Thursday, February 21, 2008

Labelling Patients

Dr Crippen posted yesterday on the government´s latest swipe at GPs - issuing ¨Sick Notes¨ for time-off-work and Invalidity Benefit, insisting, in its relentness spin against GPs, that they should not be issuing ¨Sick Notes¨ but ¨well notes¨.

I totally agree with Dr Crippen - how is he meant to know whether a condition precludes me from being a forklift truck driver in a certain factory/warehouse unless he has conducted or is presented with some kind of workload analysis?

He questioned particularly how a one-off independent evaluation of mental health patients could be justified in classifying the patient as ¨fit-for-work¨. Again I agree with him totally.

But that is not the point of this post ...

In the comments he was roundly criticised by a psychiatrist for calling people with schizophrenia ¨schizophrenics¨. Dr Crippen retorted by quoting the Newer Oxford Shorter Dictionary.

I contributed with this somewhat facetious comment ...

"Is my daughter leukaemic or even a leukaemic? Perhaps she's just plain cancerous ... :) "

On this post Lucia and I and Potentilla discussed as what we wanted to be labelled. Our tentative conclusion - neither ¨victims¨ nor ¨sufferers¨ nor ¨fighters¨ - at worse ¨cancer (or name of particular cancer) patients¨ or better still ¨people with cancer¨ as the far more politicised HIV/AIDS community is now termed.

However, given the vagaries of the etymology of the English language (across all its many variations), I think the Psychiatrist in the comments of Dr Crippen´s post yesterday distracted grossly from Dr Crippen´s argument about government health and employment policy.

Labelling of ¨social deviants¨ varies through the English language.

In politically correct culture, you will not hear the following ...

¨I am a gay¨ (noun).

but you will hear

¨I am gay¨. ¨He is gay¨ (adjective).

And acceptable in most UK male homosexual society.

¨I am queer¨ (adjective). ¨I am a queer¨ (noun).

Acceptable male homosexual to male homosexual, but ¨queer¨ in the context of heterosexual male to homosexual male is almost always derogatory.

I could continue with the terms of lesbo/dyke, nigger/black, spastic/cerebral palsy ...

Much of the terminology above is fairly recent and rapidly evolves (gay/queer have surpassed fairy) ...

But the language of mental health has not changed ... particularly as relatively few severe mental health patients can fight for themselves. I agree, Pyschiatrist, that a person with Schizophrenia should not be a Schizophrenic, but that is how Mental Health is in the English language, and until Mental Health patients or their advocates, particularly GPs like Dr Crippen, can fight for them to be recognised as people with an illness (which they are), but who have been abandoned by the NHS to non-psychiatric GP community care, then leave Dr Crippen, and the other GPs, who are totally behind the health and employment rights of the mental health patient, alone.

People with HIV/AIDS may be half way to winning their lingustic fight (principally through the efforts of gay men). They still have quite a long way to go otherwise (health, employment etc).

I would much rather be a schizophrenic or a diabetic than a schizophrenia or diabetes sufferer, fighter etc.

Dr Crippen is totally behind the rights of the mental health patient - don´t undermine it.

Linguistic fights are not appropriate on our blogs except when we talk about linguistics.

Dr Crippen will change his language when the language changes.

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