1. Pierson, Charon A. PhD, GNP, FAAN, FAANP
  2. Executive Editor

Article Content

There was a lot of political posturing on all sides when it was reported by many news outlets that seven specific words had been "banned" by the Trump administration in documents prepared for budget requests. Those words include: evidence-based, science-based, vulnerable, entitlement, diversity, transgender, and fetus. There was an immediate outcry from scientists, writers groups, advocacy organizations, and others claiming censorship and worse ( A steady flow of corrections and explanations followed from the government and agencies involved in making the recommendations.


My first reaction was not outrage but disbelief. Why, I asked, would anyone want lengthier and less precise language to say something that is perfectly conveyed by precise scientific terms? I still can't get a grip on that idea. As an editor who spends a lot of time thinking about how to say something concisely and often within a restricted number of words, it makes no sense to me. For example, I take issue with recommending that the term fetus, which has a precise definition according to any dictionary, be avoided. A fetus and its stages of development are well defined based on many years of research: The fetus develops from an embryo beginning at about the eighth week of gestation and is called a fetus until birth. Prior to that, it is called an embryo from about 4 days after fertilization to the eighth week of gestation. The key feature of the term fetus, which applies to all mammals, is that the unborn offspring must attain the actual form of the species in the embryonic period in order to attain the definition of the word fetus.


These definitions are based on hundreds of scientific studies and observations. Why would anyone want to obscure a description with imprecise terminology? I think it is also clear that the terms evidence-based and science-based have clear definitions, especially to clinicians, who make daily decisions based on the best evidence for diagnostic tests, therapeutic interventions, and life-saving emergency responses. The term transgender is also very clearly defined in dictionaries and by the legal system. The terms vulnerable, entitlement, and diversity may be a bit vague for some, but within specific disciplines, such as nursing, public health, social work, medicine, the terms are useful, commonly agreed on, and specific. Without some of these precise terms, vital conversations cannot occur; perhaps this is the reason for their banishment.


When I review manuscripts that use imprecise language, I reject them. I cannot rely on what the author is trying to convey when the words change, are vague, misspelled, or meaningless in the context of the overall direction of the paper. It would seem to me that using less precise language in a budget document would be equally problematic. Although I did not see any recommendations for substitute words, a fetus at 6 months of age is not the same as offspring (a term used in the definition of fetus) at 6 months of age; a lack of clarity could easily be confusing to the reader. That's why we have the vocabulary of science. That's why we use that vocabulary. Instructing or suggesting people avoid the use of certain terms, whether it is to avoid political skirmishes or to change the discourse of the nation, will not silence those who work in science-based occupations. We need the vocabulary of science to advance the human condition.