Conscious Language in Medical Writing: A Physician’s Perspective

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As a physician, I learned about accurate language. As a medical editor, I am learning about compassionate language. Here's how I'm merging these worlds of words.

Recently, my career as a family doctor has taken a wonderful turn into the world of medical editing. Language has always fascinated me, but with my education and work over the last two decades focusing mainly on the sciences, it’s a field that I haven’t had much opportunity to explore.

In the early stages of my medical education, there was a lot of new terminology, jargon, and odd naming conventions. It felt like learning a new language; it took time, practice, and memorization. (As a fun by-product of this, my brain contains an encyclopedic knowledge of abbreviations. I’m even an expert at guessing the definition of abbreviations I’ve never seen before. A bit of a flex, I know.)

Knowing some Latin also helped. A lot. I’m incredibly lucky and privileged that my grade 9 English teacher insisted we memorize lists of “Word Within a Word” Latin and Greek roots, prefixes, and suffixes. As a thirteen-year-old, this felt like an atrocious use of time. Now I know better. (Thanks, Ms. Joseph.) Knowing certain prefixes and suffixes helps me describe even the most obscure diseases, just from seeing the name.

So by the time I had climbed this learning curve, it was disorienting to then realize that talking about fellow humans using this new language wasn’t always good. It can offend, alienate, and confuse, while good communication can lead to better patient outcomes. The language of medicine needs to be more than just knowing the right label or diagnostic criteria. Despite the temptation, language choices are not just about being unflinchingly accurate.

As medical writers and editors, we have a wonderful opportunity to show that language is so infinitely vast that it is possible to explain complicated concepts with language that is clear, simple, and precise.

The importance of conscious language

It’s important to remember that patients have lives outside of the clinic or hospital. That referring to people as “diabetics” or “asthmatics” can be a helpful medical shorthand, but is incredibly reductive and dismissive of their multifaceted being. Referring to people repeatedly and often by their medical diagnosis, reason for presentation, or most active illness surely impacts the way doctors and health care professionals think. We need to make sure that we don’t reduce people to simplest terms to the point where we begin to dehumanize them.

Medical language is not just confined to the hospital. It is everywhere, from high impact journals, to blogs, to news articles, to patient education pamphlets, to Instagram.

Thanks to the infinitely vast world of podcasts and Twitter, I have been introduced to the wonderful editing community. One particularly wonderful resource I have recently stumbled upon is Crystal Shelly’s Conscious Language Toolkit for Writers. This resource is incredibly rich and detailed and immediately caught my attention and flagged the problems inherent in some medical language, and language in general.

In Shelly’s guide, conscious language is defined as “language rooted in critical thinking and compassion, used skillfully in a specific context” (originally coined by Karen Yin). Conscious langauge is not meant as policing for political correctness. Conscious language strives to be inclusive, respectful, and flexible. It needs to be able to change to meet the evolving needs of those it represents.

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Doctors and healthcare practitioners, in general, are busy, and this post isn’t knocking the way they communicate. They have heroically stood on the front lines for the last eighteen months, and we should be eternally grateful for their sacrifices. Instead, it’s intended as a gentle nudge to all those who communicate about health to try to incorporate even a small amount of awareness into the words we choose. 

Check out some of these resources.

Troublesome terms and phrases

Medical language spans from incredibly neutral and descriptive, to cold and clinical, to discriminatory and prejudicial. It’s especially important to consider language pertaining to persons that are marginalized or vulnerable because, as Shelly puts it, “… much of the language used to describe the groups or their circumstances has been rooted in bias, stereotypes, or exclusion.”

Ableist language

Ableism discriminates against people with disabilities. Look out for:

  • Talking about how disabilities need to be fixed or overcome
  • Implying that a disability is wrong, abnormal, or bad
  • Using slurs or terms considered offensive that some groups have reclaimed
 

Troublesome terms

Be on the lookout for these terms:

  • Addictive/like crack
  • Battling [disease]—this can imply that some are not fighting “hard enough”
  • Beat [disease]—this can imply that some did not fight “hard enough”
  • Deformed
  • Morbidly obese—this term is rooted in fatphobia
  • Special needs—this is euphemistic
  • Suffers from ­­­[disease]—having a disease does not imply that someone is suffering
  • Wheelchair-bound—this implies a restriction, while wheelchair use increases independence
 

Descriptors

Avoid using diagnostic terms as descriptors—these should not be used to describe mood fluctuations, etc. These may include:

  • Bipolar
  • Borderline
  • OCD
  • Psycho
  • Schizo

Common conventions

There are some phrases or manners of speech that are incredibly common but may not support the high standard we seek as medical editors. Examples include:

  • Implying illness is a personal failing
  • Focusing on individual responsibilities rather than societal ones to treat disease
  • Using overgeneralizations when specifics would be more appropriate or dignifying
 

On this note, consider whether it’s best to use person-first or identity-first language—the right choice may depend on the preferences of the individual described.

  • Person-first: Person with diabetes
  • Identity-first: Autistic person
 

The best way to learn new terms and see inclusive language in action is to spend time with or consume media representing people who are different from you!

Despite the temptation, language choices are not just about being unflinchingly accurate.

The role of plain language

Another facet of language that is critical to shed light on is the use of plain language. People should not be made to feel excluded because medical language is too complex. There seems to be a fear among some professionals that by using clearer language when we describe medicine or science, especially to the general public, that we are somehow “dumbing it down” or risking being accurate. As medical writers and editors, we have a wonderful opportunity to show that language is so infinitely vast that it is possible to explain complicated concepts with language that is clear, simple, and precise.

And as medical editors and writers, we need to lead the way. So far, I have found the editing community to be deeply warm and welcoming. Far from finding pedants and grammar sticklers, I have found how editors want to embrace the variations and constantly evolving nature of language. They often point out how prescriptive grammar rules are often arbitrary, and can other those from different educational, racial, geographical, and socioeconomic backgrounds. It is our job to help improve representation and inclusiveness in how individuals and groups are represented. Words matter.

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