Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies.

PURPOSE: The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by patients with schizophrenia receiving community mental health care. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is critical in order to offer a dignifying community mental health care. METHODS: A systematic search of the qualitative literature in Web of Science, PubMed, PsycINFO and Francis was performed to review the subjective experiences and ideas on stigma in outpatients with schizophrenia. RESULTS: Three major themes were identified in 18 studies and need to be taken into consideration when implementing an adequate community mental health care: (i) the continuing existence of stigma inherent in the health care setting, (ii) the importance of relational aspects of stigma encounters in daily life and (iii) the significance of the behavioural aspects related to previous stigma experiences and beliefs among patients. CONCLUSIONS: Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients' life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients' acceptance in society.

Embryonic stem cell research: terminological ambiguity may lead to legal obscurity.

National regulation on embryonic stem cell research in the European Union is ambiguous, due to a lack of consistent scientific terminology as exemplified by the Dutch Embryos Act. To force a breakthrough in this ethically dubious research topic, a more careful use of terminology would be in the interest of both the scientific community and the lawmakers, in order to avoid terminology becoming associated with research or applications for which it is inappropriate. Therefore I will first clarify the technological possibilities in an age of biological control. Secondly, we will critically analyse the statements of the European Convention on Human Rights and Biomedicine concerning embryo research and cloning. The Convention prohibits human reproductive cloning but does not take a clear position on so-called therapeutic cloning. Finally, we will give an overview of the most recent legislative initiatives within the European Union on this matter.