Communicating with Patients in a Thoughtful and Inclusive Way: New Guidance from the Canadian Public Health Association


Many of the complaints the College receives each year are focused on communication between pharmacy professionals and patients. When patients feel judged, disrespected or excluded during their encounters with pharmacists and pharmacy technicians, they may feel unwelcome or unsafe in the pharmacy, which could lead to negative health impacts.

The Canadian Public Health Association recently released a guidance document to help healthcare professionals have conversations with patients in a respectful and non-judgmental manner, with a focus on sensitive topics around sexuality, substance use and sexually transmitted and blood borne infections. The document provides overarching principles for respectful language, in addition to specific examples.

To assist healthcare professionals, the document lists terms to avoid or use with caution, an explanation of why they are problematic and what to use instead. A selected few examples are listed below, though it is important to note that patients may wish to use words that they feel best describe their own experience and healthcare professionals should be respectful of that choice.

Pharmacy professionals are encouraged to review the Language Matters guidance document to look for opportunities to examine and potentially adjust their language choices in practice. An additional useful resource is Changing the Language of Addiction from the Canadian Centre on Substance Use and Addiction.


Selected Examples from Language Matters

TERMS TO AVOID/ USE WITH CAUTION EXPLANATION USE INSTEAD
“substance abuse”, “substance misuse”, “abuser”, “junkie”, “habit” in reference to substance use These can be interpreted as communicating that the use of substances or addiction represents failure of morals, personality and willpower. “substance use”, “substance use disorder/opioid use disorder”, “problematic substance use”, “person who uses [substance]”, person with a substance use disorder
“lapse”, “relapse”, “slip” 'Lapse,’ ‘relapse’ and ‘slip’ are words that may still be commonly used by people who use substances and those working with them. However, some people feel that they imply blame and judgment toward the person who is using substances. “experienced a recurrence of [symptoms]”, “resumed”
“non-compliant”, “unmotivated”, “resistant” with respect to someone’s participation in services/care These terms reinforce paternalistic models of health care/social services. Individuals have agency, choice, and preferences, and should be active participants in decisions about their health and well-being. The use of these words can work against this goal. “not in agreement with treatment plan”, “opted not to”, “has not begun”, “experiencing ambivalence about change”
“wife”, “husband”, “boyfriend”, “girlfriend”, “mother”, “father” These words, if used without enough information about the person you are referring to, can assert an incorrect assumption about the nature of the relationship between people and an assumption about the gender of the person being referred to. “spouse”, “partner”, “parent”, “guardian”

Table adapted from “Language Matters: Using respectful language in relation to sexual health, substance use, STBBIs and intersecting sources of stigma.” Canadian Public Health Association. 2019