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Title of Journal: Clin Orthop Relat Res

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Abbravation: Clinical Orthopaedics and Related Research®

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Springer US

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DOI

10.1002/asna.18921290701

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1528-1132

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Editorial Words Hurt – Avoiding Dehumanizing Lang

Authors: Seth S Leopold Lee Beadling Mark C Gebhardt Terence J Gioe Benjamin K Potter Clare M Rimnac Montri D Wongworawat
Publish Date: 2014/07/25
Volume: 472, Issue: 9, Pages: 2561-2563
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Abstract

The authors certify that they or any members of their immediate families have no commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted articleThe words we use in scientific reporting and patient care matter Poorly chosen and carelessly used words – dehumanizing language – can hurt These words can hurt patients’ feelings they can harm our relationships with our patients and they can change the way we perceive those whom we care for or write about in ways that diminish our ability to work effectively on their behalfWho would use such language In fact many of us do at times often without even realizing it Patients are people they are not “cases” though spoken language and research reports often suggest they are With surprising frequency we receive papers with sentences like “Patients that present for treatment of …” when plainly patients as people should be referred to with the relative pronoun “who” These can be careless mistakes However in a recent paper we saw that same construction followed by “… and the surgeons who treat them …”Some of us might refer to a patient as a “diabetic” but we would not consider calling someone a “schizophrenic” or an “epileptic” The reason we prefer peoplefirst usages like “patient with diabetes” or “individual with schizophrenia” is that this kind of language makes it more clear that our patients are much more than the sum of their particular diagnoses Sometimes language one may perceive as being politically correct is simply correctAlong that same line the way we characterize control groups in research studies can change our perceptions about the patients with the disease or condition being studied Describing a control group as consisting of “normal” or “ablebodied” individuals conveys specific implications about the treatment groups that seldom are correct and in some instances can be both misleading and insulting Many diagnoses from obesity to limb loss to arthritis are attached to patients who feel they are both healthy and ablebodied and who in most important respects are ablebodied Saying or writing otherwise influences both patients’ selfperceptions and our preconceived ideas about these individuals in ways that do not improve our ability to help care for themSometimes peoplefirst language does not fit the bill Recently in the course of processing papers for a symposium on care of patients with limb loss it became evident that nearly all the papers referred to patients as “amputees” A case of mass insensitivity Quite the opposite Some groups of patients with particular diagnoses choose to selfdefine through the language they use Patients who have had amputations appear to be one such group Even the names of some leading advocacy groups – the Amputee Coalition formerly the Amputee Coalition of America wwwamputeecoalitionorg as well as the Paralyzed Veterans of America wwwpvaorg – make this quite plain Those who have cared for patients with these diagnoses know that in some settings the descriptive language some patients use can get quite colorful Both in medicine and outside it groups of individuals who have been marginalized commonly will reclaim language and use it in ways that would not be acceptable outside the group Language is power


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  1. Sterility of the Personal Protection System in Total Joint Arthroplasty
  2. Plain Radiographs Underestimate the Asymmetry of the Posterior Condylar Offset of the Knee Compared With MRI
  3. Functional Restoration of Critically Sized Segmental Defects With Bone Morphogenetic Protein-2 and Heparin Treatment
  4. Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty
  5. The Minimum Clinically Important Difference of the Patient-rated Wrist Evaluation Score for Patients With Distal Radius Fractures
  6. CORR Insights ® : Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial
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  8. CORR Insights ® : Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study
  9. Physician Competence and Skill Part I: The Role of Hospital Corporate Liability
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  11. Tendinosis-like Histologic and Molecular Changes of the Achilles Tendon to Repetitive Stress: A Pilot Study in Rats
  12. Orthopaedic Education in the United Kingdom
  13. What is the Survivorship of Fully Coated Femoral Components in Revision Hip Arthroplasty?
  14. Classifications In Brief: The Paprosky Classification of Femoral Bone Loss
  15. How Does TKA Kinematics Vary With Transverse Plane Alignment Changes in a Contemporary Implant?
  16. Letter to the Editor: Increased Anteversion of Press-Fit Femoral Stems Compared with Anatomic Femur
  17. Elderly Patients Have Similar Outcomes Compared to Younger Patients After Minimally Invasive Surgery for Spinal Stenosis
  18. How Reliable Is the Alpha-defensin Immunoassay Test for Diagnosing Periprosthetic Joint Infection? A Prospective Study
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  20. Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years
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  22. Corrosion at the Cone/Taper Interface Leads to Failure of Large-diameter Metal-on-metal Total Hip Arthroplasties
  23. Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study
  24. Recurrent Giant Cell Tumor of Long Bones: Analysis of Surgical Management
  25. Is ORIF Superior to Nonoperative Treatment in Isolated Displaced Partial Articular Fractures of the Radial Head?
  26. Has the Level of Evidence of Podium Presentations at the Musculoskeletal Tumor Society Annual Meeting Changed Over Time?
  27. Do Oxidized Zirconium Femoral Heads Reduce Polyethylene Wear in Cemented THAs? A Blinded Randomized Clinical Trial
  28. Classifications in Brief: Lauge-Hansen Classification of Ankle Fractures
  29. Strength of Antimicrobial Bone Cement Decreases with Increased Poragen Fraction
  30. High Medium-term Survival of Zweymüller SLR-Plus ® Stem Used in Femoral Revision
  31. Guest Editorial: Perioperative Pain Management in Orthopaedic Surgery: Editorial Comment
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  52. Does a Microprocessor-controlled Prosthetic Knee Affect Stair Ascent Strategies in Persons With Transfemoral Amputation?
  53. Hip Injuries in the Overhead Athlete
  54. Is Stability of the Proximal Tibiofibular Joint Important in the Multiligament-injured Knee?
  55. Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?
  56. The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing
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  58. Midterm Assessment of Causes and Results of Revision Total Knee Arthroplasty
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  60. Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?
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