Terminology can affect patients
Words that stigmatise affect patients, relatives and healthcare workers in their perception of a disease. It can influence the behaviour of an entire society towards an illness. The stigma endured by patients with substance related problems can prevent them from seeking help and add an unnecessary psychological burden. I am talking about people formerly referred to as “addicts” or “substance abuser”; it is time to remove the suggestion that a health condition is a moral, social or criminal issue. Just as we no longer speak of cretins, imbeciles or idiots when classifying psychiatric patients, we need to adapt new ways when referring to “substance abuse”.
It has become very popular to mock political correctness and I myself have shaken my head in disbelief of some of its excesses too, but when I am given factual evidence to support a change in terminology, I will listen. An article in the BMJ is reminding us of the importance that everybody including patients, governments and international bodies should use appropriate terminology in relation to controlled substances, as is outlined by the World Health Organisation.
The potential consequences of using imprecise terminology when referring to controlled medicines can affect patients and government policies. A particular duty lies with journals read by healthcare professionals. In my blog post here, I would like to extend this reminder to all medical translators to be aware of terminology that contributes to the stigma of an illness and its consequences.
A few examples on how stigma can be avoided:
The word “abuse” or equivalent words in other languages should generally be avoided unless there is a particular scientific justification. An example of an alternative term in English would be “substance use disorder”
The word “drug” is ambiguous as it can mean medication or non-medically used psychoactive substance. The recommendation is to use the word “medication” or “medicine” instead.
Medical writers should use ‘person first’ language. For example “person with substance use disorder” instead of a language that defines people by an Illness such as “addict”
The word “misuse” could be replaced with a less judgemental term such as “non-medical” or simply “use”
Awareness of stigmatisation is the first step in preventing it. If a translation allows us to choose a non judgmental term, I think we should not hesitate and do our bit to help eradicate all stigmata attached to diseases.