Exploration of Inclusive English Expressions in Medical Journals from the Perspective of Humanistic Care

This study explores inclusive English language practices in medical journals from a humanistic care perspective and proposes localized editorial strategies to improve the inclusivity, ethical quality, and international communication effectiveness of Chinese medical journals. First, it reviewes the guidance established by international authoritative organizations, including the American Medical Association (AMA), the American Psychological Association (APA), the American Chemical Society (ACS), and the Coalition for Diversity and Inclusion in Scholarly Communications (C4DISC), and conducts a systematic textual analysis to systematically examine inclusive English language practices in leading international journals, including The Lancet, New England Journal of Medicine (NEJM), Journal of the American Medical Association (JAMA), and British Medical Journal (BMJ). The analysis focused on four domains: patient and participant designations, disease naming and orthography, treatment framing and narrative voice, and wording for specific populations (e.g., age, disability, sexual and gender minorities, mental health, and HIV/AIDS). Findings indicate that international journals increasingly adopt person-centered terminology (e.g., “people with [condition]”), favor neutral and non-stigmatizing expressions (e.g., “died by suicide”), prefer active constructions that highlight agency, and carefully respect community self-identification by balancing person-first and identity-first formulations depending on context and group preference. These practices reflect three core conceptual shifts: from disease-centered to person-centered discourse, from rigid standardization to contextual sensitivity, and from deficit framing to a function-and-empowerment orientation. These approaches are underpinned by ethical principles of respect for autonomy, cultural sensitivity, precision, and empowerment, yielding practical benefits for research dissemination, reader comprehension, participant dignity, and research ethics. In contrast, this study identifies significant gaps in current Chinese medical journal practice: the absence of explicit institutional guidelines on inclusive English usage; limited awareness and skill among authors and editors regarding subtle humanistic distinctions in English; lack of routine editorial and peer-review checkpoints for non-inclusive English language; and insufficient localized resources that harmonize international norms with Chinese linguistic and cultural contexts. These deficits lead to frequent literal translations, overuse of passive constructions, inconsistent terminology, and occasional stigmatizing or ambiguous expressions that weaken international engagement and ethical presentation. To address these challenges, this study proposes a multi-layered, operational editorial framework tailored to Chinese journals, with key recommendations as follows: (1) developing authoritative, human-centered author and editor guidelines that distinguish mandatory prohibitions from recommended options and provide contextual decision rules for person-first versus identity-first usage; (2) implementing tiered capacity building through practical handbooks, online courses, and editor/reviewer certification workshops; (3) embedding structured inclusive English language checks into peer review and editorial workflows, supported by a three-level editorial review and a language-ethics committee for adjudication of contentious cases; (4) developing localized tools and resources, such as an exemplar repository, intelligent NLP-assisted screening tools adapted for Chinese authors, and empirical studies to evaluate intervention effectiveness. Ultimately, inclusive English language represents a shift from instrumental communication to ethically grounded dialogue—from viewing patients as objects of disease to recognizing them as subjects of life. Upholding the principles of autonomy, precision, cultural sensitivity, and empowerment will enable Chinese medical journals to integrate humanistic values into scientific discourse, thereby strengthening both their ethical integrity and global influence.