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Views And Reviews Acute Perspective

David Oliver: Caring about language doesn’t mean we can’t care

BMJ 2020; 370 doi: (Published 01 July 2020) Cite this as: BMJ 2020;370:m2524

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Misrepresentation of ‘Inclusive Language’: Further Comment on Oliver’s Views

Dear Editor

First of all, it was a very interesting reading in the ‘views and reviews’ section, which has been written by David Oliver in reply to a post in The Telegraph by Celia Walden. (1) The author clearly demonstrated how Walden as a news reporter has misrepresented the ‘language usage instructions’ in a style guide recommended by the Royal College of Nursing (RCN). (2) Although the issue was regarding the medical professionals, it was a very attractive piece for me as a novice linguist and researcher to look into (as the whole focus was on the topic of language) and bring some fruitful academic discussions.

In the first paragraph, the author has strongly criticized Walden for her use of the phrases and the tone in which she had written, reasonably explaining with explicit sentences the whole intention of the news report on the topic. The second paragraph very much strongly advocated the matter of academic usage (for example, scientific journals, editorials, research reports) of the ‘instructed language’ in the style guide, and actually, it was not much for the front-liners (like nurses, doctors, etc.). The third paragraph focused on the keywords which Walden thought as unnecessary to be replaced, for example, using “people with disabilities” instead of “disabled people” etc. Then the author clearly gave his own opinion, and supported RCN and the recommendation for offensive language usage, and then further refuting the claims made by Walden. The author has emphasized proper language usage, making it more correct, and leaving off any kind of offensive or stigmatized language (intended for the patients).

I totally agree with the whole viewpoint of the author, and additionally referred back to the news report by Walden in The Telegraph, UK. It was really a bad representation of the style guide and language usage instructions in that post. (3)

Some other points must be added to the author’s viewpoint (from a linguist’s perspective). Walden is not only wrong in the representation, but also showed a great lack of knowledge on the topic. The British Government itself has regularized rules for inclusive language, where directions are given on which words to be used and avoided. (4) Thereon, they added similar types of words to be replaced with an array of other words, which are less offensive to the patients. Even developed countries like New Zealand (5) issued instructions on disability etiquettes focusing on language about disability.

Some of the famous universities even designed a ‘Disability Language Guide’ for ‘people with special needs’ back in 2018. (6) I am also very much surprised because there existed significant reports in famous media platforms like Bloomberg (7) and magazines like Forbes, (8) especially focusing on the disability language; unfortunately, Walden seems ignorant of those.

The process of substituting offensive expressions or phrases (with good ones) is called euphemism, which is itself a part of linguistics (semantic aspect). (9) Very interestingly, there is an excellent and speculative research paper on the ‘special needs related euphemism’, which has been published back in 2016 and indexed in PubMed. (10) In addition to the quantitative survey and analysis, the author clearly showed that the word ‘special needs’ has become dysphemism linguistically (the opposite of euphemism - when a term becomes derogatory) with different examples (e.g., ‘dumb’ presently has offensive meaning, but in the past, it meant ‘deaf person’). All the points of this research might not be agreeable, however, the research clearly establishes the fact of euphemism for ‘certain disabilities’ and the association of positivity and negativity with certain terms; which has been clearly denied in Walden’s posts.

In conclusion, I would like to thank the author for the response to Walden where irresponsible claims were found, and to some degree took it to a point of mockery, which is very unfortunate.

1. Oliver D. David Oliver: Caring about language doesn’t mean we can’t care. BMJ. 2020 Jul 1;370.
2. Nursing. RC of. The Royal College of Nursing style guide. [Internet]. 2019. Available from:
3. Walden C. Imposing PC culture onto overworked nurses would be funny if it wasn’t so dangerous [Internet]. The Telegraph UK. 2020 [cited 2021 Jul 21]. Available from:
4. UK Government. Inclusive language: Words to use and avoid when writing about disability [Internet]. 2018 [cited 2021 Jul 21]. Available from:
5. Govt. NZ. Disability etiquette - Office for Disability Issues [Internet]. 2020 [cited 2021 Jul 21]. Available from:
6. Arizona State University. Disability Language Style Guide [Internet]. National Center on Disability and Journalisim. 2018 [cited 2021 Jul 21]. p. 1–9. Available from:
7. Bloomberg. When addressing the Abilities community, words matter and people come first | Our Stories | Bloomberg L.P. [Internet]. Diversity and Inclusion. 2019 [cited 2021 Jul 21]. Available from:
8. Pulrang A. Here Are Some Dos And Don’ts Of Disability Language. The Forbes [Internet]. 2020 [cited 2021 Jul 21]; Available from:
9. Malmkjær K (Ed. . The Routledge linguistics encyclopedia. Vol. 48, Choice Reviews Online. 2010. 241 p.
10. Gernsbacher MA, Raimond AR, Balinghasay MT, Boston JS. “Special needs” is an ineffective euphemism. Cogn Res Princ Implic [Internet]. 2016 Dec 1 [cited 2021 Jul 21];1(1). Available from: /pmc/articles/PMC5256467/

Competing interests: No competing interests

21 July 2021
Naywaz S. Shubha
Researcher, R.I.E.D., Dhaka, Bangladesh.
UG Student (3rd y.), Linguistics, University of Dhaka
131, New Palton Road, Azimpur, Dhaka-1205, Bangladesh.