Stigma and disease: changing paradigms

Stigmatising diseases can be further distinguished by their visibility and intrusiveness, and those with conditions that allow people to “pass as normal” (eg, diabetes) as discreditable may face difficulties of “information management”.

Abstract

But if diseases are not invariably stigmatising, some diseases and symptoms of disease clearly are, although which ones vary historically and across cultures. Sontag has argued that different diseases have aroused particular feelings of dread or repulsion during different eras. In the present century in the developed world, she contends, cancer has displaced tuberculosis in this respect. 3 It has been suggested too that in contemporary developed cultures more stigma typically attaches to disorders for which people are considered culpable (ie, achieved rather than ascribed stigma), and to conditions of the mind rather than the body. 4 Stigmatising diseases can be further distinguished by their visibility and intrusiveness. Goffman describes those with disorders that are stigmatising and that cannot be hidden or disguised (eg, blindness) as discredited, and those with conditions that allow people to “pass as normal” (eg, diabetes) as discreditable. Whereas the discredited may be confronted with problems of “impression management”, the discreditable may face difficulties of “information management”. 1