Biases, prejudice and resultant judgements can greatly affect communication – they may result in conflict (see Ch 14), misunderstandings (see Ch 17) and communication breakdown (Mohan et al 2004). These are good reasons why health professionals should avoid stereotypical judgements based on prejudice (Egan 2007). However, there are additional reasons to avoid stereotypical judgement. Stereotypical attitudes often develop from limited information (ignorance) or misinformed assumptions (Brill & Levine 2005, Holliday et al 2006) and thus the resultant judgement may be incorrect. This potentially means that if a health professional is relating to someone through a stereotype, they have reduced the person to something that is less than who they are and therefore the health professional is not allowing the person to have thoughts and opinions that do not conform to the stereotype. It is also possible that the stereotype is based on an unconscious belief about an ‘in’ group and a subordinate ‘out’ group (Bowe & Martin 2007). This suggests the beliefs or culture of the person making the stereotypical judgement are the standard for evaluating the ‘other’ person or culture (Tyler et al 2005). Stereotypical judgement usually occurs unconsciously and thus has serious implications for the health professional (Lyons & Kashima 2003). If unconscious, prejudice and possible resultant stereotypical judgements will unknowingly influence the communication of the health professional, with potentially unpleasant results.

Although a stereotypical judgement may benefit the person holding the stereotype because it justifies their own characteristics or value, it produces lenses that negatively affect communication. Devito (2007) states that a stereotypical judgement creates two major barriers when communicating. The first barrier occurs if there exists a set idea about the person or their group. This idea will limit the ability to hear or experience anything that is different to the constructs of the stereotype. The second barrier limits the possibility of relating to particular qualities or abilities within the person if those qualities contradict the stereotype. In such cases, the stereotypical judgement may not allow the person to be unique or different to the stereotype. For example, a young health professional can be as competent as an older one, but a stereotypical judgement may not allow them to be competent. Alternatively, an elderly person may lead a very active life despite the stereotypical judgement that states elderly people are frail and dependent. If such stereotypical judgements occur, all communicators experience limited mutual understanding, and negotiation of meaning – if it does occur – is likely to fail. More importantly, while these barriers limit the possibility of effective communication, they also limit the potential to achieve family/person-centred practice.

Stereotypical judgements often lead to expectations of particular behaviour within particular roles. This is potentially as detrimental as applying a stereotype to the characteristics of a person or group. Expectations of particular behaviour from a person in the role of an administration assistant, for example, are beneficial whenever that person behaves according to those expectations. If an individual expects an administration assistant to make their favourite hot drink every morning but the administration assistant does not consider that activity part of their role, there will be disappointment in one person and anger in the other. Understanding stereotyping facilitates consideration of what behaviour a health professional expects from the ‘other’ (Thompson 2006) and what the ‘other’ might expect from a person in the role of a health professional.