Stigma, Labelling and Stereotyping

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Stigma, Labelling and Stereotyping

• mark of shame or discredit.

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Goffman (1963)

• an undesirable attribute that is incongruous
  with our stereotype of what a given individual
  should be Goffman (1963, p.3.)

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Social identity

• Physical appearance and activities
• Professional roles
• Concept of self

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Classifications Goffman (1963)

• Discredited Visual clues, e.g. a wheelchair,
  shortness of breath, smell, clothes
• Discreditable No visual clues, therefore the
  discrepancy is hidden. E.g. Epilepsy, HIV
  positive, Schizophrenia etc.

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Types of stigma Goffman (1963)

• Stigma of physical deformity
• Stigma of character blemish
• Prejudice

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Discrepancy

• Guilt emanating from self-criticism.
• Shame emanating from disapproval from others

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Illness as deviance

• Deviance Violation of a set of laws, rules or
  social norms
• Illness Deviance

8
Legitimising Sickness

• Medical practitioners as gatekeepers
• Legitmizers

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Sick Role

• Obligations of the sick-role
• Get better as soon possible.
• Take the medicine/co-operate

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Rights of the sick role

• Entitled to exemption
• Can expect assistance

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Consider your feeling towards the following

• A colleague who is off sick is seen shopping for
  clothes in an expensive clothes store
• A patient who is due to be discharged home,
  refuses to change into his clothes and goes
  missing from the department when the taxi
  comes.
• A colleague continually takes two or three days
  sick every month, but refuses to make an
  appointment to see his/her doctor.
• A barium meal is booked at 9.am for a patient who
  has been told they must not eat from midnight.
  The patient informs you s/he has had bacon and
  eggs for breakfast in the hospital canteen.

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Labelling

• Diagnosis creates the condition
• Diagnosis becomes the label
• Pre-cursor to a self-fulfilling prophesy

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cultural stereotype

• They may concur with the stereotype
• They isolate themselves from mainstream to
  protect themselves
• Adopt a façade of compliance for convenience sake
• Make others pay for their condition (for example
  by begging)
• Actively resist the stereotype

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Stages in meeting a person who is disabled

• Fictional acceptance
• Breaking through
• Consolidation

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Patients view

• Felt Stigma
• Rationalisation
• Action strategy

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Conclusion

• Health professionals tend to stereotype according
  to diagnosis
• Labelling
• Stigmatizing
• Discrimination
• Good patients and bad patients
• Is it all a conspiracy to keep control