Pharmacists across the UK must avoid using terms such as “blackmail” and “blackout” to avoid “harmful narratives” and become more inclusive, according to a senior figure at the Pharmacists’ Defence Association (PDA), the largest union in the profession.
Nav Bhogal, chair of the PDA’s southeast committee, argued that certain terms commonly used in healthcare carry “racial undertones” and proposed neutral alternatives.
In a blog post titled Addressing the Racial Undertones in the Language of Pharmacy, Bhogal highlighted several terms he believes “perpetuate subtle forms of bias.”
One example was the use of “blackout” to describe a patient losing consciousness. “The association of ‘black’ with a negative event can contribute to the broader pattern of equating ‘black’ with undesirable circumstances,” he wrote. Similarly, Bhogal pointed to “black market,” a term often used to describe counterfeit drugs or illegal trade. He argued that using “black” to describe illegal activities “reinforces negative connotations with blackness” and suggested alternatives like “illicit” or “illegal.”
Bhogal, a pharmacist with over 25 years of experience at Boots, also critiqued the use of “blackmail” in discussions of legal or ethical issues in healthcare, stating that it “perpetuates harmful stereotypes.”
He went on to address industry-specific terminology such as “master” and “slave,” commonly used to describe processes where one controls another. “The terms evoke the history of slavery and are deeply rooted in racial oppression,” he wrote, proposing “primary” and “secondary” as more appropriate alternatives.
Explaining his reasoning for the language changes, he wrote: “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.”
In the blog post, Bhogal called on pharmacy bodies, NHS representatives and educational institutions to conduct an immediate “language review” of the material used by pharmacists and offer language training for all professionals in the industry.
He said they should challenge anyone found to be using the terms.
While the stated goal of these recommendations is inclusivity, such interventions are part of a growing trend for workplace speech codes that stray beyond the requirements of equalities law. In turn, this has raised concerns about whether such policies are, in fact, a deliberate attempt to control expression and impose ideological conformity.
This follows previous controversies, such as NHS guidelines which told staff to use “chestfeeding” rather than “breastfeeding”, and “birthing parent” rather than “mother”.
In October 2024, civil servants were told to avoid using terms to describe generations of people – such as ‘millennial’, ‘generation X’, and ‘baby boomers’ – because they allegedly reinforce negative stereotypes and are potentially offensive.
Published by the Northern Ireland Civil Service, the Inclusive Language Guide advises staff to “use more neutral, descriptive and person-centric terms to avoid describing someone only in the context of their age”, and “use language which does not reinforce stereotypes or implies that people of certain ages are good or bad at particular things because of their age”.
Britain’s flagship tourism agency, VisitBritain, has also recently provided staff with a 50-page guide advising them to avoid words like “blacklist,” “blindspot,” and “man hours,” and to instead use alternatives such as “deny list,” “missed opportunity,” and “person hours”.
VisitBritain’s language guide also warns against terms like “wheelchair bound” or “handicapped,” instead advising the use of “person who uses a wheelchair” or “disabled person.” It even suggests replacing casual expressions like “lame” with “uncool” or “cheesy” to avoid offending people with disabilities.
The guide claims that such changes are necessary to foster a “culture of belonging” and to ensure language is inclusive.
Ahead of the Paris Olympic Games in 2024, the International Olympic Committee (IOC) joined the trend, issuing guidelines discouraging journalists from using terms such as “born male” or “biologically male” to describe transgender athletes. The IOC labelled these terms “dehumanising” and urged reporters to adopt language consistent with their inclusive policies.
The move drew criticism from nine-time Wimbledon champion Martina Navratilova, who accused the IOC of waging a Nineteen Eighty-Four version of war on women”. Cathy Devine, a former lecturer in sport and physical activity at the University of Cumbria, also condemned the guide as “breathtakingly sexist and complete propaganda.”
Despite the ferocious backlash, Yiannis Exarchos, chief executive of Olympic Broadcasting Services, promised that his team in Paris would use the guidelines as “our Bible”. This framing implicitly suggests that those who diverge from its principles could be seen as, metaphorically speaking, “heretics.”
As this example suggests, speech codes risk creating a chilling effect, where individuals are discouraged from expressing themselves freely for fear of running afoul of unclear or overreaching rules.
By imposing rules that are vague or excessively broad, organisations effectively compel employees to second-guess their every word, lest they inadvertently violate some perceived standard of appropriateness. Such a climate not only erodes trust but actively suppresses the diversity of perspectives that institutions claim to value.
There’s more on the story here.
