Avoiding Stigmatization in Paternalistic Health Policy

Abstract

How should we understand stigmatization in policies that force, induce, or nudge people to make healthier choices? Sometimes when health authorities try to alleviate (inequality in) lifestyle diseases by such means, stigmatization is reinforced and additional burdens are imposed on those who are already at a disadvantage. Distinguishing between policies that rely on stigma effects and policies that produce stigma as an unintended side effect, the paper argues that stigmatization is objectionable because it makes people’s lives worse, instrumentally as well as non-instrumentally. How stigmatizing a policy is thus partly determines how desirable it is vis-à-vis other policies that might achieve the same end. In order to settle this matter, the paper suggests four evaluative dimensions and brings them to bear on three different types of policy: legal mandates, incentives, and nudges.