of FASD and of women’s alcohol consumption; 2) research related to FASD; 3) diagnosis of FASD; 4) treatment of FASD and maternal substance abuse; 5) primary disabilities associated with FASD; and 6) effects of alcohol exposure during pregnancy. Discussion: Across these six themes, we discuss three instances of ethically consequential exaggeration and misrepresentation: 1) exaggeration about FASD rates in Indigenous communities; 2) contradiction between articles about the effects of prenatal alcohol exposure; and 3) scientifically accurate information that neglects the social context of alcohol use and abuse by women. Respectively, these representations could lead to harmful stereotyped beliefs about Indigenous peoples, might generate confusion about healthy choices during pregnancy, and may unhelpfully inflame debates about sensitive issues surrounding women’s choices. (shrink)

While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of (...) class='Hi'>stigmatisation), facilitators (factors positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction. (shrink)

La couverture médiatique du conflit social des Forges de Clabecq s'est caractérisée par le développement croissant de stéréotypes censés rendre compte de la personnalité très singulière du chef de file de la délégation syndicale. Populiste, extrémiste, dictateur, gangster ou encore gourou, les figures journalistiques du leader « prolétarien » se sont succédé tout au long du conflit. Cette criminalisation croissante du mouvement social s'explique par l'intensité des enjeux politiques de ce dossier mais aussi par la méconnaissance profonde de la classe (...) ouvrière dans le chef de journalistes appartenant pour la grande majorité d'entre eux aux classes moyennes.The journalistic coverage of the social struggle of the Forges de Clabecq was characterized by the growing development of stereotypes which were supposed to describe the very singular personality of the trade unionist leader. Populist, extremist, dictator, gangster or even guru, the journalistic figures of the proletarian leader followed one another throughout the conflict. This growing criminalization of the social movement is explained by the intensity of the political stakes of this affair but also by the deep ignorance of the working-class in the case of journalists who belong to the middle class. (shrink)

To consciously bolster behaviour that is disapproved by others (i.e., stigmatised behaviour) people may hold and report a favourable attitude toward the behaviour. However, achieving such bolstering outside awareness may be more difficult. Explicit attitudes were measured with self-report measures, and the Implicit Association Test was used to assess implicit attitudes toward behaviour held by stigmatised actors (smokers) and nonstigmatised actors (vegetarians and omnivores). Smokers' showed greater attitude-behaviour consistency in their explicit attitudes toward smoking that in their implicit attitudes. By (...) contrast, vegetarians and omnivores showed attitude-behaviour-consistency at both implicit and explicit levels. Smokers' implicit negative attitudes toward smoking may reflect its status as a stigmatised behaviour, or its addictive nature. (shrink)

Résumé Après avoir dressé un historique de l’accession à la parentalité des patients séropositifs depuis le début de l’épidémie, l’article décline quelques situations spécifiques familiales. Le point commun de ces différents contextes est l’omniprésence du secret et de la honte de la contamination par le vih, qui infiltrent la relation entre parents et enfants. L’article tente d’en analyser les fonctions à la fois défensives et organisatrices au sein de la famille.

One of the ways in which sexual transmission of AIDS is addressed is through moral interventions by organisations affiliated with Christian churches. However, this approach has been heavily criticised in recent literature, implying that moral interventions by church-affiliated organisations generally lead to stigmatisation which is one of the major obstacles to their involvement in HIV prevention. This article explores the origin of this accusation and discusses the Christian-ethical aspects related to HIV or AIDS. The conclusion is that the fact (...) that churches take the Word of God and Christian morality as point of departure in HIV or AIDS intervention programmes does not imply that people who transgressed religious moral teachings may be condemned. On the contrary, the church preaches Christian forgiveness, mercy and empathy. Churches and organisations affiliated with churches should therefore be regarded as valuable partners in the fight against AIDS, for while propagating a normative lifestyle, they also preach love, compassion and support for people living with HIV. (shrink)

This article uses the African communal concept of ubuntu to reflect on the ministry of Mashoko Christian Hospital, Zimbabwe, to people living with the human immunodeficiency virus and AIDS during the early days since the discovery of the disease. The main question this article seeks to answer is: from a perspective of the African philosophy of ubuntu, how did the ministry of MCH to PLWHA challenge the fear and judgemental attitudes towards the disease within the Churches of Christ in Zimbabwe? (...) This leads to another question: what should the churches learn from MCH’s response to HIV and AIDS? This article only focusses on trends in conduct and not on a detailed history of engaging HIV and AIDS. The significance of this article is to demonstrate the important role played by faith-based organisations in complementing the compassion and care often lacking in the official churches’ response to HIV and AIDS. (shrink)

La notion de « populisme » s'est complètement transformée au cours du temps. Valorisant hier le populaire, elle le stigmatise aujourd'hui. Les usages actuels du «populisme du FN» en témoignent. S'ils font désormais consensus pour désigner dans les groupes populaires les principaux soutiens du parti frontiste, c'est au prix d'une naturalisation des interprétations du succès politique du FN oubliant le rôle des élites politiques et sociales, au prix également d'un changement de perspective sur l'autoritarisme et la signification concrète de l'appel (...) au peuple dans l'histoire sociale de la construction des démocraties.The meaning of the notion of "populism" has thoroughly changed over time. While in the past it was used in order to celebrate people's, it nowadays is used in order to stigmatize it. Current uses of the notion of the "populism of the Front National" give testimony to this change, for they help put forward the idea that the main constituency of this party is made of the "lower classes". But this hypothesis has a high analytical cost, for it implies that the interpretation of the political success of the Front National is then seen as taken-for-granted. Hence, nothing is said anymore about the role played in this success by social and political elites. Moreover, putting the blame of the renewal of hatred-prone "populism" on people's politics is a way to dangerously shift the perspective on the social history of the process of the building of modern democracies by erasing the role played by people's mobilizations. (shrink)

In 2018 and 2019 Cancer Research UK launched a controversial advertising campaign to inform the British public of obesity being a preventable cause of cancer. On each occasion the advertisements used were emotive and provoked frustration among the British public which was widely vocalised on social media. As well serving to educate the public of this association, the advertisements also had the secondary effect of acting as health promotion through social marketing, a form of advertising designed to influence behavioural changes. (...) As CRUK delivered a public health message through its campaign, the advertisements should be held according to the ethical principles which underpin healthcare in the UK. This article evaluates whether the advertisements used by CRUK in 2018 and 2019 fulfilled the ethical principles of beneficence, autonomy, non-maleficence and justice. It is found that while providing an important message, the oversimplification of obesity as being the result of personal decisions ignored the complex aetiology and served to stigmatise the target demographic, potentially disengaging them from the message. Additionally, posting cancer as the consequence of obesity invokes feelings of fear due to its connotations of suffering and premature death. Based on available evidence, the use of fear in social marketing does not create sustained behavioural change. This essay recommends that CRUK discontinue its use of such strategies in its future social marketing endeavours. (shrink)

Retractions play an important role in research communication by highlighting and explaining how research projects have failed and thereby preventing these mistakes from being repeated. However, the process of retraction and the data it produces is often sparse or incomplete. Drawing on evidence from 2046 retraction records, Quan-Hoang Vuong discusses the emerging trends this data highlights and argues for the need to enforce reporting standards for retractions, as a means of de-stigmatising retraction and rewarding practising integrity in the scholarly record.

In attempting to explain or deal with negative workplace behaviours such as workplace bullying, the notion of ‘workplace psychopaths’ has recently received much attention. Focusing on individual aspects of negative workplace behaviour is at odds with more systemic approaches that recognise the contribution of individual, organisational and societal influences, without seeking to blame a person(s) for their behaviour or personality disorder. Regarding a coworker as a psychopath is highly stigmatising, and given the relatively low prevalence of psychopathy in the community, (...) is likely to be incorrect. Sources promoting the notion of workplace psychopathy provide lists of diagnostic criteria and appear to encourage the perception that it is common. This research examines how lay persons use behavioural criteria consistent with psychopathy and the label ‘psychopath’ in relation to a coworker. 307 Australian workers completed an online survey concerning their experience of workplace bullying, which also asked them to rate a coworker’s behaviour on a range of scales to assess perceptions of psychopathy. Rates of psychopathy, when using labels and behavioural criteria, were found to be much higher than scientific estimates of prevalence, for both participants who had been bullied and those who had not. A higher proportion of non-bullied participants classified a coworker as a psychopath when using the label ‘psychopath’, compared to when using behavioural criteria. The notion that there are psychopaths in every workplace should be treated with caution to ensure that the potential for ‘misdiagnosis’ and stigmatisation do not cause further harm in situations of unacceptable workplace behaviours. (shrink)

À partir d’une pratique clinique et de recherche, cet article traite de la parentalité dans le cas où le père et/ou la mère présentent une déficience cognitive. Il souligne que cette parentalité est négativement impactée par le regard social stigmatisant, des réseaux sociaux souvent retreints et des modalités d’accompagnement dont les normes sont peu compréhensibles et lisibles pour les parents. Face à cela, l’article propose : 1) de développer un travail conjoint entre normes des professionnels et normes des parents ; (...) 2) d’ouvrir davantage sur des situations de coparentalité ; 3) de favoriser les échanges entre parents ayant une déficience cognitive et avec eux le développement du partage d’expériences. Le partage d’émotions, d’affects, de rêves et de cauchemars devant commencer dès l’enfance. (shrink)

The stigmatisation of the gecekondu in post-1945 Turkey is a common theme in the literature. However, these studies have drawn little connection with health issues, even though these are known to be important in the mechanisms of stigmatisation. Policies for tuberculosis (TB) control—then Turkey's “number one health issue”—have tended to focus on individual and biological factors, to the detriment of social or environmental ones that could contribute to making TB a matter of politics and not only of policies. (...) A close study of the practices of the numerous TB-control actors nevertheless reveals an entanglement of the social, the environmental, and the medical questions. Through the emblematic but unknown case study of the TB-control pilot area created in Zeytinburnu in 1961, this article studies discourses, but also graphic representations, portraying the gecekondu as unhealthy, revealing an underlying environmental conception of TB among Turkish public health actors. The choice of Istanbul's biggest gecekondu neighbourhood to be a pilot area originated from a common conception of the gecekondu areas as pathogenic, but also contributed to reinforcing this vision and adding it to the very definition of the gecekondu. It thus participated in the stigmatisation of these areas and their inhabitants, even if some of the study's conclusions undermined the common vision of the gecekondu as populated by poor, rural migrants. However, the pilot project was also conceived as a way to integrate the inhabitants into the modern city. The “pilot” character of the area, if characteristic of the vocabulary of the 1960s, which were also the time of the attempt to “socialise the health services” in Turkey, is questionable. The project displayed a desire to know and control this specific territory rather than a genuine promotion of broader environmental changes to be replicated on a national scale. (shrink)

‘Homophobia’ is shorthand for stigmatising attitudes and practices towards people who demonstrate sexual diversity. In this article, we reflect on how African Christian faith may become redemptive rather than violent in the context of lesbian, gay, bisexual, transgender and intersex forms of sexuality.

À partir des résultats d’une recherche qualitative et participative ayant impliqué des personnes qui vivent avec un problème de santé mentale, des intervenants et des gestionnaires de milieux de pratique en santé mentale et visant à explorer les représentations d’une intégration sociale jugée réussie, cet article propose une analyse et une réflexion sur les conditions de possibilité d’une société suffisamment bonne et inclusive pour les personnes vivant avec un problème de santé mentale. L’élargissement du prisme de la reconnaissance sociale s’est (...) dégagé comme une condition essentielle à cet égard qui, elle-même, implique certaines conditions, avec en particulier un travail de reconnaissance de la différence en tant que telle et la mise à distance d’une logique d’utilité. (shrink)

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...) in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

This article argues that access to meaningful sexual experience should be included within the set of the goods that are subject to principles of distributive justice. It argues that some people are currently unjustly excluded from meaningful sexual experience and it is not implausible to suggest that they might thereby have certain claim rights to sexual inclusion. This does not entail that anyone has a right to sex with another person, but it does entail that duties may be imposed on (...) society to foster greater sexual inclusion. This is a controversial thesis and this article addresses this controversy by engaging with four major objections to it: the misogyny objection; the impossibility objection; the stigmatisation objection; and the unjust social engineering objection. (shrink)

In The legal determinants of health: Harnessing the power of law for global health and sustainable development, Gostin et al. provide a sustained account of how law can and should be used as an instrument of health promotion. We pick up on the themes of this report with a specific focus of the importance of abortion for women’s sexual and reproductive health and the impact that particular ways of framing abortion in law can have on the lives of women and (...) girls. In this short comment, we wish to emphasize that abortion regulations need to move beyond frameworks based on narrow understandings of harm towards more progressive agendas that take into account the social determinants of health in order to reduce barriers to care. This contribution is particularly relevant to the Commission’s criticism that those ‘[l]aws that stigmatise or discriminate against marginalized populations are especially harmful and exacerbate health disparities’. (shrink)

Albinism is a global public health issue but it assumes a peculiar nature in the African continent due, in part, to the social stigma faced by persons with albinism in Africa. I argue that there are two essential reasons for this precarious situation. First, in the African consciousness, albinism is an alterity or otherness. The PWA in Africa is not merely a physical other but also an ontological other in the African community of beings, which provides a hermeneutic for the (...) stigmatising separateness or difference of the PWA. The second reason hinges on a distinction drawn by Jürgen Habermas between the ethical point of view and the moral point of view. While the former consists of the ethos, customs, or idea of the good shared by a group of persons with a shared tradition or way of life, the latter consists of what is good for all and transcends particular traditions or ways of life. Consequently, the African ethical point of view, the ethics of solidarity, justifies within the African worldview the established alterity and, by implication, stigmatization of PWAs. On this view, actions that promote harmony and prevent discord and disequilibrium among accepted beings in the African community are permissible. I further show that unless there is a change in the physical and ontological conception of PWAs and a leap from the ethical point of view to the moral point of view, the negative attitudes toward PWAs will not change. The leap to the moral point of view does not suggest an abandonment of the ethical point of view but only recommends that the two meet halfway in respect for universally accepted norms of human actions. To achieve this, I will show that much needs to be done in the areas of policy formulation, law, health care services, and education. (shrink)

While empirical studies of research ethics and integrity are increasingly common, few have aimed at national scope, and even fewer at current results from Central and Eastern Europe. This article introduces the results of the first national research integrity survey in Estonia, which included all research-performing organisations in Estonia, was inclusive of all disciplines and all levels of experience. A web-based survey was developed and carried out in Estonia with a call sent to all accredited Estonian research institutions. The results (...) indicate that the vast majority (89%) of respondents consider research ethics and integrity issues important and view falsification, fabrication, and plagiarism (FFPs) as the most severe forms of misconduct. Self-reporting of FFPs is generally comparable to levels published in other studies (6.2%). Gift authorship (41%) and hampering the work of a colleague (32%) were problematic practices most noticed among colleagues. At the same time, two of the noticed questionable research practices (QRPs) – salami-slicing and misuse of research funding – were seen as less severe, hinting at the existence of counter-norms that career advancement rules and structural factors like funding policies may encourage. The availability of research ethics and integrity guidelines was considered good. Ethical aspects of studying potentially stigmatising data in a very small research community are discussed in the article and results are analysed through counter-norms and normative dissonance frames. (shrink)

This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the (...) debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall. (shrink)

Les questions morales pénètrent nos représentations, nos pratiques, nos politiques. Qu'il s'agisse, dans le monde privé, d'interpréter les conduites des autres et de discipliner les siennes propres, ou bien, dans l'espace public, de sanctionner des déviances et de réguler des populations, nos sociétés mobilisent des normes, des valeurs et des affects, qu'illustrent notamment les tensions entre la raison humanitaire et l'ordre sécuritaire. Redonnant toute sa force critique au concept d'économies morales, les auteurs réunis ici par Didier Fassin et Jean-Sébastien Eideliman (...) en explorent les multiples facettes à travers une série d'enquêtes conduites sur quatre continents. Des lieux d'enfermement des étrangers en France aux prisons de haute sécurité aux Etats-Unis, de la stigmatisation des familles roms en Italie à la marginalisation des enfants de migrants en Chine, de la condamnation du tourisme sexuel en Thaïlande à l'évaluation des transactions amoureuses au Mali, des pratiques de charité en Inde aux politiques contre la pauvreté au Chili, les auteurs s'attachent à comprendre comment on gouverne et on juge, comment on assiste et on exclut. Mais ils montrent aussi que les professionnels et leurs publics n'adoptent pas de manière passive et uniforme ces modèles moraux : ils déploient des subjectivités éthiques pour résister ou " faire avec ", autour du handicap et de la toxicomanie, de l'asile et de la naturalisation, de la violence et de la finance. Cet ouvrage nous propose ainsi de penser la vie sociale et politique de la morale. (shrink)

This publication articulated in three parts, and twelve chapters endeavours to engage with the complex negative emotions and consequent phenomenon of self-deceit, radicalisation and extremism. First part: Emotions as Lines of Demarcation or Guidelines to Our Self. The Psychodynamic Surrounding of our Intentional Self; second part: Case Studies of Some Concrete Societal Encapsulations of the Negative Passions; and third part: Resisting the Colonisation of Tyrannical Affections. Possible Paths of Mitigating Radicalisation and Extremism. What kind of educational responses can be given (...) to extremist claims of territory, identity, resources, power, and interpretations? How can a dialogue on unifying ethical principles and values aid in developing common grounds for preventing radical and extremist excesses? With authors from three continents, this publication endeavours to not only ask the uncomfortable questions with regard to the exteriorisation of human emotive predispositions and inclinations to ostracize, stigmatise and discriminate. The exit door from the extreme is also clearly presented, through four contributions, notably the interplay of Charvaka philosophy, Sikh wisdom on balanced forms of engagement with strong emotions. (shrink)

Today's world is post-colonial and post-Cold War. These twin characteristics explain why international society is also riddled with the two major forms of injustice which Nancy Fraser identified as afflicting national societies. First, the economic and social disparities between states caused outcry in the 1950s when the first steps were taken towards decolonisation. These inequalities, to which a number of emerging states now contribute, are still glaring and still pose the problem of the gap between formal equality and true equality. (...) Second, international society is increasingly confronted with culture- and identity-related claims, stretching the dividing line between equality and difference. The less-favoured states, those that feel stigmatised, but also native peoples, ethnic groups, minorities and women now aspire to both legal recognition of their equal dignity and the protection of their identities and cultures. Some even seek reparation for injustices arising from the past violation of their identities and the confiscation of their property or land. In answer to these two forms of claim, the subjects of international society have come up with two types of remedy encapsulated in legal rules: the law of development and the law of recognition. These two sets of rights are neither wholly autonomous and individualised branches of law nor formalised sets of rules. They are imperfect and have their dark side. Yet they can be seen as the first milestones towards what might become a fairer international society; one that is both equitable (as an answer to socio-economic injustice) and decent (as an answer to cultural injustice). This book explores this evolution in international society, setting it in historical perspective and examining its presuppositions and implications. (shrink)

While the presence of monsters in popular culture is ever-increasing, their use as an explicit or implicit category to frame, stigmatise, and demonise the other is seemingly on the rise. At the same time, academic interest for monsters is ever-growing. Usually, monstrosity is understood as a category that emerges to signal a transgression to a given order; this approach has led to the demystification of the insidious characterisations of the (racial, sexual, physical) other as monstrous. While this effort has been (...) necessary, its collateral effects have reduced the monstrous to a mere (socio-cultural) construction of the other: a dialectical framing that de facto deprives monstrosity from any reality. 'Monstrous Ontologies: Politics, Ethics, Materiality' proffers the necessity of challenging these monstrous otherings and their perverse socio-political effects, whilst also asserting that the monstrous is not simply an epistemological construct, but that it has an ontological reality. There is a profound difference between monsters and monstrosity. While the former is an often sterile political and social simplification, the end-product of rhetorical and biopolitical apparatuses; the latter may be understood as a dimension that nurtures the un-definable, that is, that shows the limits of these apparatuses by embodying their material excess: not a 'cultural frame', but the limit to the very mechanism of 'framing'. The monstrous expresses the combining, hybridising, becoming, and creative potential of socio-natural life, albeit colouring this powerful vitalism with the dark hue of a fearful, disgusting, and ultimately indigestible reality that cannot simply be embraced with multicultural naivety. As such, it forces us towards radically changing not the categories, but the very mechanisms of categorisation through which reality is framed and acted upon. Here lies the profound ethical dimension that monstrosity forces us to acknowledge; here lies its profoundly political potential, one that cannot be unfolded by merely deconstructing monstrosity, and rather requires to engage with its uncomfortable, appalling, and revealing materiality. This book will appeal to postgraduate students, PostDocs, and academics alike in the fields of philosophy, critical theory, humanities, sociology and social theory, criminology, human geography, and critical legal theory. (shrink)

In this article, Charlotte Blease argues that patient access to online shared clinical notes (also called ‘open notes’) may cause or exacerbate nocebo effects in two ways. 1 First, open notes may enhance patient understanding about the adverse effects of medications and treatments. However, reading information about adverse effects may lead patients to form negative expectations that, in turn, may cause or worsen symptoms via nocebo mechanisms. Second, open notes may paradoxically lower the quality of the therapeutic relationship by allowing (...) patients to detect signs of discrimination and stigma in clinical notes. By accessing their shared notes, patients may identify (or think that they are identifying) signs of stigmatisation and discrimination in clinicians’ words. This may diminish their trust while increasing their anxieties and fears, all factors that have been associated with enhanced nocebo effects. The article then suggests different strategies to mitigate nocebo effects while using open... (shrink)

This article examines the discourses that are used by the British press to represent obesity in its coverage of coronavirus disease 2019 (COVID-19). Obesity is understood to be a risk factor for COVID-19, with people with obesity being more likely to die from the virus. This study adopts a corpus-based approach to Critical Discourse Studies and utilises a novel approach to keyword analysis, based on comparing analysis corpora against two reference corpora in order to yield keywords that are, in this (...) case, characteristic compared to general coverage of both COVID-19 and obesity. It is argued that the context of the pandemic has produced a range of discourses around obesity that are more stigmatising than usual in both the tabloids and the broadsheets, with people with obesity being construed, for example, in especially fatalistic terms and as being responsible for the problems facing the country’s healthcare system. At the same time, the pandemic context also seems to have given rise to some more positive changes to press coverage of obesity, with race-related health disparities receiving more focus than usual and the right-leaning press being more likely to critique the Conservative Government than it usually is, resulting in an arguably more balanced style of reporting. (shrink)

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical (...) implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)

Marquée à juste titre par le mouvement des Annales, l’historiographie française a intériorisé lidée qu’avant 1929 dominait ce que Henri Berr avait stigmatisé sous le nom d’ « histoire traditionnelle » : une histoire politique et individualiste ne tenant pas compte des déterminations collectives, sociales ou mentales. La fameuse Introduction aux études historiques de Langlois et Seignobos (1898) serait l’expression de ce «positivisme» qu’aurait initié Gabriel Monod, fondateur de la Revue historique en 1876. Cette vision traditionnelle de l’histoire de la (...) discipline est globalement remise en cause dans cet article qui montre que les années 1870-1930 sont au contraire un moment central dans l’historiographie tant au plan institutionnel qu’au plan intellectuel, qui nous intéresse surtout ici. C’est en effet dès cette époque que s’est cristallisée laspiration à faire de l’histoire une science sociale, ce qui se comprend aisément dès lors qu’on contextualise cette histoire et que l’on replace cette discipline dans l’ensemble du champ des sciences sociales. Les années 1890–1914 voient même se développer fortement une histoire économique et une histoire sociale. 1929 apparaît alors moins comme une révolution que comme une accélération dans une direction déjà marquée. (shrink)

This article argues that public health campaigns have an ethical obligation to combat fat stigma, not mobilize it in the “war on obesity.” Fat stigma is conceptualized, and a review is undertaken of how pervasive fat stigma is across the world and across the lifespan. By reviewing the negative impacts of fat stigma on physical health, mental health, and health seeking behaviors, fat stigma is clearly identified as a social determinant of health. Considering the role of fat stigma in public (...) health, and the arguments made for using stigmatisation in public health campaigns to promote population health, it is concluded that it is a violation of public health ethics to use stigma as a tool in combatting fatness. The article concludes by making recommendations of how public health in New Zealand can combat, rather than reinforce, fat stigma. (shrink)

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

Females' tendency to place a high value on protecting their own lives enhanced their reproductive success in the environment of evolutionary adaptation because infant survival depended more upon maternal than on paternal care and defence. The evolved mechanism by which the costs of aggression (and other forms of risk taking) are weighted more heavily for females may be a lower threshold for fear in situations which pose a direct threat of bodily injury. Females' concern with personal survival also has implications (...) for sex differences in dominance hierarchies because the risks associated with hierarchy formation in nonbonded exogamous females are not offset by increased reproductive success. Hence among females, disputes do not carry implications for status with them as they do among males, but are chiefly connected with the acquisition and defence of scarce resources. Consequently, female competition is more likely to take the form of indirect aggression or low-level direct combat than among males. Under patriarchy, men have held the power to propagate images and attributions which are favourable to the continuance of their control. Women's aggression has been viewed as a gender-incongruent aberration or dismissed as evidence of irrationality. These cultural interpretations have evolutionarily based sex differences by a process of imposition which stigmatises the expression of aggression by females and causes women to offer exculpatory (rather than justificatory) accounts of their own aggression. (shrink)

It is not clear that "cultural recognition" should be a central goal of leftist politics. The idea that cultures have value simply by virtue of being cultures seems absurd, so it might be better to talk simply about eliminating prejudice and stigmatisation.

In July 2021, a series of gruesome videos exposed a case of brutal torture perpetrated by a guru or leader of the trans feminine hijra community in eastern India. This guru was allegedly of a Bangladeshi Muslim background, and various community members used the case as an alibi to target hijras of such national and religious origin, sometimes even demanding their expulsion from India. This phenomenon paralleled increasing affiliations between certain sections of trans/hijra communities and the Hindu Right. This article (...) situates this case within the broader rise of queer and trans Hindutva or Hindu nationalism and locates it as indicative of Hindutva’s expansion to its erstwhile ‘elsewheres’: areas outside its traditional strongholds such as eastern India and communities such as hijras who are known for their mixed religious practices and have been historically stigmatised by Hindu society. However, the article also analyses the case to show how hijras and related communities evidence contingently wavering political alliances and complex dynamics of intra-community power and resistance that remain irreducible to typical equations of Hindu right-wing politics. Queer/trans Hindutva might become disrupted by its potential constituents themselves, showing how Hindutva’s ‘elsewheres’ trouble its assimilationist capacities. (shrink)

This article examines the recent Council of Europe Convention on violence against women through the lens of postcolonial feminist critiques. The article argues that, while there is certainly cause for optimism, the Convention still falls into some of the traps identified by postcolonial feminists. The Convention largely circumvents the stigmatising risks that arise from framing certain VAW forms primarily as a problem of some ‘cultures’. Yet dangers linger in the Convention’s approach to ‘honour’ as an unacceptable justification for VAW. Inherent (...) risks also remain in the vulnerability frame through which the Convention views migrant, refugee, and asylum-seeker women. Applied uncritically, these approaches risk re-inscribing images of inherently powerless women victimised by their non-European ‘cultures,’ reminiscent of colonial times. (shrink)

This article argues that cruelty, as a willingness to see or orchestrate the suffering of others, is not an unfortunate side-effect of neoliberal theories put into practice but is constitutive of the neoliberal project from its theoretical inception. Drawing on Lisa Duggan’s concept of ‘optimistic cruelty’ and treating the canonical texts of neoliberal economic theory as literary artefacts, the article develops this argument through a close reading of one of the central architects of the neoliberal project, the philosopher and economist (...) Friedrich Hayek. The first part of the article examines how Hayek attempts to justify the brutality of the market order he imagines – the catallaxy – by arguing that this brutality is the natural consequence of the spontaneous evolutionary processes that move civilisation forward. The second part brings to the fore the eugenicist undertones that suffuse this vision, despite Hayek’s apparent rejection of Social Darwinism. I analyse how Hayek’s market order operates through a series of disciplinary and biopolitical technologies that use pain, frustration, punishment and stigmatisation to eliminate bad habits, practices and subjectivities. These cruel mechanisms enable the catallaxy to sort between productive and unproductive lives to ensure that available resources are directed towards the former – even if it means that the others might be left to die. As such, cruelty is an affective atmosphere that permeates the catallaxy. (shrink)

In her paper, ‘Sharing online clinical notes with patients: implications for nocebo effects and health equity’, Blease bridges findings from two research fields to describe possible unintended consequences of providing patients access to clinical notes. 1 She explains how nocebo effects, genuine psychological and physiological reactions following negative expectations, may arise after patients read such notes. Blease emphasises that the likelihood of nocebo may be greater for those patient groups who experience stigmatisation in healthcare. We argue that this is (...) the case for patients with so-called medically unexplained symptoms (MUSs) and that clinicians who work with them should consider nocebo but not for the reasons they may think. MUS is a term used to refer to persistent physical symptoms which cannot be fully or reliably attributed to a structural pathology. They include common symptoms such as chronic or recurrent pain in joints and muscles, fatigue, paresthesia or digestive... (shrink)

This article discusses findings of a qualitative study on strategies of othering observed in anti-immigrant discourse, by analysing selected examples from the UK and Polish media, together with data collected from interviews with migrants. The purpose is to identify discursive strategies of othering, which aim to categorise, denigrate, oppress and ultimately reject the stigmatised or racialised ‘other’. We do not offer a systematic comparison of the data from the UK and Poland; instead, we are interested in what is common in (...) the discursive practices of these two countries/contexts. In using newspaper together with interview data, we are combining representation and experience in identifying not only strategies of othering, but also how these are perceived by and affect the othered individuals. The paper uses the following data: 40 newspaper articles – 20 from the UK and 20 from Poland, and 19 interviews – 12 from Poland and 7 from the UK. The analysis that follows identifies five shared strategies of othering: a) Stereotyping; b) Whiteness as the norm; c) Racialisation; d) Objectification; e) Wrongly Ascribed Ethnicity. We conclude with the research limitations and outlining possible next stages, such as working with a larger corpus, investigating frequency, or including other media genres. (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)

ABSTRACT Public health communication campaigns have been credited with helping raise awareness of risk from chronic illness and new infectious diseases and with helping promote the adoption of recommended treatment regimens. Yet many aspects of public health communication interventions have escaped the scrutiny of ethical discussions. With the transference of successful commercial marketing communication tactics to the realm of public health, consideration of ethical issues becomes an essential component in the development and application of public health strategies. Ethical issues in (...) public health communication are explored as they relate to eight topics: ‘targeting’ and ‘tailoring’ public health messages to particular population segments; obtaining the equivalence of informed consent; the use of persuasive communication tactics; messages on responsibility and culpability; messages that apply to harm reduction; and three types of unintended adverse effects associated with public health communication activities that may label and stigmatise, expand social gaps, and promote health as a value. We suggest that an ethical analysis should be applied to each phase of the public health communication process in order to identify ethical dilemmas that may appear subtle, yet reflect important concerns regarding potential effects of public health communication interventions on individuals and society as a whole. (shrink)

This article examines how facial recognition technology reshapes the philosophical debate over the ethics of video surveillance. When video surveillance is augmented with facial recognition, the data collected is no longer anonymous, and the data can be aggregated to produce detailed psychological profiles. I argue that – as this non-anonymous data of people’s mundane activities is collected – unjust risks of harm are imposed upon individuals. In addition, this technology can be used to catalogue all who publicly participate in political, (...) religious, and socially stigmatised activities, and I argue that this would undermine central interests of liberal democracies. I examine the degree to which the interests of individuals and the societal interests of liberal democracies to maintain people’s obscurity while in public coincide with privacy interests, as popularly understood, and conclude that there is a practical need to articulate a novel right to obscurity to protect the interests of liberal democratic societies. (shrink)

Depuis une vingtaine d’années, les statistiques dites « ethniques » font l’objet en France d’un débat récurrent. Si elles aident à faire apparaître des contradictions et des inégalités centrales dans la société, elles sont une arme à double tranchant dans la mesure où elles entraînent également un effet de stigmatisation par l’assignation à une appartenance supposée communautaire non nécessairement revendiquée subjectivement. C’est peut-être en observant ce que se fait et se dit hors de France qu’on pourra mieux mesurer les (...) effets comparés de ce dispositif profondément ambivalent. (shrink)

Mandatory reporting of infectious diseases (MRID) is an essential practice to prevent disease outbreaks. Disease notification is a mandatory procedure for most infectious diseases, even during non-pandemic periods in healthcare. The main rationale behind MRID is the protection of public health. The information and data provided by infectious disease reports are used for many purposes, such as preventing the spread and potential negative impact of infectious diseases, assessing the national and global situation regarding reported diseases, conducting scientific research and planning (...) health policy. In this context, the relevant information benefits public health, health systems and scientific work. Additionally, the follow up and treatment of individuals with infectious diseases is a necessity in certain cases to protect those who cohabit with them. However, these benefits cannot be accepted as unrestricted justifications for MRID, since it is evident that reporting should be conducted within ethical and legal boundaries. MRID should only be devised and implemented with due regard to balancing potential benefits between all individuals, as well as between the individual and the rest of society. Disease notification systems that are not designed with a balancing and harm-reductionist approach may lead to stigmatisation and discrimination. This study aims to investigate the legal framework and ethical issues regarding the reporting of individuals diagnosed with COVID-19 in Turkey—which is a primary example of a developing country. (shrink)