MAYBE WHAT WE NEED IS A LITTLE MORE STIGMA, NOT LESS

Maybe what we need is a little more stigma, not less When U.S. Surgeon
General David Satcher declared suicide a serious national threat, he
embraced several smart ideas for fighting it. Sandwiched among the smart
proposals -- and easily overlooked next to such innovative proposals as
training hairdressers and baseball coaches to look for the predictors of
suicide -- was a plan to diminish the stigma attached to substance abuse and
suicide.

Now I'm willing to assume that Dr. Satcher's motivation was good -- to
encourage people to seek help rather than keeping their suicidal feelings
locked inside. But there's something very dangerous about reducing the
stigma attached to any destructive action. There is only a tiny step between
destigmatizing pathology and offering it up as an acceptable alternative.

A perfect example of that transformation came the very same day as Dr.
Satcher's announcement, at a convention in Massachusetts of the National
Association to Advance Fat Acceptance.

Members of this group are on a mission to do more than destigmatize fat.
Their goal is not merely to accept and love themselves as they are or to
have other people stop making fun of them for their size. No, they demand
that we embrace fat. They consider it an insult for anyone to decide that he
or she would like not to be fat. The New York Times reports that many
conventioneers "say it still rankles that Oprah Winfrey, with all her
accomplishments, has described losing weight as her greatest achievement."
How dare she feel good about not being fat!

This attempted normalization of that which is neither normal nor healthy
(we're not talking about folks who are just 10 or 20 or even 50 percent
overweight) goes so far as to include attacks on the diet industry, lobbying
for a ban on "size discrimination" in civil rights laws and a campaign to
abolish such offensive terms as "morbid obesity" -- a medical term, by the
way, for people who are at least twice the normal weight for their height
and whose weight is causing physical health problems.

It's just another example of the dangerous late 20th century trend of making
sure everybody feels good about themselves, whether they should or not. In
this view, stigma is the worst possible sin. It is exponentially worse than
the self-destructive decisions individuals make about how to live their lives.

We've already transformed drug use and alcoholism far beyond what could
possibly be justified by the genetic predispositions that are inherent in
alcoholics and drug addicts. Now they're diseases, covered by the Americans
with Disabilities Act. That means that the addicted bear absolutely no
responsibility for their actions. And so stigmatization is outrageously out
of the question; stigmatizing something beyond someone's control is,
appropriately, considered inappropriate.

But are suicide and obesity (and, to some degree, alcoholism and drug
addiction) really beyond our control? Or are they -- like teen pregnancy --
personal and social ills that result from bad choices that individuals make?

And if they are the results of bad choices, aren't we really hurting the
so-called victims by removing the stigma?

The rise of births among unmarried teens tracks neatly with the elimination
of the stigma attached to out-of-wedlock motherhood. I'm old enough to
remember when single mothers of any age were social outcasts. I can't
remember one girl at my high school who gave birth before graduation. Today
teen mothers are no longer shunned -- in many cases are not even considered
out of the ordinary -- and their numbers are increasing.

Increasing stigma has just the opposite effect. Deaths caused by drunken
driving have dropped over the last two decades -- since we as a society
began to make it socially unacceptable to drink and drive. Smoking declined
as smokers became social pariahs.

But when teen drug use starts creeping back up, experts tell us it's a
result of letting up on the anti-drug message in schools.

This brings us back to suicide. San Diego State University Professor Howard
I. Kushner, author of Self Destruction in the Promised Land, recently told
The Times: "We now have an increase because we see depression and suicide as
the result of a chemical imbalance. It's legitimized because it's biological."

It's one thing for people with self-destructive habits -- or those with
habits that are destructive to others, such as pedophiles -- to fight to
remove the stigma, so they can feel better about themselves. It's quite
another for our government to try to remove the stigma.

The line between encouraging people to feel safe seeking help for their
destructive behavior and making them feel so safe that we actually encourage
the underlying destructive behavior is, admittedly, thin. But if we must
err, shouldn't it be on the side of discouraging the destructive behavior?

Maybe it's time we secularize the Christian directive of hating the sin but
loving the sinner. If, in the name of reaching out to the sinner, we don't
hate the sin -- if we don't hate the pathology, if we don't call it what it
is -- then we're going to help create more "sinners" than we'll ever be able
to save.

Ms. Scoppe can be reached at cscoppe@thestate.com or at (803) 771-8571.