Can we break medical language barriers and prejudice?

A recent article in The Lancet exhorts medical professionals and researchers to change behaviors that perpetuate medical language barriers and prejudice. It’s a noble request, but the article may leave even the most motivated reader asking “How?”

There are two main kinds of medical language barrier evoked in the article. The first kind is in medical research. Most medical research is written and published in English. For non-native English speakers, this can mean at least occasional the inconvenience, challenges, and confusion of reading or writing in a language that’s not your native one. But for researchers and doctors who don’t speak English at all, the consequences are much more serious.

For instance, if a researcher refuses or is unable to write their findings in English or to have their work translated, a number of prestigious medical journals with worldwide circulation won’t publish them. This creates a barrier in two ways: Non-English speaking researchers are denied access to certain publications, and English speakers who don’t speak the language that the research is written in are denied access to these findings. This situation can seriously impede advances in medicine.

Another medical language barrier is the one that can exist between doctors and their patients. This goes beyond medical jargon; the Lancet article reports that many doctors don’t speak the native language of the local population. They might be on short-term humanitarian missions, for instance. It can also be the case when a doctor works in a location where numerous languages are spoken. The medical language barrier can cause everything from a lack of connection between doctors and patients to medical misunderstandings that could prove fatal.

The Lancet article also addresses another barrier: culture. If doctors, healthcare workers, and researchers don’t understand a group’s culture, it’s harder to communicate with patients about things like the importance of certain treatments or even to give them a clear diagnosis.

Another issue the article brings up is the naming of diseases and other health conditions. This problem was recently in the spotlight when the World Health Organization (WHO) mandated that COVID-19 variants no longer be referred to by their (supposed) place of origin.

As we explored in a previous article, naming conditions this way isn’t a new practice. But calling diseases after countries or groups can incite prejudice and lead to hate crimes, like violence against Asians in the US after COVID-19 was called names like “the China flu.”

The Lancet article also points out that many health classifications like “tropical medicine” can lump together different cultures, making it harder for researchers and doctors to understand their patients’ more specific needs and lifestyles - let alone their humanity. Other conditions, like rypanosoma brucei rhodesiense, contain the names of colonizers, which can cause bad feelings and prejudice among patients and doctors who are aware of them.

All of these are excellent points, but as much as these practices should change, how can they? The article offers no advice.

Looking elsewhere, we can see that the WHO has managed to find a new system for naming COVID-19 variants, using Greek letters rather than place names (the delta variant is currently being watched and worried over by many countries).

But the solution to some of these other problems may not be so (comparatively) easy. For instance, ideally a healthcare provider would know the local language, but that may not be possible if they’re participating in a short-term humanitarian mission or emergency operation; there wouldn’t be enough time to learn.

Similarly, it would be ideal for medical professionals to speak all languages so that they can read medical research from around the world. But this simply isn’t possible.In this case, it seems that medical research does need a lingua franca, and since English seems to be it, why not? That said, as we’ve seen in previous articles, medical journals could also do their part, by offering free translation and by printing the original paper alongside its English translation.

As for the cultural barrier, it would be a good idea for organizations and individual medical researchers and professionals to have easy access to short cultural training courses or, at the very least, printed or online information on a particular culture. Using these resources should be the norm, especially for those who are already able to access them.

None of these suggestions are perfect and they would take time to implement and become a standard, of course. But things can change for the better, as the new COVID-19 variant naming system shows. Maybe one day, solutions like these could be used on a large scale to weaken medical language and cultural barriers, if not break them entirely.

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