Best Practices in Descriptive Medical Nomenclature:
The Campaign to End the “R” Word
Rick Rader, MD
Board of Directors
Seth Keller, MD
Board of Directors
American Academy of Developmental Medicine and Dentistry
Committee’s on Public Policy, External Affairs, Education, and
Student Chapters
The Practice of Medicine:
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Eloquent, descriptive, often cryptic nosology
Dynamic, Progressive, Evolving
Changes over time
Transacts within the context of mainstream society
Doctor of Physic circa 1540
Medicine’s terminology and nomenclature evolves along
with its beliefs, practices and procedures.
Even the name “medicine” is a progressive adaptation
from the original word “physic”.
Discarded Archaic Medical Terms
La Grippe: influenza
Screws: arthritis
Ague: malaria
Bursten: hernia
Coryza: a cold
Mormal: gangrene
The term “Monsters” has been replaced
with “teratogenic defects”
Twenty years ago pediatricians would
readily describe this child as a FLK
(funny looking kid).
Language May Help Create, Not Just
Convey, Thoughts and Feelings
The disciplines of neurolinguistics and psycholinguistics
suggest that language shapes our attitudes
Oludamini Ogunnaike, Yarrow Dunham, Mahzarin R. Banaji. The language of implicit preferences. Journal of
Experimental Social Psychology, 2010; 46 (6) 999
When called upon to describe individuals with
suboptimal intelligence physicians responded
with a litany of descriptive terms…
Moron
• A clinical descriptive term relating to an individuals cognitive
status.
• Reassigned by society to become a negative, stigmatizing
pejorative term
Idiot
• A clinical descriptive term relating to an individuals cognitive
status.
• Reassigned by society to become a negative, stigmatizing
pejorative term
Feeble Minded
• A clinical descriptive term relating to an individuals cognitive
status.
• Reassigned by society to become a negative, stigmatizing
pejorative term
Imbeciles
• A clinical descriptive term relating to an individuals cognitive
status.
• Reassigned by society to become a negative, stigmatizing pejorative
term
Retard
• A clinical descriptive term relating to an individuals cognitive
status.
• Reassigned by society to become a negative, stigmatizing
pejorative term
Rosa’s Law
President Obama signs bill S.2781 (October 2010) Removing the
terms “Mental Retardation” and “Mental Retarded” from federal
health, education and labor policy. “Individual with an intellectual
disability” and “intellectual disability” become preferred terms
Resolution 805-10
Eliminates “mental retardation” from
their documents; replaces “intellectual
disability” as preferred term. 2011
“Mental Retardation” dropped
May, 2013
“Mental Retardation” eliminated in
favor of “Intellectual Disabilities”
“Mental Retardation” dropped
American Academy of Developmental Medicine
and Dentistry declares “Mental Retardation” no
longer represents a valid medical diagnosis;
“Intellectual Disability” proposed as the
preferred term.
Special Olympics Initiative
Pledge your support to eliminate the
demeaning use of the r-word
Best Practice Recommendations
Eliminate “retarded” and “mental retardation” in:
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Conversations
Presentations
Case Notes
Referral Letters
• Death Certificates
• Research Articles
• Public Health Reports
• Teaching Rounds and Lectures
“I’m not my name. My name is
something I wear, like a shirt. It gets
worn. I outgrow it, I change it.”
-Jerry Spinelli