It has become increasingly evident that our language in the healthcare sector, particularly in pharmacy, contains terms that, whether intended or not, carry racial undertones. Words such as blacklist, whitelist, master/slave, black market, black sheep, blackout, blackmail are embedded in our professional vocabulary.
While these terms have evolved into technical jargon over time, we must acknowledge that their associations with race, power dynamics, and negativity can be harmful. At a time when healthcare strives to be more inclusive, it is essential to rethink our use of such language in the pharmacy sector.
Commonly used terms with racial undertones
1. Blacklist / Whitelist
Where it’s used: In pharmacy, the terms ‘blacklist’ and ‘whitelist’ are frequently used colloquially. ‘Blacklist’ typically refers to drugs that cannot be prescribed on the NHS, while ‘whitelist’ might refer to those that are approved or included.
Racial undertones: The association of ‘black’ with something negative or forbidden, and ‘white’ with something positive or permissible, perpetuates the idea that ‘black’ is bad and ‘white’ is good.
Alternative suggestions: Denylist or excluded list for ‘blacklist’ and allowlist or approved list for ‘whitelist’.
2. Master/Slave
Where it’s used: While more common in IT and technical systems, terms like ‘master/slave’ may appear in some healthcare and pharmacy systems where one process controls another.
Racial undertones: The terms evoke the history of slavery and are deeply rooted in racial oppression.
Alternative suggestions: Primary/secondary or leader/follower are more neutral alternatives.
3. Black Market
Where it’s used: In the context of pharmacy, discussions about counterfeit drugs, unregulated suppliers, or illegal drug trading often refer to the ‘black market’.
Racial undertones: The use of ‘black’ to describe illegal or illicit activities reinforces negative connotations with blackness.
Alternative suggestions: Illicit market, unregulated market, or illegal market.
4. Black Sheep
Where it’s used: Although not a formal term in healthcare, it may be used informally to describe someone who is an outcast within a team or organisation.
Racial undertones: This idiom reinforces the idea that ‘black’ is undesirable, contrasting it with a ‘white’ norm.
Alternative suggestions: Outlier, nonconformist, or different thinker.
5. Blackout
Where it’s used: ‘Blackout’ is a common term in both medical discussions (referring to loss of consciousness) and in hospital settings (referring to power outages).
Racial undertones: Though not inherently racial, the association of ‘black’ with a negative event (such as loss of consciousness or failure) can contribute to the broader pattern of equating ‘black’ with undesirable circumstances.
Alternative suggestions: Loss of consciousness, fainting, or power failure.
6. Blackmail
Where it’s used: In legal or ethical discussions within healthcare, particularly around coercion or extortion.
Racial undertones: The negative connotation associated with ‘black’ in this term further perpetuates harmful stereotypes.
Alternative suggestions: Extortion, coercion, or intimidation.
The impact of language in healthcare
Language is a powerful tool that shapes perceptions, professional relationships, and the way we interact with patients. In pharmacy, where professionals are on the front line of healthcare and patient care, the words we use in our everyday practice matter deeply. If we, as pharmacists, continue to use terms that carry historical, racial, or cultural baggage, we risk perpetuating subtle forms of bias that can undermine our efforts to create an inclusive, welcoming environment for all.
In a sector that serves a diverse population, the use of racially charged language, no matter how unintentional, can alienate both colleagues and patients. This is particularly important in the NHS, where inclusivity and diversity are core values. Pharmacy professionals, including those in community, hospital, and primary care settings must be sensitive to the ways in which language can perpetuate harmful narratives, even in technical contexts.
Our role in reviewing the language used
While some publishers may already have removed such terms from their publications, longstanding everyday use of language may still survive from generation to generation of practitioner in the workplace or be reintroduced by colleagues joining from environments that have not yet addressed this issue. We therefore need to check that official pharmacy sources use appropriate wording and also challenge any continued use of outdated terms in day-to-day practice.
As a PDA Representative, I call on the relevant stakeholders (pharmacy bodies, NHS representatives, and educational institutions) to begin reviewing and updating the language in pharmacy and healthcare resources. Here are a few steps that can be taken:
- Language review: Actively conduct a comprehensive review of reference materials.
- Training and education: Provide training to pharmacy professionals to raise awareness about the importance of inclusive language and the impact of outdated terminology.
- Professional standards: Encourage the GPhC to incorporate language standards into their professional frameworks and codes of conduct.
- Public advocacy: Use platforms such as the PDA to publicly advocate for inclusive, neutral language across all pharmacy settings.
Language in healthcare should reflect the principles of inclusion and equality that are core to the NHS and pharmacy practice in the UK. Words like blacklist, whitelist, master/slave, and others have no place in an environment where we are striving to create an equitable space for both healthcare workers and patients. By actively working to remove or replace these terms with neutral alternatives, the pharmacy profession can lead the way in fostering a truly inclusive culture.
It’s time for us, as healthcare professionals, to take responsibility for the language we use and to ensure that it reflects the values we uphold every day in the care we provide.
Will using non-racial undertones end racism? No, I honestly do not think so. However, I feel that this would help ensure that we all think about the words we use and the impact it has on others.
By community pharmacist, Chair of the PDA’s Southeast Regional Committee, and co-opted member of the PDA BAME and Ability Networks, Nav Bhogal
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