Oregon Health & Science University (OHSU) SCHOOL OF MEDICINE – An important piece to understanding inequities and adequately addressing them is critically analyzing the language and concepts we use every day communicating with our patients, with each other, through our medical documentation, and through our research.
Language is continuously evolving and this table is by no means a perfect or comprehensive list, however, we hope that it serves as a resource to critically think about the language we use and propagate, and how we might make conscious efforts to move towards inclusivity.
Respectful & identity-affirming language puts our humanity at the center. Inclusive language allows everyone to feel recognized, valued, invited and motivated to contribute at their highest level.
OHSU School of Medicine Outdated Medical Terminology BY Rohi Gheewala, Med24 José Manuel Carrillo-Castro, Med24 Sean Bowden, Med24
Eponyms
An eponym is a person, a place, or a thing after whom or which someone or something is, or is believed to be, named. We acknowledge the effort to transition away from eponyms, however from our literature review, there are currently no alternatives for Hansen’s disease.
Outdated Medical Terminology
OUTDATED TERM: Buffalo Hump
- WHY IS IT HARMFUL? Derogatory towards overweight individuals.
- ALTERNATIVE TERM: Supraclavicular and/or dorsocervical fat pad
OUTDATED TERM: Mongolian Spot
- WHY IS IT HARMFUL? Historicallly, individuals with these skin findings were stigmatized to be racially inferior; term originated with the incorrect belief that it was most common in Mongolian populations (1,2).
- ALTERNATIVE TERM: Slate grey nevus, congenital dermal melanosis
OUTDATED TERM: Dwarfism
- WHY IS IT HARMFUL? Linked to the root meaning ‘to deceive,’ implying an inherent moral defect in individuals with short stature (3). Also, historically been linked to intellectual disability which is inaccurate.
- ALTERNATIVE TERM: Individual with short stature, little person
OUTDATED TERM: Cretinism
- WHY IS IT HARMFUL? Derogatory slang term for someone perceived as foolish or incompetent; historically used to mean “human being” as a reminder that individuals with this condition were humans and not beasts (3,5).
- ALTERNATIVE TERM: Congenital iodine deficiency syndrome, congenital hypothyroidism
OUTDATED TERM: Mental Retardation
- WHY IS IT HARMFUL? Retardation is often used as a synonym for “dumb” or “stupid” and equates people with disabilities as such (6).
- ALTERNATIVE TERM: Individual with intellectual disability or developmental delay
OUTDATED TERM: Substance abuse (abuser)
- WHY IS IT HARMFUL? Stigmatizing because it reduces an individual’s identity to their struggle with substance (alcohol, tobacco, recreational drug, or other substance) use; denies dignity (8).
- ALTERNATIVE TERM: Individual with substance use disorder, individual who suffers from addiction
OUTDATED TERM: Leprosy
- WHY IS IT HARMFUL? Historically used as a metaphor for “all that is impure, immoral, and dreadful” (9).
- ALTERNATIVE TERM: Hansen’s Disease
OUTDATED TERM: Moon face or facies
- WHY IS IT HARMFUL? Slur used for Asians and Pacific Islanders (10).
- ALTERNATIVE TERM: Swelling or puffing of face
OUTDATED TERM: Red man syndrome
- WHY IS IT HARMFUL? Slur used for Indigenous people (11, 12).
- ALTERNATIVE TERM: Swelling or puffing of face
OUTDATED TERM: Wegener’s Granulomatosis
- WHY IS IT HARMFUL? Named after a member of the Nazi party (13).
- ALTERNATIVE TERM: Granulomatosis with Polyangiitis
OUTDATED TERM: Reiter’s arthritis
- WHY IS IT HARMFUL? Named after a member of the Nazi party (14).
- ALTERNATIVE TERM: Reactive Arthritis
OUTDATED TERM: Asperger’s Syndrome
- WHY IS IT HARMFUL? Named after a member of the Nazi party (15).
- ALTERNATIVE TERM: Autism Spectrum DisorderAutism Spectrum Disorder
OUTDATED TERM: Cushing’s Disease or Syndrome
- WHY IS IT HARMFUL? Named after an anti-Semitic and racist individual who supported the atrocities of the Nazi party towards Jewish individuals (16).
- ALTERNATIVE TERM: Hypercortisolism
REFERENCES
1. Yale S, Tekiner H, Yale ES. Reimagining the Terms Mongolian Spot and Sign. Cureus. 2021 Dec 13;13(12):e20396. doi: 10.7759/cureus.20396. PMID: 35036226; PMCID: PMC8752411.
2. Zhong CS, Huang JT, Nambudiri VE. Revisiting the history of the “Mongolian spot”: The background and implications of a medical term used today. Pediatr Dermatol. 2019 Sep;36(5):755-757. doi: 10.1111/pde.13858. Epub 2019 May 29. PMID: 31141213.
3.Guevara-Aguirre J, Guevara C, Guevara A, Gavilanes AA. Branding of subjects affected with genetic syndromes of severe short stature in developing countries. BMJ Case Rep. 2020 Feb 9;13(2):e231737. doi: 10.1136/bcr-2019-231737. PMID: 32041755; PMCID: PMC7021096.
4. Lenz, L. (2015, February 25). A Brief History of Dwarfism. Pacific Standard. Available from: https://psmag.com/social-justice/a-brief-history-of-dwarfism-and-thelittle-people-of-america. 5. Jacobs, F. (2020, February 5). The shocking, forgotten history of cretinism. Big Think. Available from: https://bigthink.com/health/history-of-cretinism/
6. https://www.bu.edu/wheelock/the-use-of-the-r-word-and-why-its-a-problem/
7.Nash C, Hawkins A, Kawchuk J, Shea SE. What’s in a name? Attitudes surrounding the use of the term ‘mental retardation’. Paediatr Child Health. 2012 Feb;17(2):71-4. doi: 10.1093/pch/17.2.71. PMID: 23372396; PMCID: PMC3299349.
8. Partnership to End Addiction. (n.d.) Words Matter: The Language of Addiction. Available from: https://drugfree.org/article/shouldnt-use-word-addict/
9. Deps P, Cruz A. Why we should stop using the word leprosy. Lancet Infect Dis. 2020 Apr;20(4):e75-e78. doi: 10.1016/S1473-3099(20)30061-X. Epub 2020 Mar 2. PMID: 32135079. Outdated Medical Terminology REFERENCES
10. Mathews KA, Park MS. The Post-Racial Church: A Biblical Framework for Multiethnic Reconciliation. Kregel Academic; 2011.
11. Bradford A. “Red man syndrome:” thoughts on an anachronistic term. Fam Med. 2013 Jul-Aug;45(7):509-10. PMID: 23846972.
12. Austin JP, Foster BA, Empey A. Replace Red Man Syndrome With Vancomycin Flushing Reaction. Hosp Pediatr. 2020 Jul;10(7):623-624. doi: 10.1542/hpeds.2020- 0125. PMID: 32571794.
13. Falk RJ, Gross WL, Guillevin L, Hoffman G, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts R. Granulomatosis with polyangiitis (Wegener’s): an alternative name for Wegener’s granulomatosis. J Am Soc Nephrol. 2011 Apr;22(4):587-8. doi: 10.1681/ASN.2011010081. Epub 2011 Mar 3. PMID: 21372208.
14. Keynan Y, Rimar D. Reactive arthritis–the appropriate name. Isr Med Assoc J. 2008 Apr;10(4):256-8. PMID: 18548976.
15. Czech H. Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna. Mol Autism. 2018 Apr 19;9:29. doi: 10.1186/s13229-018-0208-6. Erratum in: Mol Autism. 2021 Jun 21;12(1):45. PMID: 29713442; PMCID: PMC5907291.
16. Blitzer D, Coleman N, Amory S. A Complex History: Reckoning With Prejudice in Surgery’s Past. Ann Surg. 2021 Mar 1;273(3):e81-e82. doi: 10.1097/SLA.0000000000004523. PMID: 33214431.
