A new article led by DruGS team member Emily Lenton addresses the constitutive role of medical records in the production of stigma. Stemming from a research partnership developing novel strategies to address stigma related to blood-borne viruses and sexually transmissible infections in healthcare services, this new article analyses how the very process of producing medical records can be implicated in stigma. Offering insight into how these issues take shape in practice, this article examines data generated during in-depth interviews conducted with clinical and nonclinical healthcare workers in Australia.

Interview participants expressed several concerns about the ways such records can produce and reproduce stigma associated with numerous health conditions, identities, and practices. Thinking through how the process of gathering and recording personal information shapes data production, reproduction, access and dissemination, the article considers whether and to what extent these processes and systems help to generate, maintain or exacerbate stigma. Working with Bruno Latour’s notion of ‘affordances’, the analysis approaches medical records as a technology that affords healthcare capacities and subjects and, in this sense, can reflect and reproduce social and political arrangements. Approached in this way, stigma and related instances of discrimination are examined as affordances of electronic health management systems that works to shape healthcare experiences and outcomes. Overall, the article offers an account of the ways that institutions and structures responsible for the governance of electronic health management systems need to contend with the important entanglements between medical record systems and stigma and concludes with recommendations for how policymakers, health service leaders and researchers might intervene in the production of stigma afforded by these forms of communication.

As lead author Emily Lenton explains,

Electronic health management systems are sometimes thought of as fairly neutral processes of simply gathering and recording important information. Yet, our research indicates that they can work to reproduce long standing stigmatising dynamics and healthcare inequities. We need to think through these processes and systems as more than technical artifacts and identify ethical tensions in their design and delivery.