{"id":1265,"date":"2017-08-16T10:21:28","date_gmt":"2017-08-16T10:21:28","guid":{"rendered":"https:\/\/blogs.bmj.com\/spcare\/?p=1265"},"modified":"2017-11-01T15:40:33","modified_gmt":"2017-11-01T15:40:33","slug":"pejorative-words-or-the-bed-blocker-with-acopia-in-bed-14-that-passed-away-having-lost-her-fight","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/spcare\/2017\/08\/16\/pejorative-words-or-the-bed-blocker-with-acopia-in-bed-14-that-passed-away-having-lost-her-fight\/","title":{"rendered":"Pejorative Words or ‘The bed blocker with acopia in bed 14 that passed away, having lost her fight’"},"content":{"rendered":"

By Dr Ollie Minton <\/a>(Consultant in Palliative Medicine, somewhere in London town),\u00a0Dr Erica Borgstrom <\/a>(Medical Anthropologist, Open University),\u00a0Dr Mark Taubert <\/a>(Consultant in Palliative Medicine, somewhere in Wales)<\/em><\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

When The Adventures of Huckleberry Finn<\/em> was first published,\u00a0readers were not much disturbed by Mark Twain\u2019s use of the n-word<\/em>, let alone ‘injun’<\/em>, terms that have been replaced by slave<\/em> and Indian<\/em> in the latest versions. Back then, profanity and public morality were hotter issues and they would have found today’s scrutiny of those terms curious. We are all guilty of using a patois that we have acquired in our jobs, often handed on to us by our seniors and long-established colleagues. Indeed these turns of phrases are so commonplace that there is an ever growing list known to journalists far and wide; there\u00a0are examples\u00a0in\u00a0book\u00a0form<\/a>, as well as frequently updated phrases<\/a>, and an ever on-going debate on clich\u00e9s and jargon on twitter ( for example: https:\/\/twitter.com\/johnrentoul<\/a>). This is \u2013 as you can imagine \u2013 not a new phenomenon and we all can quote examples of eye-rolling management speak<\/em>.<\/p>\n

But the term pejorative language<\/em> refers to words and phrases that hurt, insult, or disparage someone or something. Also called a\u00a0derogatory term<\/em> or a term of abuse<\/em>. The label pejorative<\/em> (or derogatory<\/em>) is sometimes used in dictionaries\u00a0to identify expressions that offend or belittle a subject. Nonetheless, a word that’s regarded as pejorative in one context\u00a0may have a non-pejorative function or effect in a different context.<\/p>\n

Some see banned words and phrases as a sign of an ever-increasing political correctness society, others point out the offence that\u00a0has been caused. Take the often used description ‘anti-ageing’ in cosmetics. You have heard it frequently, but did you ever think that perhaps older people may find it challenging and off-putting?<\/p>\n

A list of verboten ‘bon mots’ listed on a whiteboard in a Welsh hospital<\/em>\u00a0circulated on Twitter <\/a>recently, which had specific relevance to the specialty of palliative care. Whether we can agree on a definitive list remains to be seen \u2013 that\u2019s for the comments section below. But\u00a0it is a core set to get us started and a visual summary of ideas collated so far.<\/p>\n

The themes that emerged were euphemisms for death or dying like \u201cpass away\u201d or “pass on”. Phrases like \u201cnothing more can be done\u201d, or \u201cthey lost the fight\u201d were also scrutinized. Spelling errors like the extra ‘d’ that some people add at the end of ‘advance’ in Advance Care Plan were seen as minor irritations that distort the true meaning of a phrase.<\/p>\n

The language we use day to day in medicine\u00a0was put in more spotlight\u00a0in a recent TEDX talk\u00a0 <\/a>by Dr Mark Taubert. We try to select our words carefully and sensitively\u00a0\u2013 or at least should do within the specialty \u2013 which is to say we recognise the need for careful phrasing of uncertainty, prognostication, and deterioration, \u201cwhile fostering hope\u201d. Equally we cannot control the public perception or media interpretation of what we do; the word \u201cpathway\u201d, and all of its connotations, has stayed around to haunt us.\u00a0We rarely use the term\u00a0in our local settings\u00a0and now have strong feelings about its use in any context in relation to dying and death. Words evoke emotions, whatever the logical side of our brain tells us about the dictionary definition.<\/p>\n

Phrase that made the abovementioned list include: \u201dthe patient is poorly\u201d, \u201csocial admission\u201d, \u201cbed blocker\u201d, and is \u201cnot coping\u201d or the non-word “acopia”. These terms are judgment laden and do not necessarily add useful information to the user or the recipient. Even if they serve as a form of professional shorthand, they are usually woefully inaccurate and obscure a person\u2019s experience. The lack of objective outcome measures perhaps compounds our ability to convey this.<\/p>\n

In summary we should all expect \u201cbest supportive care\u201d whatever the diagnosis or stage of illness, even when a full recovery can be expected. It should not require a room full of professionals at the MDT (multidisciplinary meeting) to decide on this, especially in the absence of the patient themselves. It should certainly not imply that \u201cnothing more can be done\u201d. What the \u2018banned phrases\u2019 list does is challenge how we articulate what palliative care does and how we talk about patients in perhaps a more respectful way, rather than describe them as “the ovarian in bed 14.”<\/p>\n

End note: if you want to find out more about the visual summary of \u2018banned phrases\u2019 and how to create your own, see the Twitter discussion <\/a>initiated by Dr Mark Taubert and the resulting blog and graphics <\/a>by Dr Erica Borgstrom.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Dr Ollie Minton (Consultant in Palliative Medicine, somewhere in London town),\u00a0Dr Erica Borgstrom (Medical Anthropologist, Open University),\u00a0Dr Mark Taubert (Consultant in Palliative Medicine, somewhere in Wales)               When The Adventures of Huckleberry Finn was first published,\u00a0readers were not much disturbed by Mark Twain\u2019s use of the n-word, let […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":246,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1979,1],"tags":[],"class_list":["post-1265","post","type-post","status-publish","format-standard","hentry","category-social-media","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts\/1265","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/users\/246"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/comments?post=1265"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts\/1265\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/media?parent=1265"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/categories?post=1265"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/tags?post=1265"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}