Derogatory Language in Charting: The Domino Effect
DOI:
https://doi.org/10.33940/culture/2021.3.7Abstract
“Dr. Smith” is meeting with a patient in Room 3 who has been admitted for abdominal pain and nausea. He suspects the patient may have appendicitis and will need her appendix removed. Dr. Smith begins to chart, “Ms. Dorian is a 34-year-old female; has a history of abusing alcohol; and is here to be consulted for an appendectomy upon admission for nausea, vomiting, and abdominal pain.”
The Room 3 nurse sits down at the computer to review Dr. Smith’s note on her patient. “Hmmm, maybe a consult for substance use would be helpful for this patient,” she thinks. The nurse puts in an electronic consult request for a social worker to meet with the patient in Room 3.
A few hours later, a unit social worker knocks on the door of Room 3. “Hello, I’m here to conduct an assessment for substance use and discuss alcohol-use resources.” The patient is holding her abdomen while she looks with wide eyes at the social worker. “I have been sober for 15 years. Why are you here?”
References
P Goddu A, O’Conor KJ, Lanzkron S, et al. Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record [published correction appears in J Gen Intern Med. 2019 Jan;34(1):164]. J Gen Intern Med. 2018;33(5):685-691. doi:10.1007/s11606-017-4289-2
Leonieke C. van Boekel, Evelien P.M. Brouwers, Jaap van Weeghel, Henk F.L. Garretsen, Stigma Among Health Professionals Towards Patients With Substance Use Disorders and Its Consequences for Healthcare Delivery: Systematic Review, Drug Alcohol Depend, Volume 131, Issues 1–2, 2013,https://doi.org/10.1016/j.drugalcdep.2013.02.018.
Words Matter: Terms to Use and Avoid When Talking About Addiction. NIDAMED https://www.drugabuse.gov/sites/default/files/nidamed_words_matter.pdf
Jensen ME, Pease EA, Lambert K, et al. Championing Person-First Language: A Call to Psychiatric Mental Health Nurses. J Am Psychiatr Nurses Assoc. 2013;19(3):146-151. doi:10.1177/1078390313489729
Rose D, Thornicroft G, Pinfold V, Kassam A. 250 Labels Used to Stigmatise People With Mental Illness. BMC Health Serv Res. 2007;7:97. Published 2007 Jun 28. doi:10.1186/1472-6963-7-97
John F. Kelly PhD, Richard Saitz MD & Sarah Wakeman MD (2016) Language, Substance Use Disorders, and Policy: The Need to Reach Consensus on an “Addiction-ary”, Alcohol Treat Q, 34:1, 116-123, DOI: 10.1080/07347324.2016.1113103
Kelly, J. F., Dow, S. J., & Westerhoff, C. (2010). Does our Choice of Substance-Related Terms Influence Perceptions of Treatment Need? An Empirical Investigation With Two Commonly Used Terms. J Drug Issues, 40(4), 805–818. doi:10.1177/002204261004000403
Ashford RD, Brown AM, McDaniel J, Curtis B. Biased Labels: An Experimental Study of Language and Stigma Among Individuals in Recovery and Health Professionals. Subst Use Misuse. 2019;54(8):1376-1384. doi:10.1080/10826084.2019.1581221
Verheij RA, Curcin V, Delaney BC, McGilchrist MM. Possible Sources of Bias in Primary Care Electronic Health Record Data Use and Reuse. J Med Internet Res. 2018;20(5):e185. Published 2018 May 29. doi:10.2196/jmir.9134
Leonieke C. van Boekel, Evelien P.M. Brouwers, Jaap van Weeghel, Henk F.L. Garretsen, Stigma Among Health Professionals Towards Patients With Substance Use Disorders and Its Consequences for Healthcare Delivery: Systematic Review, Drug Alcohol Depend, Volume 131, Issues 1–2, 2013, (http://www.sciencedirect.com/science/article/pii/S0376871613000677)
