Words by Lisa Burns
Dr. Phil Hutchinson, Professor of Philosophy at MMU Cheshire, led a discussion on ‘Shame and Disclosure’ at Manchester Metropolitan University (MMU) last night. In the first real outing of his new paper, Hutchinson explored the links between the spread of STIs and HIV, and the socially ingrained sense of shame surrounding sexuality.
After writing his book Shame and Philosophy in 2008, Hutchinson said he was fascinated by the concept of shame in the context of modern moral philosophy, which focuses on actions. With a view to creating ‘a framework for understanding shame’, Hutchinson discussed the matter of late diagnoses of HIV. Although HIV is treatable, if diagnosed late it has different consequences. It makes the sufferer ten times more likely to die within a year of diagnosis; resulting in higher treatment costs, and unaware that they are carrying the virus, sufferers spread HIV further.
Late diagnoses currently comprise 50% of all HIV diagnoses in the UK. This shocking figure provided the context for Hutchinson to question why so many people are reluctant to attend sexual health examinations, and to be honest with clinicians and current partners. The answer, Hutchinson proposed, was a sense of shame. “Draconian attitudes towards STIs,” he stated, “draw on very fine-grained cultural specifics,” regarding sexual morality and honour. British culture often refers to STIs as ‘dirty’, and if given the all-clear upon examination, one may claim to be ‘clean’. These labels, Hutchinson argued, are part of a cultural narrative that stigmatises those who contract STIs and HIV. The aim of his study of shame was to, ‘rationally reconstruct the cycle – bringing to consciousness the source of the shame makes it available to rational scrutiny.’
Perhaps the most surprising finding of Hutchinson’s study was that many clinicians themselves feel shame, which prevents them from offering HIV tests to patients. Often this is due to cultural beliefs, such as ‘it is not appropriate for a young clinician to ask a 60-year-old if they need a HIV test’, or a misplaced desire to avoid offence to those of other religions or ethnicities. Hutchinson noted that intercultural relations between clinicians and patients were beset by embarrassment and misunderstanding. “The onus relies on the clinician taking the lead.” If the medical professional feels shame when asking a patient about their sexual habits, then it follows that the patient is not at ease to be candid.
The lecture certainly presented challenges towards current British societal attitudes and preconceptions regarding sexuality, shame, and sexual health. Hutchinson’s study brings to light the fact that shame, in the context of STIs and HIV, is hindering the progress of prevention and cure. “If we reduce the role shame plays, we will reduce the number of late diagnoses.” Cultural stigmatisation of sexuality and sexual infection prompts people to avoid testing, lie about their real sexual habits, and thereby block progress in finding cures for STIs.
And that is where the real shame lies.
Lisa Burns studies History and English at MMU. When she’s not got her nose in a book, she loves having adventures in the great outdoors! Follow her on Twitter: @LittleRobin09