April 24, 2024

Clarifying the ethics of shame

A recent article on stigmatization in reproductive health provides an unfortunately confused treatment of a topic of great contemporary relevance.

Is it ever good to stigmatize? This question has received significant attention of late in many bioethical and medical journals.

Indeed, the International Journal of Obstetrics and Gynaecology recently published an editorial by two University of Tornoto bioethicists discussing stigmatization in healthcare. The article, entitled Reducing Stigma in Reproductive Health, criticises the continuing stigmatization of both users and providers of reproductive healthcare. The article focuses particularly on the ongoing shaming of individuals involved in abortions, be they doctors or patients:

Gynecologists who undertake lawful abortions, for instance, should be afforded the same respect as others, not denigrated as “abortionists,” even when providing services in the private sector that public sector facilities decline to undertake. The role of creating stigma as a governmental public health strategy, for instance to reduce cigarette smoking, may remain politically contentious but, regarding patients and providers of reproductive healthcare, the judgment remains that “[s]tigma can without exaggeration be considered a barbarous and unacceptable form of regulation that a humane society must reject”.

The significance of the article seems to lie not so much in the novelty of its comments on abortion stigmazation, but in its underdeveloped distinction between ‘contentious’ and ‘non-contentious’ examples of stigmatization. The authors claim that stigmatizing smoking may be an effective means of improving ‘individual and public health’, but stigmatizating abortion remains “barbarous and unacceptable”.

Should stigmitization be based on a paternalistic attitude toward impacts on ‘individual and public health’? The article seems to endorse a potentially “barbarous and unacceptable” practice, only to condemn it in the same breath. Whilst this is yet another contribution to a voluminous literature, it seems the topic warrants further attention.

Xavier Symons
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