AMA releases document on appropriate language and health equity

[Matthew9Thirtyfive]

If someone is actually upset and is dehumanized by the use of the words (especially in a doctor-patient setting), then not using the words is the only reasonable approach. But again, that's what i literally said in the early posts agreeing with not using the words "diabetic" and "asthmatic". I asked Moko about whether they saw anyone offended by blacklist/whitelist for a reason (to see if they share similar stigmatization).

But that wasn't my argument. That's the point of being mindful in using language and not offending people which i agreed. My point is the AMA took this legitimate suggestion and added a lot of absurd nonsense that diluted and weakened its message. And linguistically speaking, i was viewing blacklist/whitelist in context of a grayscale that had no racial meaning. If that's factually wrong, i'll reevaluate.

Right, but what we’re saying is that just because there are less reasonable suggestions, that isn’t a good argument to discredit the whole thing which some people will do.

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[DD214]

Right, but what we’re saying is that just because there are less reasonable suggestions, that isn’t a good argument to discredit the whole thing which some people will do.

Some of us are enlightened enough to see behind the curtain

 

[Lawpy]

Right, but what we’re saying is that just because there are less reasonable suggestions, that isn’t a good argument to discredit the whole thing which some people will do.

That i don't disagree. I just think the message would be stronger by removing the nonsense

 

[Matthew9Thirtyfive]

Some of us are enlightened enough to see behind the curtain

That’s one way to describe it, but not one based in reality.

 

[Billiam95]

It is really interesting that America equates anything related to someone’s identity as “politics”. Also, why does this alienate 50% of the membership? Who is the group you are referring to?

This document alienated approximately 50% of posters in this thread - I think it's fair to extrapolate this small sample to the general physician population. Republicans are doctors, too.

 

[Billiam95]

Why should using preferred language that doesn’t offend or dehumanize patients alienate any physician? Are your political beliefs so deeply rooted that you’re offended that patients don’t like being referred to by their disease and would rather keep making them feel bad just to stick it to the “woke culture?”

I reject that premise that normal speech is dehumanizing, nor will I modify my speech to placate woke online mobs.

 

[DD214]

That’s one way to describe it, but not one based in reality.

So you don't recognize the insidious attempts of proponents of "social justice" to change the language and therefore the thought patterns associated with it?

I also suggest you read 1984

Then read it again

 

[Matthew9Thirtyfive]

I reject that premise that normal speech is dehumanizing, nor will I modify my speech to placate woke online mobs.

So when a patient with sickle cell says it is dehumanizing to them to be called a sickler, then what…they’re lying?

And thanks for proving my point. You care more about your own feelings than about those of your patients. Republicans are doctors too, but being a Republican doesn’t automatically make you not care about people. That’s just being self centered and a jerk.

 

[Matthew9Thirtyfive]

So you don't recognize the insidious attempts of proponents of "social justice" to change the language and therefore the thought patterns associated with it?

I also suggest you read 1984

Then read it again

Classic.

 

[VA Hopeful Dr]

You’re still missing the point.

The only person I’ve ever heard call an Asian yellow was another Asian. But apparently some dude just used it at a talk about racism lol.

Umm... Yellow Peril - Wikipedia

 

[Matthew9Thirtyfive]

Umm... Yellow Peril - Wikipedia

Just because I’ve never heard anyone say it doesn’t mean it isn’t a slur. Just means I’ve never heard it. I didn’t deny its existence.

 

[Crayola227]

It is really interesting that America equates anything related to someone’s identity as “politics”. Also, why does this alienate 50% of the membership? Who is the group you are referring to?

I want you to come play with us in SPF

 

[nofliesonme]

What racial negative association is there with yellow?

Yellow streak, yellow belly, code yellow, yellow dog, yellow journalism, yellow bellied chicken, yellow peril, yellow press

 

[Matthew9Thirtyfive]

Yellow streak, yellow belly, code yellow, yellow dog, yellow journalism, yellow bellied chicken, yellow peril, yellow press

Yellow belly and other yellow belly versions of being a coward are not racial and never have been. That’s what I thought he was getting at. Have never heard any of the others. Had to look them up.

 

[Crayola227]

You’re still missing the point.

The only person I’ve ever heard call an Asian yellow was another Asian. But apparently some dude just used it at a talk about racism lol.

You might not be aware but "yellow" has been used for Asian people about as much as "red" for American Natives. It's not rare or uncommon in circles that use such language and have for centuries.

 

[DD214]

Classic.

So you can't actually refute my point which ties directly into the document in question that started this entire thread?

Open your eyes, or keep your head buried in the sand

 

[Matthew9Thirtyfive]

You might not be aware but "yellow" has been used for Asian people about as much as "red" for American Natives. It's not rare or uncommon in circles that use such language and have for centuries.

Yes, about 4 people have said that in this thread. I have literally never heard anyone say yellow for Asians except an Asian doctor lol. But clearly it has been and probably continues to be used plenty.

 

[Matthew9Thirtyfive]

So you can't actually refute my point which ties directly into the document in question that started this entire thread?

Open your eyes, or keep your head buried in the sand

Your “point” is not an actual valid argument.

So you don't recognize the insidious attempts of proponents of "social justice" to change the language and therefore the thought patterns associated with it?

This presupposes that the people suggesting these changes have an ulterior motive. It’s not actually an argument for why that is, but rather a loaded question meant to put the other side on the defense and prove a negative. Classic tactic.

I also suggest you read 1984

Then read it again

This is just reference to a novel, clearly meant to imply that anyone who disagrees with you just doesn’t know enough.

So there’s no point to refute. You didn’t make any valid points.

 

[VA Hopeful Dr]

Yes, about 4 people have said that in this thread. I have literally never heard anyone say yellow for Asians except an Asian doctor lol. But clearly it has been and probably continues to be used plenty.

I will say I've never personally heard anyone say it outside of discussing history so it might not be something that's currently used all that often.

 

[Crayola227]

So you don't recognize the insidious attempts of proponents of "social justice" to change the language and therefore the thought patterns associated with it?

I also suggest you read 1984

Then read it again

If that is the aim though, I still have to wonder what's so awful. Is it always wrong to try to change thought patterns in this way? I say no. Maybe sometimes.

 

[Crayola227]

I will say I've never personally heard anyone say it outside of discussing history so it might not be something that's currently used all that often.

If you're around enough racists that are racist enough or racist that way, you'll hear it and not that uncommonly either. Don't ask me how I've been lucky enough to overhear shyte like this as much as I have.

 

[VA Hopeful Dr]

If you're around enough racists that are racist enough or racist that way, you'll hear it and not that uncommonly either. Don't ask me how I've been lucky enough to overhear shyte like this as much as I have.

Yeah I guess there's lots of racism SC doesn't have. I didn't realize that anti-Semitism was still a thing until my 20s.

 

[DD214]

This presupposes that the people suggesting these changes have an ulterior motive.

"Social justice" leading to tearing down of our country into full blown socialism IS their ulterior motive

They want to change the language to change thought patterns to soften resistance to their far left agenda

These are exactly the kinds of things Orwell warned about

Again, actually READ the novel and see for yourself how this is unfolding in our country

 

[Matthew9Thirtyfive]

Yeah I guess there's lots of racism SC doesn't have. I didn't realize that anti-Semitism was still a thing until my 20s.

It’s very much a thing. It’s getting more aggressive again, and the number of people who justify it is huge, even in medicine.

 

[Billiam95]

So when a patient with sickle cell says it is dehumanizing to them to be called a sickler, then what…they’re lying?

And thanks for proving my point. You care more about your own feelings than about those of your patients. Republicans are doctors too, but being a Republican doesn’t automatically make you not care about people. That’s just being self centered and a jerk.

Comply - or else!

 

[Matthew9Thirtyfive]

"Social justice" leading to tearing down of our country into full blown socialism IS their ulterior motive

Again, you’re not presenting an evidence. Just stating an opinion as fact.

They want to change the language to change thought patterns to soften resistance to their far left agenda

So not wanting patients to feel marginalized is part of a liberal agenda to convert the country to socialism?

These are exactly the kinds of things Orwell warned about

Again, actually READ the novel and see for yourself how this is unfolding in our country

I’ve read it. Multiple times. It’s a novel, not a documentary.

 

[Lawpy]

This is a clear example of racial bias in medicine that needs to be addressed urgently

https://www.nejm.org/doi/full/10.1056/nejmc2029240

https://www.nejm.org/doi/full/10.1056/NEJMc2101321

The AMA should be focusing on this in addition to the initial recommendation of avoiding racially offensive and stigmatizing language rather than undermining its own case with extreme examples and anticapitalist rants

 

[WhittyPsyche]

So let me understand. Yellow and brown also face racial stigmatization. Is your suggestion to redefine any words associated with red, yellow, brown and black that can potentially have any negative meaning associated to it?

There are deeper changes that need to be done to make any progress in racial equity. Medicine is still using white as a prototype for decision making. That's a massive problem in itself and something that needs to be addressed urgently. Of course, if the idea that the lingustic uses of colors have their history of negative connotations based on stereotypes is true, then the language would need to change.

I’m not sure if you are intentionally being obtuse. So to help me clarify with your own question..

What words use yellow with an assumed negative connotation? Brown? Then we can address that specific word.

You already conceded that implicit bias occurs by associations. But now you throw in words like blackberries— what is the repulsiveness/negative of black berries?

The word black isn’t the bad thing. The association and separation of the association is what we are discussing aka implicit bias of language. The issue isn’t that there is a problem with those colors, or the gray scale, but the use of the word. Blackberries does not fit that bill. You are conflating the issue.

 

[WhittyPsyche]

You're not paying attention and as I said before it is obvious you didn't do your homework

This isn't about the rules of the English language, it is about blatant PC overreach championed by the AMA which calls for "Black" to be capitalized and "white" to always be written in lowercase

Please do yourself a favor and read 1984 by George Orwell. You'll learn something

Jesus you are a brick wall. I was waiting for your Orwell call. Your entire rant has been a regurgitation of the Baltimore Sun article (aka word vomit).

The capitalization of Black has legitimacy and the AMA didn’t champion it FYI.
I do not have to use that term to address a separate point or to acknowledge the legitimacy of it. You are 4 messages in still harping on this. If you want any meaningful engagement from me you can try having productive responses.

 

[DD214]

So not wanting patients to feel marginalized is part of a liberal agenda to convert the country to socialism?

Here's a gem from page 12

Equality as a process means providing the same amounts and types of resources across populations. Seeking to treat everyone the “same,” ignores the historical legacy of disinvestment and deprivation through historical policy and practice of marginalizing and minoritizing Getting on the same page: An equity primer AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity, 2021–2023 —12— communities. It has generated unequal society that traces back prior to the founding of our country. Through systematic oppression and deprivation from genocide, forced removal from land and slavery, Indigenous and Black people have been relegated to the lowest socioeconomic ranks of this country. The ongoing xenophobic treatment of undocumented Brown people and immigrants is another example.5 Thus, intergenerational wealth has mainly benefited and exists for white families. The “equality” framework, as applied, also fails individual patients and communities. For example, high-quality and safe care for a person with a disability does not translate to ‘equal’ care. A person with low vision receiving the ‘same’ care might receive documents that are illegible, depriving them of the ability to safely consent to and participate in their own treatment. Equality fails when applied to other domains, including language, health literacy and transgender health. The resulting differences in outcomes among historically marginalized and minoritized populations have been explained away through the myth of meritocracy. It is a narrative that attributes success or failure to individual abilities and merits. It does not address the centuries of unequal treatment that have intentionally robbed entire communities of the vital resources needed to thrive.


Yes, nothing to see here.....

I suspect if you did actually read 1984 you'd see it as an inspirational guide rather than a dire warning

 

[VA Hopeful Dr]

It’s very much a thing. It’s getting more aggressive again, and the number of people who justify it is huge, even in medicine.

Yeah I'm very much aware of it now, I'm just saying I wasn't 16+ years ago because it wasn't much of a thing in SC. I suspect due to very small numbers of Jewish people in the state.

 

[doomer_md]

Again, you’re not presenting an evidence. Just stating an opinion as fact.

They defined “class consciousness” for you in the glossary at the end just in case you weren’t familiar.

Also apparently these authors think the professional clown Ibram Kendi is a reputable source. This whole document is just a circus.

 

[Matthew9Thirtyfive]

Here's a gem from page 12

Equality as a process means providing the same amounts and types of resources across populations. Seeking to treat everyone the “same,” ignores the historical legacy of disinvestment and deprivation through historical policy and practice of marginalizing and minoritizing Getting on the same page: An equity primer AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity, 2021–2023 —12— communities. It has generated unequal society that traces back prior to the founding of our country. Through systematic oppression and deprivation from genocide, forced removal from land and slavery, Indigenous and Black people have been relegated to the lowest socioeconomic ranks of this country. The ongoing xenophobic treatment of undocumented Brown people and immigrants is another example.5 Thus, intergenerational wealth has mainly benefited and exists for white families. The “equality” framework, as applied, also fails individual patients and communities. For example, high-quality and safe care for a person with a disability does not translate to ‘equal’ care. A person with low vision receiving the ‘same’ care might receive documents that are illegible, depriving them of the ability to safely consent to and participate in their own treatment. Equality fails when applied to other domains, including language, health literacy and transgender health. The resulting differences in outcomes among historically marginalized and minoritized populations have been explained away through the myth of meritocracy. It is a narrative that attributes success or failure to individual abilities and merits. It does not address the centuries of unequal treatment that have intentionally robbed entire communities of the vital resources needed to thrive.


Yes, nothing to see here.....

I suspect if you did actually read 1984 you'd see it as an inspirational guide rather than a dire warning

So you have a problem with giving people good and appropriate care? Is that what you’re saying?

You also still haven’t answered the question about how a patient saying the terms used in the examples dehumanizes them is somehow part of a socialist agenda.

 

[Matthew9Thirtyfive]

They defined “class consciousness” for you in the glossary at the end just in case you weren’t familiar.

Also apparently these authors think the professional clown Ibram Kendi is a reputable source. This whole document is just a circus.

I don’t need to read a 50 page document to tell someone their “argument” isn’t valid. The construct of it alone makes it an invalid argument.

 

[Lawpy]

I’m not sure if you are intentionally being obtuse. So to help me clarify with your own question..

What words use yellow with an assumed negative connotation? Brown? Then we can address that specific word.

You already conceded that implicit bias occurs by associations. But now you throw in words like blackberries— what is the repulsiveness/negative of black berries?

The word black isn’t the bad thing. The association and separation of the association is what we are discussing aka implicit bias of language. The issue isn’t that there is a problem with those colors, or the gray scale, but the use of the word. Blackberries does not fit that bill. You are conflating the issue.

That they are related concepts is my point. I'm glad you acknowledged the word black in itself isn't a bad thing (which is one point of clarification). My point was the differing interpretations on white = good and black = bad that have little to do with racial connotations and more to do with how it's related to grayscale. Your point is that these associations are racially driven and determined, when i didn't see it as such.

People discuss in literary and film critique of stories being too black-and-white and lacking gray morality that has a mix of both attributes. That line of reasoning has to do with the grayscale gradient and little to do with racial connotations. So by the same extension, words like black hat, blacklist, blackmail are more to do with the grayscale gradient of bad and not with the racial implication that the race black itself is bad.

Of course, this entire discussion hinges on the idea that using words that can dehumanize and offend people should be avoided, which i don't disagree at all and have made that clear.

 

[Matthew9Thirtyfive]

That they are related concepts is my point. I'm glad you acknowledged the word black in itself isn't a bad thing (which is one point of clarification). My point was the differing interpretations on white = good and black = bad that have little to do with racial connotations and more to do with how it's related to grayscale. Your point is that these associations are racially driven and determined, when i didn't see it as such.

People discuss in literary and film critique of stories being too black-and-white and lacking gray morality that has a mix of both attributes. That line of reasoning has to do with the grayscale gradient and little to do with racial connotations. So by the same extension, words like black hat, blacklist, blackmail are more to do with the grayscale gradient of bad and not with the racial implication that the race black itself is bad.

Of course, this entire discussion hinges on the idea that using words that can dehumanize and offend people should be avoided, which i don't disagree at all and have made that clear.

You’re completely minimizing the issue.

 

[WhittyPsyche]

This document alienated approximately 50% of posters in this thread - I think it's fair to extrapolate this small sample to the general physician population. Republicans are doctors, too.

That was precisely why I asked you to clarify who is being alienated. You don’t say “white people”, or “older (traditional) people”, you say republicans…Which I think you make clear that anything that mentions a demographic identity is politics, and that by nature it alienated republicans. Maybe this is wishful thinking on my part, but I would not think all republicans are alienated by racial equity. If they are then the logical conclusion would be the party is formed and based on maintaining racial status quo aka racial inequity.

Naive or not… I would hope no legitimate republican takes that position. Polarization has made political affiliations into the most ridiculous ideologies. It’s strange to see. As an immigrant from a multi-party system it’s honestly dumbfounding.

 

[Lawpy]

You’re completely minimizing the issue.

How? The point is if people are feeling dehumanized by the supposed racial connotations of the words, then avoiding using those words is the necessary approach. What i'm disagreeing is that the words had racial connotations in the first place.

 

[doomer_md]

I don’t need to read a 50 page document to tell someone their “argument” isn’t valid. The construct of it alone makes it an invalid argument.

Are you serious?

 

[Matthew9Thirtyfive]

How? The point is if people are feeling dehumanized by the supposed racial connotations of the words, then avoiding using those words is the necessary approach. What i'm disagreeing is that the words had racial connotations in the first place.

Right but you’re just tunnel visioning on that. Despite it not originally having any racial connotations, the fact that black = bad is so ingrained in our society and African Americans are called black from the time they’re born is a very real issue.

 

[Matthew9Thirtyfive]

Are you serious?

Yes. Constructing an argument with a loaded question to shift the burden of proof to forcing the other side to prove a negative is an invalid argument. That’s not really a matter of opinion.

 

[WhittyPsyche]

I want you to come play with us in SPF

Ha! I will definitely not do that.

Forums for discussions like those “intellect” parlors of the ole days (save the racism and misogyny) would be more fruitful places to engage in sociopolitical discussions. Online anonymous forums just serve as cesspools for arguments and polarization in which neither side has any intention of actually broadening their point of view but only to put down the opposing side. I’ll pass.

 

[doomer_md]

Yes. Constructing an argument with a loaded question to shift the burden of proof to forcing the other side to prove a negative is an invalid argument. That’s not really a matter of opinion.

There’s clear Marxist undertones in the entire document. They defined “free market” according to James Petras who’s a socialist who supported Hugo Chavez. Completely unrelated, he’s also a massive anti-Semite. Change your mind on the document yet?

 

[WhittyPsyche]

@Lawpy

FYI I responded to your message to me before reading your continued exchanges with others that somewhat responded to my other points. I am still 20 messages behind in this thread.

So to underline I think you understand that the etymology of the word does matter and some words and their connotations aren’t just coincidence. I would also say I disagree that if someone gives 20 recommendations and 10 are really really dire and 5 are more benign that the inclusion of the 5 benign undermines the entire recommendation. But that is my outlook, I do not agree with most attempts to throw the baby out with the bath water. But that may be a difference in perspective.

 

[Lawpy]

Right but you’re just tunnel visioning on that. Despite it not originally having any racial connotations, the fact that black = bad is so ingrained in our society and African Americans are called black from the time they’re born is a very real issue.

And that's an issue that's much deeper than a linguistic meaning. Society is using white as a prototype and standard for pretty much everything, especially in medicine. Tackling that would resolve much of the implicit bias and racial connotation issues than redefining and replacing words that didn't have underlying racial implications.

But if the words themselves are universally despised by the affected communities because of the negative associations, then the words need to be replaced.

 

[Matthew9Thirtyfive]

There’s clear Marxist undertones in the entire document. They defined “free market” according to James Petras who’s a socialist who supported Hugo Chavez. Completely unrelated, he’s also a massive anti-Semite. Change your mind on the document yet?

Okay that’s an actual argument. I’ll have to skim the document when I’m not on inpatient.

As I said, I haven’t read it. I’m not saying anything about it. I’m just pointing out the invalidity of the other argument.

 

[Lawpy]

@Lawpy

FYI I responded to your message to me before reading your continued exchanges with others that somewhat responded to my other points. I am still 20 messages behind in this thread.

So to underline I think you understand that the etymology of the word does matter and some words and their connotations aren’t just coincidence. I would also say I disagree that if someone gives 20 recommendations and 10 are really really dire and 5 are more benign that the inclusion of the 5 benign undermines the entire recommendation. But that is my outlook, I do not agree with most attempts to throw the baby out with the bath water. But that may be a difference in perspective.

It's more that the few good recommendations are overshadowed by many bad recommendations and political talking points.

 

[Lawpy]

Okay that’s an actual argument. I’ll have to skim the document when I’m not on inpatient.

As I said, I haven’t read it. I’m not saying anything about it. I’m just pointing out the invalidity of the other argument.

Table 5: Contrasting Conventional (Well-intentioned) Phrasing with Equity-focused Language that Acknowledges Root Causes of Inequities

Conventional:

For too many, prospects for good health are limited by where people live, how much money they make, or discrimination they face.

Revision:

Decisions by landowners and large corporations, increasingly centralizing political and financial power wielded by a few, limit prospects for good health and well-being for many groups.

I should point out the OP gave misleading examples from the document that defeated his own point. The document is problematic for many reasons

 

[WhittyPsyche]

It's more that the few good recommendations are overshadowed by many bad recommendations and political talking points.

But even you admitted that you aren’t fully aware of the historical context, sociological constructs, or lived experiences that have gone into the recommendations so how have you determines that there are many bad to few good?

I am willing to approach topics with the assumption that just because I don’t find it offensive/valid/whatever on first pass does not mean that it isn’t. Most people here seem to just have a knee jerk response to social change in general and that the status quo is good enough.

Well the status quo is never good enough, that’s the foundation of civilized society, it is ever evolving.

 

[Lawpy]

But even you admitted that you aren’t fully aware of the historical context, sociological constructs, or lived experiences that have gone into the recommendations so how have you determines that there are many bad to few good?

I am willing to approach topics with the assumption that just because I don’t find it offensive/valid/whatever on first pass does not mean that it isn’t. Most people here seem to just have a knee jerk response to social change in general and that the status quo is good enough.

Well the status quo is never good enough, that’s the foundation of civilized society, it is ever evolving.

I wasn't aware that words like blacklist and blackmail had racial connotations that's tied to the society's racist view that black = evil and not the grayscale view of morality. Nor was i aware that people were offended by these words (hence my earlier question to Moko in first page of this thread).

I'm aware of the historical and sociological context of language in general and the need to avoid stigmatizing language.

I have no issues with recommendations like replacing noncompliance with nonadherence and reducing the power dynamic in doctor-patient relationship