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

What do events such as scandals, industrial accidents, activist threats, and mass shootings have in common? They can all trigger an audience’s stigma judgment about the organization involved in the event. Despite the prevalence of these stigma-triggering events, management research has provided little conceptual work to characterize the dimensions and processes of organizational event stigma. This article takes the perspective of the evaluating audience to unpack the stigma judgment process, identify critical dimensions for categorizing types (...) of event stigma, and explore the role of the stigmatizers’ aesthetic, emotional, and cognitive reactions as well as their practical considerations in producing what we call “sticky stigmas.” Our event stigma typology provides clarity regarding how stigmas differ based on the types of events and audiences’ reactions and why some event stigmas are stronger and more long-lasting than others. We highlight the role of emotions and aesthetics in stigma formation and the various ethical dilemmas that influence stigma stickiness. (shrink)

The concept of organizational stigma has received significant attention in recent years. The theoretical literature suggests that for a stigma to emerge over a category of organizations, a “critical mass” of actors sharing the same beliefs should be reached. Scholars have yet to empirically examine the techniques used to diffuse this negative judgment. This study is aimed at bridging this gap by investigating Goffman’s notion of “stigma-theory”: how do stigmatizing actors rationalize and emotionalize their beliefs to (...) convince their audience? We answer this question by studying the stigma over the finance industry since 2007. After the subprime crisis, a succession of events put the industry under greater scrutiny, and the behaviors and values observed within this field began to be publicly questioned. As an empirical strategy, we collected opinion articles and editorials that specifically targeted the finance industry. Building on rhetorical analysis and other mixed methods of media content analysis, we explain how the stigmatizing rhetoric targets the origins of deviant organizational behaviors in the finance industry, that is, the shareholder value maximization logic. We bridge the gap between rhetorical strategies applied to discredit organizations and ones used to delegitimize institutional logics by drawing a parallel between these two literatures. Taking an abductive approach, we argue that institutional contradiction between field and societal-level logics is sufficient, but not necessary to generate organizational stigma. (shrink)

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

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s obligation to (...) its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

Over time, there has been a steady increase of workplace health promotion programs that aim to promote employees’ health and fitness. Previous research has focused on such program’s effectiveness, cost-savings, and barriers to engaging in workplace health promotion. The present research focuses on a downside of workplace health promotion programs that to date has not been examined before, namely the possibility that they, due to a focus on individual responsibility for one’s health, inadvertently facilitate stigmatization and discrimination of people with (...) overweight in the workplace. Study 1 shows that the presence of workplace health promotion programs is associated with increased attributions of weight controllability. Study 2 experimentally demonstrates that workplace health promotion programs emphasizing individual rather than organizational responsibility elicit weight stigma. Study 3, which was pre-registered, showed that workplace health promotion programs emphasizing individual responsibility induced weight-based discrimination in the context of promotion decisions in the workplace. Moreover, focusing on people with obesity who frequently experience weight stigma and discrimination, Study 3 showed that workplace health promotion programs highlighting individual responsibility induced employees with obesity to feel individually responsible for their health, but at the same time made them perceive weight as less controllable. Together, our research identifies workplace health promotion programs as potent catalysts of weight stigma and weight-based discrimination, especially when they emphasize individual responsibility for health outcomes. As such, we offer valuable insights for organizations who aim to design and implement workplace health promotion programs in an inclusive, non-discriminatory way that benefits all employees. (shrink)

Everyday there are revelations of organizations behaving in discreditable ways. Sometimes these actions result in damage to an organization's reputation, but often they do not. In this article, we examine the question of why external stakeholders may overlook disclosed discreditable actions, even those entailing ethical breaches. Drawing on stigmatization theory, we develop a model to explain the likelihood of reputational loss following revelations of discreditable actions. The model integrates four properties of actions (perceived control, perceived certainty, perceived threat, and perceived (...) deviance), stakeholder motivation, and media coverage. Implications for theory and for practitioners concerned with reputation management are discussed. (shrink)

Organizational members are likely to harbor different allegiances, values, and identifications that can affect how they respond to their organization’s stigmatization. Drawing on the empirical case of a public broadcaster in South Korea initially stigmatized for its association with an authoritarian government, we focus on the responses of different intra-organizational groups to stigma and their interactions with each other and with external audiences. We find that faced with stigma, groups in the organization were divided about how (...) to respond, with those defying the stigma and advocating a close relationship with the government competing with those who shared the values of stigmatizing audiences. Both groups sought control over journalism work, the organizational attribute for which the broadcaster was stigmatized, allying with external audiences that shared their respective visions. The dominance of the group that defied the stigma led to increased stigmatization of the organization by existing audiences and additionally prompted the participation of initially passive audiences in its denigration, eventually leading to organizational decline. We contribute to the literature on stigma by promoting an understanding of heterogeneity among members in stigmatized organizations and its implications for the consequences of stigma. We also contribute to theorizing stigmatization as a relational process by demonstrating how the heterogeneity of organizational members’ experience of stigma interacted with audience heterogeneity and highlighting the relative roles played by active and passive audiences in bringing about the decline of a stigmatized organization. (shrink)

How do social audiences negotiate and handle stigmatized organizations? What role do their heterogenous values, norms and power play in this process? Addressing these questions is important from a business ethics perspective to improve our understanding of the ethical standards against which organizations are judged as well as the involved prosecutorial incentives. Moreover, it illuminates ethical concerns about when and how power imbalances may induce inequity in the burdens imposed by such social evaluations. We address these questions building on two (...) event-based case studies involving Hells Angels Motorcycle Club Norway, and contribute to organizational stigma theory in three ways. First, social evaluations of a stigmatized organization by multiple audiences are found to interact, collide and combine in a labelling contest. Second, we show that labels employed in this contest are pushed to either negative extremes or positive extremes. Finally, we show when and how power represents a double-edged sword in social evaluation processes, which can be wielded either to the benefit or to the detriment of the actors under evaluation. (shrink)

This study introduces the concept of moral imagination in a work context to provide an ethical approach to the controversial relationships between dirty work and dirty workers. Moral imagination is assessed as an essential faculty to overcome the stigma associated with dirty work and facilitate the daily work lives of workers.The exercise of moral imagination helps dirty workers to face the moral conflicts inherent in their tasks and to build a personal stance toward their occupation. Finally, we argue that (...) organizations with dirty work groups should actively adopt measures to encourage their employees' exercise of moral imagination. This study investigates how organizations might create conditions that inspire moral imagination, particularly with regard to the importance of organizational culture as a means to enhance workers' moral sensitivity. Furthermore, this investigation analyzes different company practices that may derive from a culture committed to moral imagination. (shrink)

For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps. A sample was generated via PubMed using (...) keywords “[(ethics OR *ethic*) AND suicid*] AND [English (Language) OR French (Language)]” (final N = 52), ethics content was extracted according to scoping review methodology, and categorized thematically. We identified three main areas posing ethical challenges for health professionals caring for suicidal individuals and their families. These were: (1) making clinical decisions for patients in acute care or when presented with specific circumstances; (2) issues arising from therapeutic relationships in chronic care, and (3) organizational factors. There is considerable uncertainty about how to resolve ethical issues when caring for someone who is suicidal. The stigma associated with suicide and mental illness, problems associated with risk–benefit assessments, and the fear of being held liable for malpractice should a patient die by suicide were overarching themes present across these three categories. Caring for suicidal patients is clinically and ethically challenging. The current literature highlights the complexity and range of decisions that need to be made. More attention should be paid to the difficulties faced by healthcare professionals and the development of solutions. (shrink)

BackgroundAdolescents living with human immunodeficiency virus (HIV) experience challenges, including lack of involvement in their care as well nondisclosure of HIV status, which leads to poor adherence to antiretroviral therapy (ART). Parents have authority over their children, but during adolescence there is an increasing desire for independence. The aim of the study was to explore adolescents’ experience of challenges identified by adolescents ages 10–19 years attending HIV care and treatment at Temeke Regional Referral Hospital in Tanzania. MethodsAn exploratory descriptive qualitative (...) design was employed in the HIV Care and Treatment Centre (CTC) in the Out-Patient Department at the Temeke Regional Referral Hospital in Tanzania with adolescents living with HIV who were 10–19 years of age. A total of 22 adolescents participated in semi-structured face-to-face interviews after parental consent and adolescent assent were obtained. Participants were interviewed about their participation in decisions to be tested for HIV and enrolled in the CTC, concerns surrounding disclosure of their HIV status to the adolescent or to others, stigma and discrimination, and the effect of these challenges on their adherence to medication. All interviews were audio-taped, transcribed verbatim in Swahili, and back-translated to English. Data analysis included both inductive and deductive thematic analysis.ResultsQualitative themes identified included lack of participation in decisions about HIV testing, challenges to enrollment in care and treatment; issues around disclosure of HIV status, such as delays in disclosure to the adolescent and disclosure to other persons and benefits and harms of such disclosures; and factors supporting and interfering with adherence to ART, such as parental support, organizational (clinic) support and problems, and self-stigmatization and shame.ConclusionLack of adolescents’ involvement in their care decision making and delayed disclosure of HIV status to the adolescent were identified concerns, leading to poor adherence to ART among adolescents. Disclosure to others, especially teachers, helped adolescents at school to take their medication properly. Disclosure to others led to stigma and discrimination for some adolescents. More research is needed to better understand the role of disclosure and its benefits and challenges for HIV-positive adolescents in Tanzania. (shrink)

Does speaking up ruin one’s life? Organizational and whistleblowing research largely accept that “whistleblower” is a negative label that effects one’s well-being. Whistleblowing research also emphasizes the drawn-out process of speaking up. The result is a narrative of the whistleblower as someone who suffers indefinitely. In this paper, I draw on theories of stigma, labelling, and identity, specifically stigmatized identity, to provide a more nuanced understanding of whistleblower stigma as relational and temporary. I analyse two cases of (...) whistleblowing, one where the label “whistleblower” was accepted, and one where it was eventually rejected. By comparing how the whistleblower responds to stigmatizing and non-stigmatizing others, I explore how whistleblower stigmatization emerges, or does not, in interactions. This paper makes two important contributions. First, I add to the growing research on whistleblower stigmatization a more nuanced and developed framework: one that sees the interaction between whistleblowers and others as relational. Second, I provide an understanding of the identity “whistleblower” as one that can be temporary and revisable. Research has highlighted how whistleblowing is a process, but little attention has been paid to how one “moves on” from being a whistleblower and the potential stigmatization associated with the role. Rather than assuming a whistleblower is stuck with this identity—and the associated stigma—for life, I provide insight on how “whistleblower” can be a positive label that opens one up to support, and even when it is stigmatized, it does not have to be an end state. (shrink)

We highlight exclusionary practices in management research, and demonstrate through example how a more inclusive management literature can address the unique contexts of persons with disabilities, a group that is disadvantaged in society, globally. Drawing from social psychology, disability, self-employment, entrepreneurship, and vocational rehabilitation literatures, we develop and test a holistic model that demonstrates how persons with disabilities might attain meaningful work and improved self-image via self-employment, thus accessing some of the economic and social-psychological benefits often unavailable to them due (...) to organizational-employment barriers. Our longitudinal study provides evidence of the self-image value of ‘doing’ in self-employment, highlighting the potential to reduce stigma and improve generalized self-efficacy and self-esteem. Implications for self-image theory, entrepreneurship training and development, and public policy related to persons with disabilities are discussed. (shrink)

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized athletes aged 16 years and older, registered with the Australian Institute of Sport. Mental health outcomes included mental health symptoms, general psychological distress, (...) risky alcohol consumption and eating disorder risk. Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem. (shrink)

Although many organizations around the world have engaged in corporate social responsibility programing, there is little evidence of social impact. This is a problematic omission since many programs carry the stigma of marketing ploys used to bolster organizational image or reduce consumer skepticism. To address this issue and build on existing scholarship, the purpose of this study was to evaluate a socially responsible youth employability program in the United Kingdom. The program was developed through the foundation of a (...) professional British soccer team to bolster employability and life skills for marginalized London youth. Program funding was provided by a large multinational bank as part of their CSR agenda. This evaluation was undertaken to understand the beneficiary impacts associated with program deployment. Results from the pre-intervention/post-intervention, sequential mixed-method evaluation show statistically significant differences among several “soft” beneficiary outcomes. However, results are mixed regarding whether the “hard” outcome of employment was achieved by program participants. Qualitative findings buttress these results, indicating a high level of motivation for work, attitude enhancement, and satisfaction with program delivery. (shrink)

Manager stewardship behavior, defined as an ethical initiative whereby managers subjugate their personal interests to protect their organization’s long-term welfare, has been widely considered beneficial for organizations and subordinates. However, is manager stewardship behavior also viewed as good in the eyes of peers? This research examines peer reactions to manager stewardship behavior. Drawing on person perception theory, we expect that a peer may credit and support manager stewardship behavior or stigmatize and undermine it depending on his or her attributions ( (...) class='Hi'>organizational concern versus impression management). Study 1 (a vignette experiment: _n_ = 200) found that manager stewardship behavior is related to credit evaluation by a peer and subsequently increases peer support and decreases peer undermining when attributed to organizational concern motives; however, it is related to stigma evaluation by a peer and subsequently increases peer undermining and decreases peer support when attributed to impression management motives. Study 2 (_n_ = 221) replicated the results of Study 1 using a field survey design. These findings expand our understanding of the implications of stewardship behavior from a peer perspective and offer insight for managers into how to engage in stewardship behavior wisely. (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)

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

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

Abstract:Organizational justice is a behavioral science concept that refers to the perception of fairness of the past treatment of the employees within an organization held by the employees of that organization. These subjective perceptions of fairness have been empirically shown to be related to 1) attitudinal changes in job satisfaction, organizational commitment and managerial trust beliefs; 2) behavioral changes in task performance activities and ancillary extra-task efforts to assist group members and improve group methods; 3) numerical changes in (...) the quantity, quality and efficiency of divisional outputs; and—though this is far more tentative—4) eventual changes in the competitive advantage and financial performance of the full organization. The authors propose that these constructs can be applied to all stakeholders, rather than just to the current employees of the firm, and that objective determinations of fairness by the managers can be related to subjective perceptions of fairness by the stakeholders that will result in the sequential series of attitudinal, behavioral and numerical changes that will lead to performance improvements. In short, the authors propose a normative stakeholder theory of the firm, based upon ethical principles, that will have testable descriptive hypotheses derived from the behavioral constructs. (shrink)

Abstract:Organizational justice is a behavioral science concept that refers to the perception of fairness of the past treatment of the employees within an organization held by the employees of that organization. These subjective perceptions of fairness have been empirically shown to be related to 1) attitudinal changes in job satisfaction, organizational commitment and managerial trust beliefs; 2) behavioral changes in task performance activities and ancillary extra-task efforts to assist group members and improve group methods; 3) numerical changes in (...) the quantity, quality and efficiency of divisional outputs; and—though this is far more tentative—4) eventual changes in the competitive advantage and financial performance of the full organization. The authors propose that these constructs can be applied to all stakeholders, rather than just to the current employees of the firm, and that objective determinations of fairness by the managers can be related to subjective perceptions of fairness by the stakeholders that will result in the sequential series of attitudinal, behavioral and numerical changes that will lead to performance improvements. In short, the authors propose a normative stakeholder theory of the firm, based upon ethical principles, that will have testable descriptive hypotheses derived from the behavioral constructs. (shrink)

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

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

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

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

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

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

The word stigma comes from ancient Greece, and was initially used in reference to signs or symbols physically cut into or burned onto the bodies of those deemed to be of an inferior status. It was a marking of one's tarnished and flawed character. Today, stigma is more often attached to one's social standing, personality traits, or psychological makeup. "People are no longer physically branded; instead they are societally labeled—as poor, as criminal, homosexual, mentally ill, and so on. (...) These labels influence public perceptions and behavior and lead to devaluation and denigration of those who are so labeled" (Wahl 1999, 11–12).The modern usage of the term stigma and contemporary focus on the concept as a topic of .. (shrink)

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

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

The debate on the notion of function has been historically dominated by dispositional and etiological accounts, but recently a third contender has gained prominence: the organizational account. This original theory of function is intended to offer an alternative account based on the notion of self-maintaining system. However, there is a set of cases where organizational accounts seem to generate counterintuitive results. These cases involve cross-generational traits, that is, traits that do not contribute in any relevant way to the (...) self-maintenance of the organism carrying them, but instead have very important effects on organisms that belong to the next generation. We argue that any plausible solution to the problem of cross-generational traits shows that the organizational account just is a version of the etiological theory and, furthermore, that it does not provide any substantive advantage over standard etiological theories of function. (shrink)

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

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

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

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

Conventional quantitative methods for the measurement of organizational legitimacy consider mainly three sources that make judgments about organizations visible: news media, accreditation bodies, and surveys. Over the last decade, however, social media have enabled ordinary citizens to bypass the gatekeeping function of these institutional evaluators and autonomously make individual judgments public. This inclusion of voices beyond functional and formally organized stakeholder groups potentially pluralizes the ongoing discussions about organizations. The individual judgments in blogs, tweets, and Facebook posts give indication (...) about the broader fit between an organization’s perceived behavior and heterogeneous social norms and therefore constitute an indicator of organizational legitimacy that can be accessed and measured. We propose the use of social media data and sentiment analysis to study the affect-based responses to organizational actions by citizens. We critically discuss and compare the method with existing quantitative methods for legitimacy measurement and apply them to a recent case in the banking industry. We discuss the value of the method for studying the process of legitimacy construction as the expression and negotiation of normative judgments about organizations by various evaluators. (shrink)

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

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

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

What factors in the organizational culture of an ethically exemplary corporation are responsible for encouraging ethical decision making? This question was analyzed through an exploratory case study of a top pharmaceutical company that is a global leader in ethics. The participating organization is renowned in public opinion polls of ethics, credibility, and trust. This research explored organizational culture, communication in issues management and public relations, management theory, and deontological or utilitarian moral philosophy as factors that might encourage ethical (...) analysis. Our understanding of organiza tional ethics is enhanced by elucidating factors the case revealed as encouraging ethical analysisan organizational culture that emphasizes the importance of ethics, Theory Y management, a symmetrical worldview valuing innovation and dialogue, a counseling role for issues management or public relations in the dominant coalition, rewarding ethical behavior, ethical analysis using moral philosophy, consistency between individual values and organizational philosophy, and ethics training. These factors, and perhaps others as yet unidentified, worked together to create an environment that encouraged ethical decision making at the exemplar organization. (shrink)