[The Intrinsic Problem of Labeling in Healthcare].

ABSTRACT

While everyday prejudice and stereotypes may seem harmless, they can cause problems for interpersonal interactions and have drastic consequences for professional caregivers. American sociologist Goffman (1963) defined "stigma" as an individual being disqualified from complete social acceptance. Stigmatization and social stigma convey long-discounted stereotypes and social discrimination in specific ways, resulting in an individual being psychologically categorized as unwelcome or an outcast and, in turn, notable differences between their virtual and actual social identity. Link and Phelan (2001) defined stigmatization as the simultaneous occurrence of four processes (1) distinct labeling; (2) stereotyping labels with unwelcome attributes; (3) separating "us" from "them" by framing labeled individuals as different; and (4) discriminating against labeled individuals. Evidently, stigmatization is a complex and multifaceted social process that comprises labeling, stereotyping, separating, depriving (of status), and discriminating through the exercise of power (Link & Phelan, 2001). Stigmatized individuals often perceive themselves as different from and devalued by others (Jacoby et al., 2005). Stigmatizing others may provide individuals with a higher perceived locus of control, stronger self-esteem, and reduced anxiety (Heatherton et al., 2000). Stigmatization significantly impacts the physical and mental health of victims. For example, it can make patients stressed, prolong the length of their hospitalization, and increase their likelihood of receiving a depression diagnosis (Budhwani & De, 2019). The main causes of social stigmatization are ignorance, lack of understanding, misinformation, and misunderstanding (Kok et al., 2018). The research has demonstrated that healthcare professionals may stigmatize and discriminate against the patients for which they are caring, hurting the dignity of their patients (Alenezi, 2022) and leading to a lack of trust in patient-physician relationships, reducing patients' opportunities to receive adequate care (Tyerman et al., 2021), hindering their treatment and recovery, and resulting in lower-quality healthcare and prognoses (Copeland, 2021). Therefore, reducing stigmatization in healthcare institutions is necessary to improve healthcare services and boost trust between patients and healthcare teams. During the COVID-19 pandemic, frontline healthcare workers stigmatized and discriminated against many patients during their process of care, harming the mental health of these patients (Tsukuda et al., 2022). These pandemic-era experiences highlight the need for healthcare workers to reflect empathetically on their behavior from various perspectives. Given that empathy and attitude are linked to each other, Economou et al. (2020) argued that anti-stigmatization efforts should prioritize and strengthen healthcare workers' perspective-taking abilities. The nursing-development process should focus on reestablishing behavioral and professional norms to eliminate labeling, instill empathy, emphasize relationships, and develop moral maturity to mitigate stigmatization among patients (Copeland, 2021). The Lancet, a prestigious medical journal, created The Lancet Commission to end stigma and discrimination in mental health with the assistance of over 50 renowned healthcare experts. Strategies for countering stigmatization include the incorporation of relevant training programs and educational interventions aimed at improving how students understand disease and reducing discriminatory behavior against patients. The healthcare sector must focus on the impacts of stigmatization on both healthcare providers' behaviors and treatment quality rather than merely assessing the knowledge and attitudes of healthcare providers (Thornicroft et al., 2022). This approach can help ensure patients receive high-quality healthcare that promotes their recovery, is tailored to their needs, and is free from discrimination and stigmatization.