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Definitions and theoretical models of the stigma construct have gradually progressed from an individualistic focus towards an emphasis on stigma's social aspects. Building on other theorists' notions of stigma as a social, interpretive, or cultural process, this paper introduces the notion of stigma as an essentially moral issue in which stigmatized conditions threaten what is at stake for sufferers. The concept of moral experience, or what is most at stake for actors in a local social world, provides a new interpretive lens by which to understand the behaviors of both the stigmatized and stigmatizers, for it allows an examination of both as living with regard to what really matters and what is threatened. We hypothesize that stigma exerts its core effects by threatening the loss or diminution of what is most at stake, or by actually diminishing or destroying that lived value. We utilize two case examples of stigma--mental illness in China and first-onset schizophrenia patients in the United States to illustrate this concept. We further utilize the Chinese example of 'face' to illustrate stigma as having dimensions that are moral-somatic (where values are linked to physical experiences) and moral-emotional (values are linked to emotional states). After reviewing literature on how existing stigma theory has led to a predominance of research assessing the individual, we conclude by outlining how the concept of moral experience may inform future stigma measurement. We propose that by identifying how stigma is a moral experience, new targets can be created for anti-stigma intervention programs and their evaluation. Further, we recommend the use of transactional methodologies and multiple perspectives and methods to more fully capture the interpersonal core of stigma as framed by theories of moral experience. Keyword: Stigma Theory; Measurement; China; Moral experience; Mental illness; USA

Careful analysis of transcripts of interviews we conducted with a sample of persons identified as suffering epilepsy or seizure disorders in an epidemiological study in Turkey revealed not only that life stories of illness have an overall narrative structure but that the interviews were composed as a corpus of shorter stories. Analytic concepts from reader response theory bring attention to aspects of both the overall life story and the stories told about illness. In particular, we identify 'subjunctivizing tactics' present in the narrative representation of illness that allow sufferers and their families to justify continued care-seeking and to maintain hope for positive, even 'miraculous,' outcomes. In particular, these narratives maintain multiple perspectives and the potential for multiple readings, suggesting alternative plots about source and outcome of illness, and they represent potency and the possibilities for healing through stories of encounters with the mysterious.

Oncologists encounter the uncertainty of time horizons in their patients' lives. Although American oncologists are given a cultural mandate to instill hope in the therapeutic narratives they create with patients, uncertainty leads them to expressions of time without horizons or of time with highly foreshortened horizons as they seek to create for patients an experience of immediacy rather than of chronology. The distinctiveness of the American pattern is highlighted through comparison with Japanese exemplar cases and stories of therapeutic practices in oncology. Concepts drawn from narrative analysis of temporality and the construction of the therapeutic plot are employed.