Using euphemisms and jargon in health economics

Are they drug addicts or the chemically dependent?

Are they old people or senior citizens?

Do health economists really need to use the politically-correct (PC) euphemisms of medicine? When is it okay to use jargon in health economics?

As noted by our former editor, Dr David Woods, euphemisms have been referred to as verbal placebos – a way of discussing unpleasant topics in a more palatable manner. But do euphemisms really change the way we think? And should Health economists be encouraged to use them when discussing their economics research of medical topics?

In a recent essay in the Archives of Neurology, the author suggested that the word ‘dementia’ be replaced with actual name of the disease (e.g. corticobasal disease) or the term ‘cognitive impairment’, to avoid the image of a demented individual (i.e. someone who is crazy or out of their mind). Although these terms avoid the stigma of dementia, are they any more relevant to a lay audience? Do they confer the desired information to the patient and loved ones about the condition? One could argue that they simply create more confusion.

“The rationale for encouraging PC euphemisms is to remind physicians (primarily) and other healthcare providers that patients are, first and foremost, people.”

We see many other examples of euphemisms in both lay and medical lexicons, such as cancer survivor, instead of cancer patient; people with diabetes, instead of diabetics; differently abled, instead of disabled. The rationale for encouraging PC euphemisms is to remind physicians (primarily) and other healthcare providers that patients are, first and foremost, people; to avoid letting the patient fall into role of ‘the sick person’; and to avoid any stigma associated with a condition.

An informal survey of a few physicians revealed that euphemisms can have a role to play in avoiding confusion with patients, but the key is honest, open communication in language that all parties understand. However, when discussing medicine among colleagues, more-direct, less-PC language is appropriate. As gynaecologist Margaret Grotzinger, MD, notes;

“I don’t think it would make a difference in terms of how a doctor views or treats a patient – I think that is rooted in the physician’s personality and not by what words [he or she] uses.”

There is also the shorthand that doctors use amongst themselves (e.g. an OCDer, which is a patient with obsessive-compulsive disorder, or ‘the transplant’ in Room 310). Traditionally we have been taught to avoid jargon in formal communication (oral and written), but with colleagues, we often use jargon, if only because it’s easy. According to veteran medical editor Edie Schwager;

“jargon is not a pejorative term in itself. It’s simply a shorthand way of communicating with colleagues, a specialised language used within specialised groups. There’s good jargon and there’s bad jargon. But it all depends on how it’s used. If it’s used to obfuscate, to defraud, it’s very, very bad.”

Should this encouragement of euphemisms or PC language apply to those on the periphery of medicine (e.g. health economists, statisticians, clinical trial designers)? Should Health economists be able to use jargon when discussing their work? In true PC fashion, the answer is, it depends. The health economist, like any physician or any other speaker, must know his or her audience. After all, clarity – not soothed feelings or pedantry – is the ultimate goal. If euphemisms or jargon will best reach those targets, health economists should use them. As politicians learn, time and time again, words do mean things.

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