Stigma, Ethics and Policy: A Response to Bayer

Abstract:     
In Stigma and the Ethics of Public Health: Not Can We but Should We, 67 SOCIAL SCIENCE & MEDICINE (2008), Ronald Bayer asks whether "stigmatization always represents a threat to public health?" and whether "there [are] occasions when the mobilization of stigma may effectively reduce the prevalence of behaviors linked to disease and death?" In this commentary, I offer an unambiguous answer: Yes, and No. For purposes of an ethical analysis of stigma in public health practice, we should ignore Erving Goffman's treatment of stigma as a universal phenomenon. We should instead start with his account of how stigma works, and follow scholars like Bruce Link and Jo Phelan in trying to understand stigma as a harmful phenomenon experienced by vulnerable groups. It remains unclear that smokers, the group Bayer chooses as is example, are stigmatized in that sort of framework. If they are, the state and those working under its auspices should not be promoting or indulging that stigma in any way, because stigma is a barbaric form of social control that relies upon the most primitive and destructive of emotions. And chances are it won't work anyway.

Number of Pages in PDF File: 11

Keywords: Public Health, Ethics, Shaming, tobacco

Accepted Paper Series