Education and debateDo we need a new word for patients?Let's do away with “patients”Commentary: Leave well aloneBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7200.1756 (Published 26 June 1999) Cite this as: BMJ 1999;318:1756
Do we need a new word for patients?
In these days of public involvement and active participation, has the term “patient” become an offensive anachronism or does it capture what is positive about the special relationship between health workers and ill people? A former chairman of the Patients' Association and a clinician argue for and against “patients.”
Let's do away with “patients”
- Julia Neuberger, chief executive (firstname.lastname@example.org)
- King's Fund, London W1M 0AN
- Department of Geriatric Medicine, Hope Hospital, Salford M6 8HD
The word “patient” conjures up a vision of quiet suffering, of someone lying patiently in a bed waiting for the doctor to come by and give of his or her skill, and of an unequal relationship between the user of healthcare services and the provider. The user is described simply as suffering, while the healthcare professional has a title, be it nurse or doctor, physiotherapist or phlebotomist.
Patient comes from the Latin “patiens,” from “patior,” to suffer or bear. The patient, in this language, is truly passive—bearing whatever suffering is necessary and tolerating patiently the interventions of the outside expert. The active patient is a contradiction in terms, and it is the assumption underlying the passivity that is the most dangerous. It is that the user of services will remain passive in sickness, allowing the healthcare professional to take the active part and tell the user what to do. The passive patient will do what he or she is told, and will then wait patiently to recover. The healthcare professional is the healer, while the recipient of healthcare services is the healed, and does not need to take a part in any decision making or in any thinking about alternatives.
An unequal relationship
Clearly this is a gross overstatement, but there is some truth in it. The word patient does conjure up that sense of passivity, because that is its true meaning; the idea of active participation sits poorly with it. Thus, the strongest argument against the use of patient to describe a user …