I googled “non-adherent vs. non-compliant” and found
references to the former used in medicine from as far back as 1998 but most
hits were from this century. I could not identify the origination of the switch
or why the term non-compliant was perceived to be judgmental.
I suppose compliant has a more submissive connotation, and
God knows, we should not consider patients as subjugated, but adherent really
means sticky as an adjective and follower as a noun. Is a patient who takes his
meds “sticky” or a “follower”? The difference between the two definitions,
compliant and adherent, is minor at best.
Who decides these things anyway? I don’t remember this being
discussed anywhere.
This phenomenon is not unique to the US. Public health
workers in the UK were recently informed that the use of the word “obese” could
be viewed as derogatory by obese people. The workers were told “that patients
may respond better if they are encouraged to achieve a ‘healthier weight.’” The
full story is here
and is worth reading if only for this amusing mixed metaphor uttered by an
opponent of the UK advice, “If you beat around the bush then you muddy the
water."
There is research on this subject. A 2012 paper from the journal Obesity
[soon to be renamed “Healthier Weight,” I guess] describes a survey of a lot of
people whose weight formerly would have been termed obese but now should properly
be called unhealthily weighted. The term fatness was rated as significantly
more undesirable than all others and excess fat, large size, obesity and heaviness were rated as significantly more objectionable
than the remaining terms, such as weight problem,
BMI, excess weight and the best of all, weight.
It’s not clear how just describing someone as “BMI” or
“weight” will get the message across, but then I didn’t perform the study.
Question: what do you do with a person who needs to achieve
a healthier weight but is non-adherent?
This post appeared on Sermo yesterday and
attracted 28 comments. As you might expect, most did not like the idea of
politically correct terminology.
8 comments:
Yep, sometimes being politically correct is a negative for unhealthy people. I don't think political correctness is good for medicine, it makes patients feel like the problem isn't as bad as it is, so they are less likely to be "adherent" as they might be otherwise. Better to "stick" to telling people what the deal is than tiptoe around it.
Tonja, well put. Thanks.
The term "politically correct" is a right-wing ideological hat-trick. Considering ways in which language can reflect sensitivity to historically underserved factions — women, people of color, people with disease, and yes people of greater-than-perhaps-desirable-weight. I agree it lands us in comical situations with ever-shifting euphemisms, but it's no more "politically correct" than, say, ignoring such concerns. Which has been tacitly politically correct for centuries. And continues to be.
Ruth, you make a good point.
Asking questions are really nice thing if you are not understanding anything totally, except this piece of writing gives nice understanding yet.
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Ruth - The problem with "political correctness" is that it subordinates the truth to a position of secondary importance. By controlling what is acceptable in the public discourse through the instrumentation of public disesteem freedom of speech is harmed. The remedy for speech you don't agree with is more speech. Not persecution.
Tom B, give me liberty or give me (clinical, no make it brain) death.
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