Best Practices in Descriptive Medical Nomenclature: The Campaign to End the “R” Word

Rick Rader, MD Seth Keller, MD Board of Directors Board of Directors

American Academy of Developmental Medicine and DentistryCommittee’s on Public Policy, External Affairs, Education, and

Student Chapters

• Eloquent, descriptive, often cryptic nosology • Dynamic, Progressive, Evolving• Changes over time• Transacts within the context of mainstream society

The Practice of Medicine:

Medicine’s terminology and nomenclature evolves along with its beliefs, practices and procedures.

Even the name “medicine” is a progressive adaptation from the original word “physic”.

Doctor of Physic circa 1540

La Grippe: influenza

Screws:  arthritis

Ague: malaria

Bursten:  hernia

Coryza:  a cold

Mormal:  gangrene

Discarded Archaic Medical Terms

The term “Monsters” has been replaced with “teratogenic defects”

Twenty years ago pediatricians would readily describe this child as a FLK

(funny looking kid).

The disciplines of neurolinguistics and psycholinguistics suggest that language shapes our attitudes

Language May Help Create, Not Just Convey, Thoughts and Feelings

Oludamini Ogunnaike, Yarrow Dunham, Mahzarin R. Banaji. The language of implicit preferences. Journal of Experimental Social Psychology, 2010; 46 (6) 999

When called upon to describe individuals with suboptimal intelligence physicians responded

with a litany of descriptive terms…

Moron

• A clinical descriptive term relating to an individuals cognitive status.

• Reassigned by society to become a negative, stigmatizing pejorative term

Idiot

• A clinical descriptive term relating to an individuals cognitive status.

• Reassigned by society to become a negative, stigmatizing pejorative term

Feeble Minded

• A clinical descriptive term relating to an individuals cognitive status.

• Reassigned by society to become a negative, stigmatizing pejorative term

Imbeciles

• A clinical descriptive term relating to an individuals cognitive status.

• Reassigned by society to become a negative, stigmatizing pejorative term

Retard

• A clinical descriptive term relating to an individuals cognitive status.

• Reassigned by society to become a negative, stigmatizing pejorative term

Rosa’s Law

President Obama signs bill S.2781 (October 2010) Removing the terms “Mental Retardation” and “Mental Retarded” from federal health, education and labor policy. “Individual with an intellectual disability” and “intellectual disability” become preferred terms

Resolution 805-10

Eliminates “mental retardation” from their documents; replaces “intellectual disability” as preferred term. 2011

“Mental Retardation” dropped

May, 2013“Mental Retardation” eliminated in favor of “Intellectual Disabilities”

“Mental Retardation” dropped

American Academy of Developmental Medicine and Dentistry declares “Mental Retardation” no longer represents a valid medical diagnosis; “Intellectual Disability” proposed as the preferred term.

Special Olympics Initiative

Pledge your support to eliminate the demeaning use of the r-word

Best Practice Recommendations

Eliminate “retarded” and “mental

• Conversations• Presentations• Case Notes• Referral Letters

retardation” in:

• Death Certificates• Research Articles• Public Health Reports• Teaching Rounds and Lectures

“I’m not my name. My name is something I wear, like a shirt. It gets

worn. I outgrow it, I change it.” -Jerry Spinelli