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I’ll have the honour of chairing the BMA annual representative meeting this year, and events like these are a really important time for us to think about the language we use when we talk to each other.
This isn’t about ‘political correctness’. It’s about using language in a way which reflects good manners and sensitivity.
Here are some things I’ve learned from my own experience. I’d welcome other suggestions too.
1 Naturally, we spend a lot of time talking about the patients we serve. When we refer to conditions, they’re something a person has, not what a person is. People have diseases, they don't suffer from them.
2 People of the same age group are not one homogenous mass. This may sound obvious, but so often you hear of older (or younger) people supposedly having a collective attitude, or ascribed with the same abilities or lack of them - as if millions of people who happened to be of similar age would all do and say the same thing. This tends to rob people of their individuality.
3 Unless you’re a child prodigy, most people have to wait until they’re adults until they qualify as doctors. So, no woman attending a doctors’ conference, and no other women for that matter, should be referred to as a ‘girl’. ‘Ladies’, ‘love’ and ‘dear’ are regarded as patronising by many women and should be avoided. Instead, we have names and professional titles and we should use them.
4 A distinction is sometimes drawn between LGBTQ+ and ‘straight’ people. This shouldn’t happen. Trans-gender people can be any sexual orientation, including straight. And remember that LGBTQ+ may possibly be referring to both sexual orientation and gender identity.
5 We must put the person before the disability. We should not speak of people as if they are walking, talking disabilities. They are people with a disability. And we should avoid terms that imply normalcy or being healthy when referring to people without a disability. They are simply people without a disability.
6 We should avoid irrelevant ethnic descriptions as we avoid irrelevant gender descriptions of people. And if we speak of the ethnicity of an individual, it is better to say what they are – for example black or Asian – rather than group them all together under the collective name – ‘black and minority ethnic’ given to all people who are not part of the white majority in the UK.
7 It’s best to avoid Christian-centric terms. So ‘Helena’ is my first name rather than my Christian name.
8 And finally, a very specific one which a colleague shared with me recently. If you are looking for a conversation starter with a women at a conference, then by all means talk about the weather, and how they got there, but it can be a real wind-up to be asked about the husband left at home, having to somehow look after the kids without burning the fish fingers. It’s a statement one often hears, and contains so many assumptions. Would you ask a man about his female partner at home, having to look after the kids, poor thing? I doubt it.
Helena McKeown is acting chair of the BMA representative body
Good to see leadership from the top, Acting Chair. How are we to address you?
Please feel free to call me Helena when I’m not chairing the meeting. During the meeting it’s appropriate to refer to the acting chair of the meeting as acting chair, thank you for asking.
Thank you for this wonderful contribution. We have the same problems in the US. I would only add to your advice that we should respect generational differences. Although modern developed societies—even those in which English is not the dominant language—are characterized by growing informality, many older people are offended when a younger person assumes that upon first meeting, the older person won’t object to being addressed on a first-name basis.
Therefore, if you’re aged 30 or younger and you meet for the first time an older person aged 70 or so, be honest: “We haven’t met before, and I want to be sure I address you properly. Do you prefer to be called [Mr or Mrs] Smith, or would it be all right if I called you by your first name?” You’ll receive an honest answer, and might make a friend for life, because your respect for their individuality and dignity will make a favorable impression. You might even be surprised: “I won’t mind if you call me by my first name”. Above all, don’t impose Ms upon an older woman. Older women, especially if they’ve spent decades at home taking care of their husbands and children, are proud to have done so, especially if they’ve sacrificed a career in order to do it. To them Mrs is an honorable title.
Traditionally, when address is asymmetrical between an older person and a younger one [the older person calls the younger one by first name, but the younger one calls the older one by title and last name], it’s the older person who takes the initiative in shifting address forms to the symmetrical first-name basis.
If you’re younger, this shift will be difficult to make, especially if you’ve known the older person for a long time, and he or she is much older than you and widely respected. I’ll never forget how painful it was for me to switch to symmetrical first-name address with an older physician (MD) whom I admired and always called Dr _____. He finally became irritated and said to me, “If you insist on calling me Dr _____, then I’ll start calling you Dr Anderson—because I have a PhD. [I’m a medical editor and consultant linguist.] I was horrified by the prospect, and immediately began calling him by his first name.
These generational differences occur in other countries too, although they play out in more complex ways than they do in English—for instance in francophone countries, between the pronouns “tu” (informal) and “vous” (formal).
Doctors face name problems especially with older patients. Regrettably, many doctors avoid the problem altogether, by omitting names. When they enter the exam room, they smile, and simply say, “How are you today?” Doctors should do better than this.
Janet Byron Anderson, medical editor and consultant linguist, North Olmsted, Ohio
There is some disagreement amongst communities on the 'person-first' vs 'identity first' language.
Some explanation for those who don't want to read those:
On 1, particularly within communities of neurodiverse people, people self describe: "I am autistic"; "I am an autistic woman" in the same way you would say "I am blonde" rather than "I am a person with blondeness". Surveys have found that autistic people tend to see autism as part of them, inseparable, rather than something they 'have' and which requires cure. Whilst 'person-first' language is designed to promote respect for the humanity of individuals, it actually tells them that something that is intrinsic to their person is negative.
On 5, there are many people who will defend the right to name themselves as disabled. This responds commonly to a social model of disability - ie that society puts barriers in place to disable people, and these people are then disabled, whereas if the world was accessible they would not be. See this HuffPost article on the issue: https://bit.ly/2IXM20F