Importance of Precise Language in Medical and Scientific Communications

by Diane Neer

Sitting on my desk is a 1950 Merck Manual I picked up at an estate sale for fifty cents. It has several pages devoted to polio with no mention of the as-yet-undiscovered vaccine. It also has a chilling description of the procedure for “electroshock therapy” given to a fully conscious patient. It serves as a reminder of how dramatically medicine has evolved, even in just the last 60 to 70 years. Today, polio has all but been eradicated (just 74 reported cases in 2015),1 and “electroshock therapy,” now known as electroconvulsive therapy, is conducted under general anesthesia.2 As science and medicine have progressed, so have our ways of communicating about them. It is important for medical writers and medical editors to stay up to date with current medical language and terminology just like we stay up to date with the latest medical developments and discoveries.

1950 Merck Manual Front Cover

1950 Merck Manual Interior Pages

 

People are not diseases

People are often scared when they are diagnosed with a disease. There are so many questions about prognosis, treatments, and quality of life. People want to maintain their independence and sense of self. The last thing they want is to become their disease. Yet in the not-so-distant past, it was common to hear terms like “cancer victims” and “AIDS victims” in the news. Multidimensional individuals were often reduced to one characteristic and called “diabetics,” as if their blood sugar became their most defining trait. If Grey’s Anatomy is any indication, surgeons may still refer to their patients as the “appendectomy” in curtain 4 or the “lap coli” on the way to the OR. Words matter. It can be subtle. Which sounds more respectful to the person? An HIV patient? Or a patient infected with HIV? All of these terms can diminish the degree to which patients are seen (and treated) as individual human beings. It may take some adjustment, but it is important to keep in mind as you are writing and editing medical communications. Refer to individuals respectfully, using terms such as “patient with diabetes” or “people living with HIV.”

Diseases are not people…or places

With all due respect to our collective tears watching Gary Cooper give his moving speech in Pride of the Yankees, the World Health Organization (WHO) would not approve of calling amyotrophic lateral sclerosis Lou Gehrig’s disease. In the past, some disease names have had negative effects on groups of people or people in certain geographic areas. In the case of H1N1, which was unfortunately referred to as “swine flu,” the result was over a billion dollars in losses to the pork industry in just the first 6 months.3 Other examples abound: Siamese twins, Legionnaire’s disease, Ebola, West Nile Virus, and German measles (which some wanted to call “liberty measles” during World War I4). In 2015, WHO shared some best practices for naming new diseases,5 in which they advise against using geographic locations; people’s names; species/classes of animals or food; cultural population, industry, or occupational references; or terms that incite undue fear (eg, “fatal,” “epidemic”).

R-E-S-P-E-C-T, find out what it means to me

Doctors can’t prevent and treat sickness without people who want to stay healthy. Pharmaceutical companies can’t test potentially life-saving treatment options without people who volunteer for clinical trials. When we communicate about the people who play a vital role in healthcare and research, it’s important that we give them the respect they deserve. When I see the word “subject” used in a clinical trial report, I can’t help but visualize the investigator wearing a golden crown and an ermine robe as he or she surveys the “subjects” below. The American Medical Association Manual of Style suggests avoiding the term “subject” and instead referring to “participant” or “patient,” whichever is appropriate, and goes on to explain that “subject” may be considered “impersonal, even derogatory, as if the person in the study were in a subservient role.”6

As doctors and researchers continue their groundbreaking work to keep people healthy, those of us involved in communicating their results should be breaking new ground in communications; staying abreast of ever-changing medical, scientific, and social terminology; and ensuring that the words we use are carefully chosen and respectful.

We would love to get your feedback about how language affects your work in medical and scientific communications or hear your suggestions for future topics in the Words Matter series. Get in touch by leaving a comment today or emailing Diane Neer, Senior Medical Editor II, MedThink SciCom.

 

References

  1. Does polio still exist? Is it curable? World Health Organization. http://www.who.int/features/qa/07/en. Accessed March 9, 2017.
  2. Electroconvulsive therapy (ECT). Mayo Clinic. http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161. Accessed March 9, 2017.
  3. Pork industry still reeling from swine flu. ABC News. http://abcnews.go.com/Business/pork-industry-reeling-swine-flu/story?id=8840004. Accessed March 13, 2017.
  4. French fries off US menu. BBC News. http://news.bbc.co.uk/2/hi/europe/2784577.stm. Accessed March 13, 2017.
  5. World Health Organization best practices for the naming of new human infectious diseases. World Health Organization. http://apps.who.int/iris/bitstream/10665/163636/1/WHO_HSE_FOS_15.1_eng.pdf. Accessed March 13, 2017.
  6. Correct and preferred usage of common words and phrases. AMA Manual of Style, 10th ed. http://www.amamanualofstyle.com/view/10.1093/jama/9780195176339.001.0001/med-9780195176339-div1-117?rskey=9ncG5W&result=1. Accessed March 13, 2017.

 

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