The AMA urges us to promote health equity by adding progressive political language to what were once simple statements of fact.
The American Medical Association has just released Advancing Health Equity: A Guide to Language, Narrative and Concepts. Jesse Singal has been tweeting about it, calling it “a strange document that calls for doctors to insert progressive politics into even plain statements of fact.”
Some of the most egregious language can be seen in Table 5:
While this is all true, I think such language is too cumbersome, convoluted, confusing, and inappropriate to have it intrude on doctor/patient conversations. I think those conversations should be focused on science and medicine, and political statements can be expressed elsewhere. But that’s my personal opinion, as well as that of my husband: he says if his doctor said anything like this, he would find a new doctor. He goes to his doctor for medical reasons, not to be harangued by someone’s political agenda.
We are urged to reform our language, to call ex-cons/felons “Formerly incarcerated/returning citizen/persons with a history of incarceration”. To call diabetics “persons with diabetes”. To avoid the use of the words “blackmail” and “blackball”. To say “enslaved person” rather than “slave.” To avoid using the words “master” and “slave” in software/tech. To say “white” rather than Caucasian, and not to capitalize “White”. To avoid saying target, tackle, combat, or other terms with violent connotation when referring to people, groups, communities, or public health measures (no more “war against drugs” or “war against cancer”.) To replace “homeless” with “people who are experiencing homelessness”.
The AMA says “our current state is built on the land and labor of others in ways that violated the fundamental principles of equity”. And “health equity cannot be achieved without explicit recognition and reconciliation of our country’s twin, fundamental injustices of genocide and forced labor”.
I don’t disagree with that, and I think we should all be more aware of these issues, but I don’t think forcing the discussion into the doctor/patient conversation by specifying the language to be used is the best cure for the inequity that exists throughout our society. Words matter, but our language evolves slowly, not by fiat. The AMA’s Guide is misguided, but it has value in that it will make us think and engage in productive discussions.
I have always been skeptical of “politically correct” language, never more so than in the 1970s when I wrote a letter from the flight surgeon’s office to all the missile officers at F.E.Warren Air Force Base. The letter was kicked back to me for revision because it featured “politically incorrect” language. I had used male pronouns, and they said I should have used language that included women. I refused to revise it because women were not allowed to be missile officers for the Minuteman missiles stationed on our base and I knew that every single one of our missile officers was a cis-gender male. They wanted me to include individuals who were not, and could not be, included. “Political correctness” would have been factually wrong. Political correctness has clearly gone too far.
This article was originally published in the Science-Based Medicine Blog.