Banning Words

Back in February of 2000 Gary Schwitzer first published an article on the 7 words that should not be used by reporters or healthcare workers. These included the following:

• 
  Cure
  Miracle
  Breakthrough
  Promising
  Dramatic
  Hope
  Victim

It was felt that each of these terms was vague and sometimes meaningless when used in a health care context.

These terms can be exciting and possibly help sell papers or move a reporter's story onto page one, but they can be also be dangerous terms that mislead vulnerable people in times of crisis.

Political correctness and the banning of certain words can also be a problem. There are terms that may describe a patient and/or their behavior that is less than flattering, but it is accurate and does add valuable information to the chart and the history.

I disagree with some reporters that using terms like incompetent cervix; the patient failed chemotherapy; or the non-compliant patient represents harmful language by healthcare workers.

Journalists may want to tone down certain words, but physicians need to accurately describe the patients and/or their condition and some of this terminology is very helpful when communicating amongst healthcare workers.

News reports that cover clinical trials also face a challenge with word choices. Trials are performed in an effort to define and decide what new treatments work and which ones don’t.

There should be unbiased reporting although in today’s era, I am not sure this is possible.

Stories shouldn't lead people to believe that the evidence of efficacy and safety is already in hand while the trials go on. "Therapeutic misconception" is a legal term referring to a situation in which people who agree to enroll in clinical trials believe there will be certain benefit from their participation in the experiment.

The clinical trial is an experiment and is not truly a treatment or a therapy, and journalists shouldn't refer to it as such until the evidence is in.

To be more accurate, using the term "patients" to refer to people who agree to enroll in trials is also incorrect in some ways. In these clinical trials, these people are research subjects or participants (more polite terms than guinea pig).

Sensationalizing by journalists can spread "therapeutic misconceptions" by hyping unproven ideas. How often do we hear about a new “wonder drug” only to have it taken off the market a couple of years later?

Words used to describe health care and medical developments are important just as they are in many other arenas. We need to choose wisely and in the appropriate settings.

Richard Horton, editor of The Lancet, understands this problem very well. He is already beginning the process of discouraging use of the word "conclusion" in scientific papers. Horton says that the notion of any single truth, or conclusion, in medicine is nonsense, and that the word, therefore, loses its meaning. "Rather," he writes, "the word interpretation implies an uncertainty that seems more appropriate. The interpretation readers take away from a piece of research depends upon their own background and perspective, as well as their own personal reading of the paper!"

Journalist and newscasters should also heed his advice.