Contexte : L’ensemble des troubles causés par l’alcoolisation fœtale (ETCAF), un diagnostic complexe qui comprend une vaste gamme de troubles neurodéveloppementaux, résulte de l’exposition à l’alcool dans l’utérus. L’ETCAF demeure mal compris par les Canadiens, ce qui pourrait contribuer à la stigmatisation dont souffrent les personnes atteintes d’ETCAF et les femmes qui consomment de l’alcool pendant leur grossesse. Méthodes : Pour mieux comprendre comment l’information sur l’ETCAF est présentée dans la sphère publique, nous avons analysé le contenu de 286 (...) articles tirés de dix grands journaux canadiens de langue anglaise (2002-2015). Nous avons utilisé le codage inductif pour établir une grille de codage à partir des données, puis nous avons appliqué de façon itérative des codes identifiés sur l’échantillon, en vérifiant la fiabilité intercodeurs. Résultats : Nous avons identifié six grands thèmes liés au contenu cliniques et scientifiques des médias : 1) prévalence de l‘ETCAF et de la consommation d’alcool chez les femmes ; 2) recherche en lien avec l’ETCAF ; 3) diagnostic d’ETCAF ; 4) traitement de l’ETCAF et de l’abus de substances par les mères ; 5) incapacités primaires associés à l’ETCAF ; et 6) effets de l’alcool pendant la grossesse. Discussion : Dans le cadre de ces six thèmes, nous examinons trois types d’exagération et de fausse représentation qui ont des conséquences sur le plan éthique : 1) l’exagération des taux d’ETCAF dans les communautés autochtones ; 2) la contradiction entre les articles sur les effets de l’exposition prénatale à l’alcool ; et 3) l’information scientifiquement exacte qui néglige le contexte social de la consommation et de l’abus d’alcool par les femmes. Respectivement, ces représentations pourraient mener à des croyances stéréotypées préjudiciables au sujet des peuples autochtones, pourraient créer de la confusion quant aux choix sains pendant la grossesse et risqueraient d’enflammer inutilement les débats sur des questions délicates concernant les choix des femmes. (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)

Unlike Hannah, who eventually had a child, there are women today who remain childless. In the modern world, there are various reasons why women choose not to have children. Therefore, when interpreting the Hannah narrative in modern times, it is important to consider these evolving aspects of barrenness. This article applies historical-critical exegesis, narrative reading and a descriptive approach to examine Hannah’s experience in the Nigerian context. It also evaluates African traditional beliefs on childlessness in light of modern realities. The (...) study reveals that many women in pronatalist societies worldwide now choose to be child-free because of reasons such as difficulty finding marriage partners or financial instability. As these factors are also present in Nigeria, childless Nigerian women should embrace their situation and find happiness instead of succumbing to stigmatisation. To support these Christian women, the church in Nigeria must accept and teach the truth that not every woman needs to bear children.Contribution: This article contributes to the discussion on Christian attitudes towards childlessness. It argues that the interpretation of Hannah’s infertility in today’s world should consider new circumstances, such as voluntary childlessness. In light of this argument, Nigerian women without children should embrace their situation and find happiness instead of succumbing to societal stigma. (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)

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)

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)

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.

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 (CRUK) 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)

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)

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)

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.

Dans la Russie post-soviétique, on dénombre environ 12 millions de personnes qui vivent en situation de handicap. Cependant, les recherches scientifiques consacrées à ce large segment de la société russe, principalement à propos de la stigmatisation et de l’auto-stigmatisation, sont rares. Les textes autobiographiques écrits par des personnes qui présentent un handicap, entre 1990 et 2010, permettent de mieux comprendre les expériences de ces personnes dans la Russie post-soviétique. Ces textes témoignent notamment des principales stratégies que les personnes (...) qui présentent des incapacités motrices congénitales ou acquises ont adopté afin de s’adapter aux défis de la vie quotidienne. Le diagnostic médical a profondément transformé le statut social et le mode de vie de ces personnes. Cet article examine le diagnostic selon la perspective des théories du “rite de passage” vers un autre monde, le monde des personnes handicapées, leur “bas-monde.” En s’appuyant sur les autobiographies de personnes handicapées, cet article révèle comment les étiquettes et les notions appliquées à l’infirmité au sein de la société russe contemporaine sont enracinées dans la culture russe dans son ensemble et dans les attitudes soviétiques envers le handicap et les personnes handicapées. (shrink)

Les étudiants sourds et malentendants (ÉSM) représentent une catégorie de personnes dont les besoins éducatifs spécifiques sont restés sans réponse dans le système éducatif indien. Cette étude, basée sur un travail de terrain, a été menée à l’Anushruti Académie pour les sourds (AAS), une école pour les étudiants ÉSM située dans la ville de Roorkee en Inde. Elle repose sur l’observation de ces enfants dans les salles de classe et des entretiens approfondis avec leurs professeurs afin de cerner leurs positions (...) à l’égard des grands débats sur l’éducation des élèves ÉSM. Les questions de la langue et l’acquisition du langage parlé, les méthodes d’enseignement, la relation dialectique des élèves à la technologie et leur confrontation avec la stigmatisation sont utilisés afin de cerner les expériences vécues des élèves. L’étude souligne la nécessité d’utiliser un langage unificateur qui intègre le contenu usuel du développement académique. Cela renforcera l’accès des étudiants aux différentes disciplines académiques et leur permettra de d’aller au-delà des niveaux élémentaires de réussite scolaire. (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.

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)

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)

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)

Background: Some patients are stigmatised as difficult patients by healthcare professionals. This phenomenon has great many negative consequences. The behaviours of healthcare professionals towards difficult patients are important. Objective: To explore the behaviours of all healthcare professionals towards difficult patients. Research Design: This study was based on a cross-sectional research design using structural equation modelling. Participants and Research Context: Two hundred and fifty-four healthcare professionals were involved in the study in Turkey. ‘Participant Information Form’ and the ‘Healthcare Professionals Behaviour Assessment (...) Questionnaire For Difficult Patient’ were used to collect data from participants. Ethical Consideration: Ethical approval was obtained from Gazi University Ethics Committee for the study. Informed consent of the participants in the study was taken and the confidentiality of the participants was ensured. Findings: It was explored that the behaviours of healthcare professionals towards difficult patients were categorised into ethical, supportive and negative. The highest mean score was supportive behaviour and the least mean score was negative. According to structural equation modelling, the most important predictor of difficult encounters was an ethical dimension. One-unit increase in ethical behaviour contributed to 0.92 unit increase in positive patient behaviour. Discussion: Patients generally are perceived as ‘difficult patient’ by the healthcare professionals, so the patients’ treatment and care services are affected negatively due to healthcare professionals’ negative beliefs and attitudes. The healthcare professionals should behave supportively towards difficult patients. Conclusion: Healthcare professionals should be aware of management strategies in dealing with difficult encounters. The behaviours of healthcare professionals should be improved in a positive way and awareness of ethical dimension of difficult encounters should be increased. (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.

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)

The idea of a ‘tobacco-free generation’ promises to make smoking a thing of the past by making cigarettes unavailable to birth cohorts in the future. If implemented, such a generational ban would lead to a society in which some individuals are allowed the freedom to smoke while others are not. This paper examines the ethical significance of this fact through the lens of ‘relational egalitarianism’, an approach to social justice that emphasises equal and respectful social relationships. It explores various dimensions (...) in which a society can fail to live up to the idea of equal status, such as the denial of moral agency, discrimination, stigmatisation, the unequal recognition of interests and violations of political equality. While acknowledging the complexity of practical and ethical challenges, the paper maintains that the generational ban need not violate egalitarian commitments. (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 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)

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)

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)

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)

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)

Some people of colour feel shame in response to racist incidents. This phenomenon seems puzzling since, plausibly, they have nothing to feel shame about. This puzzle arises because we assume that targets of racism feel shame about their race. However, I propose that when an individual is racialised as non-White in a racist incident, shame is sometimes prompted, not by a negative self-assessment of her race, but by her inability to choose when her stigmatised race is made salient. I argue (...) that this can make sense of some shame responses to racism. My account also helps to highlight some of the emotional and cognitive costs of racism that have their root in shame as well as a new form of hermeneutical injustice and distinctive communicative harms, contributing to a fuller picture of what is objectionable about racism. (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)

ABSTRACT Chemsex is a phenomenon in which typically gay, bisexual, trans, queer, and/or related communities of men take psychoactive drugs while having sex, often without a condom. The practice can lead to increased rates of HIV transmission, sexual assault, and in extreme cases murder. GBTQ+ men are already a stigmatised group so those who engage in chemsex face multiple stigmas. This study examines the ways that two types of media report on chemsex while negotiating these stigmas. We take a large (...) data set of newspaper articles written for the general British public and a smaller data set of magazines aimed at GBTQ+ men to examine how chemsex is represented in the media. We find that the mainstream press focus on extreme criminal cases involving chemsex, while the media aimed at GBTQ+ men focus on counselling services and discuss chemsex in relation to gay culture. Chemsex is unlikely to go away, and so we address how information about it is conveyed in different media and call for more research in this area. (shrink)

Background: Studies have established that negative perceptions of people living with HIV/AIDS exist among nursing students throughout the world, perceptions which can be detrimental to the delivery of high-quality nursing care. Objectives: The purpose of this research was to explore socio-cultural influences on the perceptions of nursing students towards caring for people living with HIV/AIDS. Research design: The study was guided by stigma theory, a qualitative descriptive research approach was adopted. Data collected via semi-structured interviews were thematically analysed. Participants and (...) research context: Participants were 21 international and Australian undergraduate nursing students enrolled in a Bachelor of Nursing programme at an Australian university. Ethical considerations: Ethical approval was granted by the Social and Behavioural Research Ethics Committee at the study university. Participation was entirely voluntary; informed consent was obtained before the study commenced; confidentiality and anonymity were assured. Findings: Three major themes were found: blame, othering and values. Complex and interrelated factors constructed participant perceptions of people living with HIV/AIDS, perceptions underscored by the prevailing culturally construed blame and othering associated with HIV/AIDS. The study found discordance between the negative personal beliefs and perceptions some nursing students have towards people living with HIV/AIDS, and the professional values expected of them as Registered Nurses. Discussion: There was considerable commonality between this and previous studies on how homosexuality and illicit drug use were perceived and stigmatised, correlating with the blame directed towards people living with HIV/AIDS. These perceptions indicated some nursing students potentially risked not fulfilling the ethical and professional obligations the Registered Nurse. Conclusion: Nursing curriculum should be strengthened in relation to comprehending the meaning of being stigmatised by society. Educational institutions need to work towards enhancing strategies that assist nursing students to reconcile any incongruity between their personal beliefs and requisite professional nursing values. (shrink)

This paper deals with the history of “pathogenic environments,” understood as places, regions, or environments whose characteristics are considered to be the origin of diseases in the human beings. While some specific environments were almost universally considered noxious, some others had a different trajectory. Crowded and poorly-ventilated premises as well as tropical regions were perceived as “the most unhealthy spots in the world.” However, the progressive “medicalisation” of hospitals transformed what were previously considered to be hellholes into therapeutic places. This (...) does not mean that iatrogenic diseases disappeared, but that hospitals tended to be seen in a more positive way. Similarly, European colonial expansion changed medical perspectives on tropical regions. Western physicians became increasingly convinced not only that could they prepare Europeans for long travel, but also that they could shape foreign environments. For instance, the perception of the Caribbean climate gradually changed “from deadly to healthy” from the middle of the 19th century onwards. Changes in perceptions could thus follow scientific progress, but also arise from political agendas and stigmatising narratives. Victims of the harmful influences of a pathogenic environment were often presented as responsible for their fate. For instance, some were accused of not carrying out the instructions delivered by the administrative or medical authorities. The process of (un)making pathogenic environments thus offers privileged access to the understanding of the relationship between health and environment. This paper provides situated accounts of how some places or regions came to be perceived as pathogenic or ceased to be so. It explores avenues of research, such as the study of lay perspectives on health and environment, the dangers of travel itself, and the connection between environmental health and military medicine. (shrink)

In 'The duty to miscegenate', I harness John Stuart Mill's 19th century theory of social freedom to explain and to dismantle contemporary racialised and gendered injustice. In the first chapter—Social stigmatisation: 'a social tyranny'—I argue that persons racialised-and-gendered-as-black-women were, in the past, unjustly stigmatised by legal penalties against 'miscegenation' and are still, today, unjustly stigmatised by white male avoidance of cross-racial marriage and companionship. In the second chapter—Encounters that count: 'a foundation for solid friendship'—I argue that we can dismantle (...) this stigmatisation, by engaging in regular and frequent cross-racial commensality with persons racialised-and-gendered-as-black-women. In the third chapter—White right: 'a right to avoid'—I argue that, although we have a right to avoid commensal encounters with others, we do not have a right to avoid persons we racialise as black. On the contrary, we have a duty to encounter them, on terms of equality and intimacy. (shrink)

Here, I argue that Dixon et al. have overstated the prevalence of forms of prejudice; many stigmatised groups are currently the targets of overtly hostile evaluation and treatment by others. I also believe that the target article oversimplifies its presentation of prejudice researchers' primary theoretical and policy goals and that it overlooks important work in intergroup emotions.

Inspirée d’un cadre poststructuraliste, cette étude qualitative de « réception d’un médium » nous a permis de mettre en lumière les « lectures » que font une vingtaine de consommateurs de pornographie des notions de masculinité, de race et ethnicité, du milieu gai et du genre en lien avec la pornographie qu’ils consomment. Les résultats qui émergent de notre analyse critique de discours sont à l’effet que les lectures des consommateurs sont majoritairement dominantes, reproduisant ainsi les stéréotypes présents en société (...) et qui sont re/produits et véhiculés dans la pornographie qu’ils consomment. Les récits des participants attestent du fait que ces derniers remettent peu en question ce qu’ils voient dans le matériel pornographique ; matériel pouvant avoir certaines répercussions sur des indicateurs de santé mentale en accentuant et perpétuant certaines formes de stigmatisation chez certains groupes sociaux. Inspired by a poststructuralist perspective, our qualitative exploratory media reception study offers a critical discourse analysis of 20 male pornography consumers, focusing on their readings of masculinity, race/ethnicity, the gay world, and gender in relation to the pornography they consume. For the most part, results show dominant readings of these categories, which suggests that social stereotypes are produced, reproduced, and transmitted through the medium of pornography. Participant narratives reveal individuals who rarely question what is shown in pornographic material; the latter having potential implications for certain mental health indicators, as well as perpetuating and accentuating forms of stigmatization among specific social groups. (shrink)

La philosophie transcendantale kantienne serait coupable, dans la lecture hégélienne, de réintroduire « l’opposition rigide du subjectif et de l’objectif, de la pensée et des objets, de l’uni­versalité abstraite et de la singularité sensible de la volonté », là même où elle pose la nécessité de leur unification. L’identification par Hegel de la problématique d’un entendement intuitif, au cœur de l’esthétique kantienne, révèle et relève toutefois d’un décentrage problématique, qui conduit nécessairement Hegel à stigmatiser le caractère seulement subjectif de la (...) réconciliation kantienne de l’universel et du particulier, de la pensée et de l’intuition sensible.Toutefois la pertinence de la critique hégélienne de Kant demande à être prouvée, ce que nous nous proposons de faire en examinant d’abord l’analyse hégélienne du jugement de goût kantien, le jugement esthétique dans la philosophie hégélienne et enfin le sens de l’expérience esthétique conçue indépendamment de l’appréciation esthétique. (shrink)

Background: To place a dependent with severe dementia in a nursing home is a painful and difficult decision to make. In collectivistic oriented societies or families, children tend to be socialised to care for ageing parents and to experience guilt and shame if they violate this principle. Leaving the care to professional caregivers does not conform with the cultural expectations of many ethnic groups and becomes a sign of the family’s moral failure. Research design: Qualitative design with individual in-depth interviews (...) with nurses, family members and dementia care coordinators in Norway, Montenegro, Serbia and South Africa. Braun and Clarke’s six analytic phases were used. Ethical considerations: The project was approved by the Regional Committee for Research, South-Eastern Norway; the Norwegian Centre for Research Data; the Ethics Committee; University of Limpopo, MEDUNSA Campus, South Africa; and by the local heads of the respective nursing homes or home care services. Interviewees were informed orally and in writing and signed an informed consent form. Findings: Healthcare professionals tend to be contacted only when the situation becomes unmanageable. Interviewees talked about feelings of obligation, shame and stigma in their societies regarding dementia, particularly in connection with institutionalisation of family members. Many lacked support during the decision-making process and were in a squeeze between their own needs and the patients’ need of professional care, and the feeling of duty and worry about being stigmatised by their surroundings. This conflict may be a source of pre-decision regret. Conclusion: Family caregivers need help to understand the behaviours of persons with dementia and how to access the formal and informal services available. Thus, they may provide effective support to patients and family carers alike. Supportive interventions for caregivers need to be tailored to meet the individual needs of both the caregiver and the persons with dementia. (shrink)

Le propos de ce texte est d’interroger quelques-unes des mises en discours de la notion de risque appliquée à l’enfant, afin de soulever les questions éthiques trop souvent laissées dans l’ombre et néanmoins inhérentes à ces discours. Les auteurs analysent principalement ceux qui proviennent de la psychologie, de la démographie et de la sociologie de la famille à propos de l’impact des désunions conjugales sur le destin des enfants. Cela afin de démontrer l’extrême polysémie de la notion de risque et (...) d’interroger les effets stigmatisants du recours abusif à cette notion du côté des interventions publiques. (shrink)

Psychiatric genomics research protocols are increasingly incorporating tools of deep phenotyping to observe and examine phenotypic abnormalities among individuals with neurodevelopmental disorders. In particular, photography and the use of two-dimensional and three-dimensional facial analysis is thought to shed further light on the phenotypic expression of the genes underlying neurodevelopmental disorders, as well as provide potential diagnostic tools for clinicians. In this paper, I argue that the research use of photography to aid facial phenotyping raises deeply fraught issues from an ethical (...) point of view. First, the process of objectification through photographic imagery and facial analysis could potentially worsen the stigmatisation of persons with neurodevelopmental disorders. Second, the use of photography for facial phenotyping has worrying parallels with the historical misuse of photography to advance positive and negative eugenics around race, ethnicity and intellectual disability. The paper recommends ethical caution in the use of photography and facial phenotyping in psychiatric genomics studies exploring neurodevelopmental disorders, outlining certain necessary safeguards, such as a critical awareness of the history of anthropometric photography use among scientists, as well as the exploration of photographic methodologies that could potentially empower individuals with disabilities. (shrink)

En France, les personnes issues des minorités, principalement d'origine extra-européenne , sont susceptibles de connaître la discrimination, la stigmatisation mais aussi l'exclusion. La télévision, en tant que « lieu de reconnaissance », constitue un enjeu important pour ces populations. Cependant, le petit écran semble marginaliser depuis toujours ces minorités visibles non seulement en leur laissant une place limitée à l'antenne mais aussi en leur renvoyant des images majoritairement caricaturales et dévalorisantes d'elles-mêmes. Une enquête qualitative auprès de 43 individus d'origine (...) africaine et antillaise montre que les minorités sont capables de mettre en place des réactions défensives ou stratégies identitaires afin de réduire le décalage certain entre leur identité sociale - souvent dépréciatrice - et leur identité personnelle , prenant les médias comme ressources pour l'action.In France, persons belonging to minorities, mainly non-European origin , are likely to experience discrimination, stigmatization but also exclusion. Television as a "place of recognition," is an important issue for these people. However, the small screen seems to marginalize always visible minorities by giving them not only a limited role in the antenna but also by returning images mostly caricatures and demeaning to themselves. A qualitative survey of 43 individuals of African and Caribbean origin shows that minorities are able to implement defensive reactions or identity strategies to reduce the gap between some social identity - often dépréciatrice - and their personal identity , taking the media as resources for action. (shrink)

The validity of argument by disjunctive syllogism has been denied by proponents of relevant and paraconsistent logic. DS is stigmatised for its role in inferences — most notably C.I. Lewis's derivation of that fallacy of irrelevance ex falso quodlibet — that involve both it and other rules of inference governing disjunction, or, to speak more precisely, other rules of inference taken to apply to the very same disjunction that obeys DS. In avoiding these inferences the road less travelled is to (...) deny the identity rather than to deny DS: what follows is, then, an exercise in disjoining disjunctions. (shrink)