蕭乃彰／蕭中正醫療體系營運長
在醫學領域中，專業和日常的溝通用語也隨著時間的推移而不斷演變，並變得更加尊重和包容，以下為一些顯著的例子：
“mental retardation” -> “intellectual disability” (有關智能障礙)
“retarded” -> “developmentally delayed” or “person with developmental disabilities” (有關發展障礙者)
“mentally handicapped” -> “person with intellectual disabilities” or “person with cognitive challenges” (有關智能或認知障礙者)
“crippled” or “handicapped” -> “physically challenged” or “person with a disability” (有關身障人士)
“deaf-mute” -> “deaf” or “person who is deaf” (有關聾啞人士)
“invalid” or “shut-in” -> “homebound,” “person with limited mobility,” or “person with mobility impairment” (有關行動障礙者)
“elderly” or “senior citizen” -> “older adults” or “older people”（有關年長者）
“geriatric” or “senile” -> “older adult” or “person with age-related conditions” (有關與年齡相關症狀者)
“schizophrenic” or “schizo” -> “person with schizophrenia” (有關精神分裂症者)
“psycho” or “lunatic” -> “person with mental health challenges” or “individual with psychiatric disorder” (有關心理健康問題者)
“crazy” or “insane” -> “person with a mental health condition” or “person experiencing a psychiatric disorder” (有關精神健康問題者)
“mentally disturbed” or “psychotic” -> “person with a mental health disorder” or “person experiencing psychosis” (有關精神健康障礙者)
“lunatic” or “crazy” -> “person with a mental illness” or “individual experiencing mental health challenges” (有關經歷精神健康挑戰的個人)
“mental institution” or “asylum” -> “mental health facility” or “psychiatric hospital” (有關精神健康照護機構)
“mental patient” or “mental case” -> “person with mental illness” or “individual receiving mental health treatment“ (有關精神健康疾病者)
“dwarf” or “midget” -> “person of short stature” (有關身材矮小者)
“obese” -> “person with obesity” or “person who is overweight” (有關超重者)
“substance abuse” -> “substance use disorder” or “substance misuse” (有關藥物使用障礙者)
“hysterical” -> “emotionally distressed” or “in a state of distress” (有關情緒困擾者)
“confined to a wheelchair” -> “wheelchair user” (有關輪椅使用者)
“victim” -> “survivor” (有關在性侵犯或家暴創傷等情況)
“gender reassignment surgery” or “sex change operation” -> “gender-affirming surgery”（有關性別確認手術）
“homosexual” -> “gay” or “lesbian”（有關性取向）
“homosexual lifestyle” or “homosexual lifestyle choice” -> “sexual orientation” or “sexual identity” (有關性取向或性認同)
“junkie” or “drug addict” -> “person with a substance use disorder” or “individual with substance dependency” (有關具有藥物使用依賴的個人)
“alcoholic” or “drunk” -> “person with alcohol use disorder” or “individual experiencing alcohol dependence”（有關經歷酒精依賴的個人）
“caucasian” or “oriental” -> “white” or “Asian” (有關白人或亞裔人士)
“negro” or “colored” -> “black” or “African American” (有關黑人或非洲裔美國人)
“epileptic” -> “person with epilepsy”（有關癲癇症狀者）
“prostitute” or “whore” -> “sex worker” or “person in the sex industry” (有關性行業人士”
“bedridden” -> “confined to bed” or “person who is immobile” (有關無法活動者)
“amputee” -> “person with limb loss” or “individual with limb difference”（有關肢體殘缺者）
“Mongoloid” or “Mongoloid idiocy” -> “person with Down syndrome” or “individual with trisomy 21″（有關唐氏症患者或是21三體症候群患者）
“chronic fatigue syndrome” -> “myalgic encephalomyelitis” or “ME/CFS”（有關肌痛性腦脊髓炎） “quadriplegic” or “paraplegic” -> “person with quadriplegia” or “person with paraplegia” (有關四肢癱瘓者)
“gangrene leg” -> “person with gangrene affecting the leg” (有關壞疽影響腿部的個人)
“AIDS patient” -> “person living with HIV/AIDS” or “HIV-positive individual” (有關愛滋病毒陽性者)
“sexually transmitted disease” (STD) -> “sexually transmitted infection” (STI) (有關性傳染)
“transvestite” or “cross-dresser” -> “gender nonconforming” or “person who dresses in clothing typically associated with a different gender” (有關穿著與不同性別相關衣服的個人)
“tranny” or “shemale” -> “transgender” or “trans person“ (有關跨性別者)
“incurable” -> “chronic” or “manageable” (有關慢性或可控制的)
“handicapped parking” -> “accessible parking” or “parking for people with disabilities” (有關無障礙停車位)
“nursing home” -> “long-term care facility” or “skilled nursing facility” (有關專業護理機構)
“demented” -> “person with dementia” or “individual experiencing cognitive decline” (有關認知能力下降的個體) “comatose” or “vegetative state” -> “unresponsive” or “minimally conscious state” (有關最低意識狀態)
“freak” or “freak show” -> “person with a unique appearance” or “individual with physical diversity” (有關具有身體多樣性的個體)
“nappy” or “kinky” -> “natural” or “coily” (有關黑色的捲髮)
“failed suicide attempt” -> “suicide attempt” or “nonfatal suicide attempt” (有關非致命自殺未遂)
“personality disorder” -> “psychopath” or “sociopath” (有關反社會行為)
“welfare queen” or “lazy welfare recipient” -> “person receiving government assistance” or “individual in need of social support” (有關需要社會支持的個人)
“cancer victim” -> “cancer survivor” or “person living with cancer” (有關癌症患者)
以上這些醫療用語的變化，正反映出在醫療照護的層面中, 不斷努力使用更尊重、包容、以及更加強調以人為中心思維的語言。
最後再從人類歷史和語言演進的角度來分析，語言使用上的演變是一個動態的應用，文字的意義和使用的方式會隨著時間和文化的變化而不斷推進。我們應該意識到語言的多樣性和變化性，並且尊重不同文化、社會經濟、種族、和身心健康背景中的語言及表達方式。總括來說，應該以更為開放的態度和多元的觀點來看待麻州總醫院MGH對「R」字使用上的爭議，我們應該從醫學、心理學、社會學、語義學、和人文歷史學等多層面角度上來思考這個議題，並尋求建立開放對話的機制，以及尊重多元意見的環境，才可能逐步建立一個更加包容和相互溝通體諒的醫療照護環境，同時保障了病患和醫療人員之尊嚴和權利，而這一切或許可以就從我們所說的話語，和使用的詞彙來開始做起。
【以上言論為第三人投書，不代表本刊立場，讀者請本於客觀事證自行評價】
照片來源：Unsplash示意圖
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