Defense Date

4-10-2025

Graduation Date

Spring 5-8-2025

Availability

One-year Embargo

Submission Type

dissertation

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Joris Gielen

Committee Member

Peter Osuji

Committee Member

Gerard Magill

Keywords

autonomy, community engaged research, involuntary childlessness, infertility, stigma, shame, psychosocialcare, Tamil culture

Abstract

The stigma associated with involuntary childlessness has negatively affected health and well-being for several decades. This situation is particularly exacerbated for women within the Tamil socio-cultural context, resulting in feelings of shame, neglect, denial, isolation, and constituting a significant barrier to long-term access to healthcare services. Although advancements have been made in the provision of biomedical care, the psychosocial support remains inadequately addressed. Moreover, there are currently no healthcare interventions that specifically target the stigma associated with this issue, which hinders open communication with healthcare providers, delays necessary treatments, and adversely impacts overall health outcomes. The central thesis of this dissertation asserts that an anti-stigma engagement process, utilizing stigma-informed care that is culturally relevant, will effectively address stigma while delivering comprehensive biopsychosocial care. This approach aspires to enhance overall health outcomes and well-being for the women affected.

The critical components of this dissertation encompass: (1) establishing involuntary childlessness stigma as a healthcare ethical issue, thereby acknowledging the necessity of addressing it through healthcare ethical strategies; (2) investigating the impact of stigma on healthcare decision making by drawing on narratives and lived experiences of women from Tamil Nadu, South India, facing involuntary childlessness through empirical bioethics research; (3) proposing a bioethical framework for an anti-stigma engagement process to directly tackle stigma as a healthcare intervention rooted in the ethical principle of respect for persons.

Ultimately, by prioritizing the elimination of stigma, women can make informed and confident healthcare decisions while receiving compassionate, patient-centered care and support to achieve their reproductive health goals without fear of judgment or discrimination.

Language

English

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