title: What is in a cause? Exploring the relationship between genetic cause and felt stigma.
abstract: OBJECTIVE
  Concern over stigma as a consequence of genetic testing has grown in response to the recent increase in genetic research and testing resulting from the Human Genome Project. However, whether a genetic or hereditary basis necessarily confers a stigma to a condition remains unexamined.
  
  
  METHODS
  We performed a qualitative interview study with 86 individuals with one of four conditions: deafness or hearing loss, breast cancer, sickle cell disease, and cystic fibrosis. The first two groups were divided approximately between people who ascribed their conditions to a genetic or hereditary cause and those who did not.
  
  
  RESULTS
  Respondents interpreted genetic or hereditary causes and nongenetic causes in a variety of ways. Subjects with breast cancer reported the most consistently negative interpretation of genetic cause. This response concerned future ill health, not an enduring sense of stigma. Deaf and hard of hearing subjects provided the most consistently positive comments about a genetic or hereditary basis to their condition, casting familial hearing loss as a vital component of group and individual identity. Respondents with sickle cell disease and cystic fibrosis offered similar and positive interpretations of the genetic cause of their condition insofar as it meant their conditions were not contagious.
  
  
  CONCLUSIONS
  Although some subjects report feeling stigmatized as a result of their condition, this stigmatization is not uniformly associated with the condition's cause, genetic or otherwise. Instead, stigma emerges from a variety of sources in the context of the lived experience of a particular condition.
authors.affiliation: Center for Bioethics, University of Pennsylvania, 3401 Market Street, Philadelphia, PA 19104, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Sankar
authors.forename: Mildred K
authors.initials: MK
authors.lastname: Cho
authors.forename: Paul Root
authors.initials: PR
authors.lastname: Wolpe
authors.forename: Cynthia
authors.initials: C
authors.lastname: Schairer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000235:genetics / Q000523:psychology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology; D003550:Cystic Fibrosis / Q000235:genetics / Q000523:psychology; D003638:Deafness / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged