Smart Doctors, Ignorant Language Constructing Bioethical Disability Rhetoric in Medicine Open Access

Abstract

Language is paramount in the treatment and perception of people with disabilities. The category of “disability” is used to cover a diverse range of experiences, so I have chosen to narrow the scope of this research to the word retard and an associated disability, Down syndrome, as a case study. The transition of the word retard during the last century from a medical classification to a pejorative signifies the power of a single word to impact how people view those with this disability. Medical terminology has been used to incite discrimination against people with disabilities and, in the worst cases, language has even proven lethal. The eugenics movement during the Holocaust exemplifies how medical education can be utilized to provoke certain perceptions and actions towards people with disabilities. Certain practices that continue today, like selective abortion, are reminiscent of these eugenic programs and often use much of the same language. While disability sensitivity has been introduced to the specialty of genetic counseling, it has not been incorporated into the education for medical professionals across disciplines— all of whom will encounter patients with one or more disabilities. For their patients’ health and wellbeing, medical care providers have an ethical responsibility to address people with disabilities appropriately and treat them as more than a problem that requires fixing. The project will culminate in the creation of an educational guide for medical students and professionals about addressing and discussing disability in medical contexts. This can be generalized and built on in future work to cultivate disability cultural competency in medical education and prevent many of the historical mistakes surrounding the discussion and treatment of patients with disabilities.

Table of Contents

Personal Background 1 

Justifications and Methods 2 

Introduction 4 

Chapter 1: A History of the Word Retard, from Patient to Pejorative 10

The Origin Story 10 

Medical Introduction 13 

Reutilization of Language 18 

Spread the Word to End the Word 21 

Implementing Lasting Change 24 

The Campaign Continues 26

Chapter 2: The Importance of Language in Medicine 30 

The Power of Words 30 

Philosophy of Rhetoric 37 

Disability Bias in Medical Language 43 

Lessons From History 50 

Modern Eugenics 59

Chapter 3: Implementation of Disability Cultural Competency 70 

Down Syndrome Diagnoses, A Case Study 70 

Disability Cultural Competency 88 

Available Disability Cultural Competency Review 96

Conclusion 105 

Bibliography 110 

Appendix 127

About this Master's Thesis

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School	Laney Graduate School
Department	Bioethics
Degree	M.A.
Submission	Master's Thesis
Language	English
Research Field	Ethics Language, Rhetoric and Composition Education, Health
Keyword	disability rhetoric cultural competency Holocaust disability abortion Down syndrome medical education disability cultural competency disability inclusion
Committee Chair / Thesis Advisor	Jonathan Crane, Emory University
Committee Members	Rosemarie Garland Thomson, Emory University April Dworetz, Emory University Paul Root Wolpe, Emory University

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