Introduction
In their recent article, “Federal Government’s Growing Banned Words List Is Chilling Act of Censorship” (https://pen.org/banned-words-list/), Pen America compiled a list of 250 words unacceptable to the Trump administration that soon became a list of 350 words. Not to be outdone, Reuters, Gizmodo, The Washington Post, Propublica, More Perfect Union, Science, 404 Media, Popular Information, and Politico’s Energy & Environment News, all piled onto the scrum and tossed in additional words. Seeking possession of the ball, Pen America then collated, agglutinated, and alphabetated the lists into one list of 362 banned words. (Please review the list at the link above before proceeding.) Despite the widespread whinging that has been generated, there has been no rigorous, scientific research on these words (and terms). The purpose of this study is to conduct a scientific analysis of the banned words and their implications for clinical and professional nursing practice.
Lit Review (A Satirical Analysis with a Very Serious Message)
A literature review was conducted using CINAHL, PubMed, Google, and Yahoo, employing the terms analysis + scientific + banned + words. This returned 9,765,021 results. Of these, 9,765,001 articles were excluded on the basis of spelling, grammar, and lack of an abstract in English. Another 19 articles were reviewed and also excluded because they were either boring, confusing, or contained results that were contrary to my own. The remaining article was written by Pen America and became the basis for this research.
Method
The Pen America aggregated list of banned words was examined for typological attributes, orthographic error, and distributed intersectional signage.
Subjects
362 subjects were identified from an inconvenient sample from the aforementioned article. As the words themselves had no moral agency the IRB excused them from signing a consent form.
Findings
Close examination of the 362 subjects found that they preponderated in five permeable categories. These categories were race and xenophobia (100 words); sex, reproduction, and gender (68); social justice (49); environment and climate change (47); health and disease (15); disability (6); English grammar (3); locksmiths or prisoners (3); nursing (3); and several separate categories (e.g. geographic imperialism) containing only one term (e.g. of e.g., Gulf of America); several ambiguous terms (e.g., QT—quart or cutie?), and terms with contested orthographics (e.g., self-assessed v self-obsessed; anti-racism v anti racism v antiracism).
Discussion
The words themselves presented considerable difficulty in that it appears that there was some degree of packing of the lists. Attempts appear to have been made to rig the vote by including variations of the same term such as anti-racism, anti racism, antiracism as separate terms in order to increase their level of statistical significance. Another example of ballot stuffing: bias, biases, biased, biased toward, and biased towards. While it could be argued that there is a profound difference between “increase diversity” and “increase the diversity” it was not clear that they warranted being banned separately.
The emerging typology was constructed heuristically and only with some difficulty. Several categories were clear —race and xenophobia; and social justice. Other types in the typology were discerned only with great difficulty. For example, after much rumination, it was determined that key persons, key groups, and key populations referred either to locksmiths, or possibly to prisoners. Three terms were determined to be directed at nursing: person-centered, person-centered care, and people-centered care. It was, however, unclear whether person-centered care was intended to apply to inpatient care nurses and people centered-care to apply public health nurses, but the public-health nurse consultant to this research was at a conference and not immediately available. While peanut-allergies, as a banned term, was aggregated to the category of health, it raised ontological questions about other terms not on the list, with potential to be banned, such as shell-fish allergy. In addition, the word continuum was included, but why not vacuum? Some words or terms were simply unclear, such as the pristinated methane emissions. Flatus contains hydrogen, carbon dioxide and methane as 74% of the volume of human farts. Since methane and hydrogen are flammable, the banned term should clearly have been flammable flatus as opposed to methane emissions.
Another concern is the relative preponderance of terms within specific categories. It is clear that the largest category, race and xenophobia, is representative of the prevailing political concerns that the list advances. However, its apparent primacy indicates either that the category of sex, reproduction, and gender, is not an obsession after all, or possibly that the deliberate over-representation (over-representation not being banned) of racial and xenophobic words was an attempt to diminish the visibility of the obsession with sex, reproduction, and gender.
Implications for nursing
After a review of the banned terms was conducted and they were pigeon-holed into a typology, a somewhat careful search of the newest iteration of the ANA Code of Ethics for Nurses (the Code) was conducted for each banned word. The new Code employs 31% of the banned terms. Given nursing’s 150-year concerns for social justice, political engagement, environment, and health, one would would expect to see at least 51% of the banned terms in the Code. Admittedly, a number of the banned words are not relevant to nursing (e.g., agrivoltaics or rural lightening strikes), but many are, such as water efficiency. Water efficiency, clearly related to handwashing, is not included in the Code and reflects one of many serious omissions. Several nursing websites such as Nursology, NurseManifest, National Nurses United, The Truth about Nursing; and nursing journals such as Nursing Inquiry, Nursing Ethics, and Advances in Nursing Science employ a greater proportion of the banned terms. The journal Health Equity is an enviable standout in its use of banned words in its title. Nursing’s historical concern for social justice, human rights; sex, reproduction, and gender imposes a claim upon the profession, immediately, to raise its level of employment of the terms that are now banned.
There are however deeper implications of the banned words list; it contains only 15 health and disease terms despite the fact that a wrecking ball has been taken to health and health research structures that now imperils the lives of millions of children, older adults, and communities – the populace. The banned words belonging to the health and disease pigeon-hole are: Covid-19, dietary guidelines/ultraprocessed foods, fluoride, H5N1/bird flu, Marijuana, Measles, mental health, NCI (National Cancer Institute) budget, Obesity, Opioids, peanut allergies, safe drinking water, health disparity, health equity, and vaccines. With the exceptions of health disparity, health equity, and mental health, most of the banned words are not a predominant part of nursing’s expressed concern for the health and well-being of the public and health care justice. Why isn’t social determinants of health on the banned list? Or access to care? Or preventive health care? Or public health? Or food security/hunger, or well being, or health as a right, or human dignity, or human rights, or preventable deaths, or morbidity and mortality, or universal access, or reproductive rights, or…
The “only 15 banned health-related words” has different, deeper, and darker implications: that nursing has not entered the fray, that nursing has not raised its voice, that nursing has not shown outrage. If nursing’s voice were being heard, the health-related banned words would be at least tripled or quadrupled in number. Nursing needs to devote itself to increasing the number of health-related banned words that are offensive to this administration.
There are at least two immediately identifiable problems here. First, nursing statements to date, on the dismantling of health and research structures, are inward-looking, dispassionate statements on losses to nursing, such as the NINR. We are rightly angry about our losses, especially losses that were hard fought and relatively recent wins for nursing—like the NINR, the menopausal baby of the NIH. A second factor is that nursing has failed to move from self-facing losses and its attendant grief and anger, to other-concerned outrage. Where is nursing’s scholarship of outrage? Where is nursing’s activism of outrage? Where is nursing’s vocabulary of social ethics and health justice among the banned words?
Nursing has a voice of passion and compassion if it were to choose to use it. But nursing must first turn from inward-facing anger to outward facing outrage, or righteous indignation as it was called long ago, that issues into a scholarship and activism of outrage that holds destructive and powerful forces culpable. Nurses must unite and join with other other health professions to strengthen resistance—where are our outrage collaborations?
Nursing is not accountable to any regnant administration, whatever it might be. Nursing is responsible and accountable to the people of this nation. Nursing must hasten to raise its voice—it really is a matter of life and death among those whom nursing serves.