In this paper, we reflect upon shame and humiliation as threats to personal and professional integrity and moral agency within contemporary health care. A personal narrative, written by a nurse about a particular shift in a British National Health Service Accident and Emergency Department, is provided as a case study. This is critically reflected and commented upon in dialogue with insights into the nature of shame and humiliation. It is suggested that Accident and Emergency is a locus that is latently (...) prone to dynamics of shame and humiliation, a potential exacerbated within a culture subject to externally‐determined time targets that are enforced by a top‐down system of surveillance and management. The result is that nurses may lose their sense of professional competence and responsibility, moral agency, and integrity, to their own personal detriment, as well as to the detriment of patients with whom they work. Insofar as examining a small part of a whole may suggest insights into the operation and ethos of a very large system, this very particular case study narrative/reflection has some important implications and lessons for the wider organization and provision of health care in Britain and beyond. (shrink)

This article examines the phenomenology of body shame in the context of the clinical encounter, using the television program ‘Embarrassing Bodies’ as illustrative. I will expand on the insights of Aaron Lazare’s 1987 article ‘Shame and Humiliation in the Medical Encounter’ where it is argued that patients often see their diseases and ailments as defects, inadequacies or personal shortcomings and that visits to doctors and medical professionals involve potentially humiliating physical and psychological exposure. I will start by outlining a phenomenology (...) of shame in order to understand more clearly the effect shame about the body can have in terms of one’s personal experience and, furthermore, one’s interpersonal dynamics. I will then examine shame in the clinical encounter, linking body shame to the cultural stigma attached to illness, dysfunction and bodily frailty. I will furthermore explore how shame can be exacerbated or even incited by physicians through judgment and as a result of the power imbalance inherent to the physician-patient dynamic, compounded by the contemporary tendency to moralise about ‘lifestyle’ illnesses. Lastly, I will provide some reflections for how health care workers might approach patient shame in clinical practice. (shrink)

We tend to suppose that the ancient Greeks had primitive ideas of the self, of responsibility, freedom, and shame, and that now humanity has advanced from these to a more refined moral consciousness. Bernard Williams's original and radical book questions this picture of Western history. While we are in many ways different from the Greeks, Williams claims that the differences are not to be traced to a shift in these basic conceptions of ethical life. We are more like the ancients (...) than we are prepared to acknowledge, and only when this is understood can we properly grasp our most important differences from them, such as our rejection of slavery. The author is a philosopher, but much of his book is directed to writers such as Homer and the tragedians, whom he discusses as poets and not just as materials for philosophy. At the center of his study is the question of how we can understand Greek tragedy at all, when its world is so far from ours. Williams explains how it is that when the ancients speak, they do not merely tell us about themselves, but about ourselves. _Shame and Necessity_ gives a new account of our relations to the Greeks, and helps us to see what ethical ideas we need in order to live in the modern world. (shrink)

This book investigates the concept of body shame and explores its significance when considering philosophical accounts of embodied subjectivity, providing phenomenological reflections on how the body is shaped by social forces.

Through examining practices of torture, extra-judicial assassination, and first person accounts of soldiers on the ground, Bonnie Mann develops a new theory of gender.

We tend to suppose that the ancient Greeks had primitive ideas of the self, of responsibility, freedom, and shame, and that now humanity has advanced from these to a more refined moral consciousness. Bernard Williams's original and radical book questions this picture of Western history. While we are in many ways different from the Greeks, Williams claims that the differences are not to be traced to a shift in these basic conceptions of ethical life. We are more like the ancients (...) than we are prepared to acknowledge, and only when this is understood can we properly grasp our most important differences from them, such as our rejection of slavery. The author is a philosopher, but much of his book is directed to writers such as Homer and the tragedians, whom he discusses as poets and not just as materials for philosophy. At the center of his study is the question of how we can understand Greek tragedy at all, when its world is so far from ours. Williams explains how it is that when the ancients speak, they do not merely tell us about themselves, but about ourselves. _Shame and Necessity_ gives a new account of our relations to the Greeks, and helps us to see what ethical ideas we need in order to live in the modern world. (shrink)