Stigmatization in medicine: impact on patients, healthcare providers, and ethical standards of care

Abstract

Introduction. Stigmatization is a social phenomenon that adversely affects not only access to care but also the quality of medical services. In the medical context, stigma occurs when patients – or even healthcare professionals – are treated differently, with prejudice or a lack of empathy, due to certain traits, conditions, or social affiliations. Material and methods. We conducted a narrative review of stigma in healthcare settings. Searches were performed in PubMed/MEDLINE and Google Scholar, and complemented by consulting official public-health websites (WHO, ECDC, UNAIDS, Romanian MoH/NIPH) for the period 1 Jan 2000 – 27 Jul 2025 (English/Romanian). Search strategies combined terms related to stigma/discrimination, healthcare/quality of care, and vulnerable groups, with backward- and forward-citation tracking. Two reviewers screened against predefined criteria (peer-reviewed studies, reviews, authoritative institutional reports). Opinion pieces, non-healthcare contexts, duplicates, and inaccessible full texts were excluded, and evidence was synthesized qualitatively. Results. Stigma in healthcare appears as discriminatory behavior that fosters exclusion, leading to delayed diagnoses, treatment abandonment, and loss of trust in the system. Vulnerable groups – such as people living with HIV/AIDS, those with mental disorders, LGBTQ+ individuals, substance users, the homeless, and ethnic minorities – are most affected. HIV-positive patients often face avoidance, while those with psychiatric conditions may be seen as “unpredictable” or dangerous. Such attitudes harm patients’ health, deepen inequities, and erode the core ethics of equity and respect. Stigma undermines the patient–provider relationship, discouraging preventive care and adherence to treatment, and can cause complete disengagement. For providers, stigma fosters “dehumanization,” unconscious bias, and skewed clinical decisions, leading to substandard care. Healthcare workers experiencing their own health issues may internalize stigma, avoid seeking help, and compromise the care they deliver. Conclusions. Health-related stigma is widespread and takes multiple forms, profoundly degrading the quality of medical care and hindering patients’ access to services. Medical stigma generates serious systemic consequences: patients delay seeking treatment, avoid interacting with the health system, suffer emotional distress and burnout, and face extreme difficulty with social reintegration. These realities underscore the need for strategic interventions in professional education, legislation, and public awareness to combat stigma in healthcare.