Wikipedia talk:Manual of Style/Medicine-related articles

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To-do list

  • Add advice on how to incorporate the psychological, emotional, and social effects of health problems into articles.
    • should be infused throughout
    • may need some subsections, e.g., reaction to a life-threatening diagnosis
    • I support this one—and not just because I'm a psychologist! ;-) ... We have had discussion about this topic before. Let's link to such archived discussions, e.g., this one from 2008. Mark D Worthen PsyD (talk) [he/his/him] 14:36, 5 May 2021 (UTC)[reply]
  • Add advice on how to present costs.
    • accuracy ("the wholesale list price in Ruritania in 2017 according to Alice", not "the price")
    • WP:MEDMOS2020 results
    • any recommended metrics, such as cost effectiveness, cost per DALY averted,[1] etc.
  • Add statement about gender-neutral language.
    • Avoid unexpected neutrality for subjects very strongly associated with one biological sex (e.g., pregnancy, menstruation, and ovarian cancer affect "women"[2]; prostate cancer and orchiditis affect "men") but encourage gender neutrality for all others (e.g., heart disease)?
    • Defer to MOS for any individual person.
  • Reading levels
  • How to talk about suicide-related content (e.g., the "committed" RFC)
    • I've added a statement about the word "commit", and alternative phrasings. Bibeyjj (talk) 12:10, 28 October 2021 (UTC)[reply]
  • Clarify how to include "evolution" in anatomy articles (suggest under "Development" subheading). Bibeyjj (talk) 18:52, 6 October 2021 (UTC)[reply]
  • (Your idea here)

What to do with this to-do list?

It's not clear to me if the above "To-do list" is a WikiProject Medicine effort, i.e., something we, as a WikiProject, have decided (via consensus) to establish, or if it was one (unidentified) editor's idea, or something else. Can someone clarify? Mark D Worthen PsyD (talk) [he/his/him] 03:51, 4 May 2021 (UTC)[reply]

This is a collection of items that various conversations and disputes have indicated (a) it might be helpful for MEDMOS to address but (b) exactly what the consensus is or how to address the subject in MEDMOS will require further discussion.
Any editor is welcome to add a suggested topic to the list. It doesn't have to be a subject that you personally care about or relates to an article you were editing. Please add enough context that we can figure out what your subject is later.
If you feel ready to address one of the topics, then please start a new ==section== at the end of the page to ask a question or make a proposal. WhatamIdoing (talk) 06:53, 5 May 2021 (UTC)[reply]
Please don't start discussions in this section. Please do add links to prior discussions and examples or other details that you think will be helpful (signed or not, as you choose) when we have the real discussions. WhatamIdoing (talk) 16:35, 5 May 2021 (UTC)[reply]

Not really wanting to be dead

This seems to be of more general interest than I originally expected, so let me add a brief note here:

The medical literature indicates that approximately nobody actually wants to be dead. As in, if you could give people a convincing choice between: you could continue like you are now, or you could be completely happy and healthy, or you could be dead, there are basically no people who would actively prefer being dead. Death isn't an end goal, even for suicidal people. Death is perceived (rightly or wrongly) as a means towards the actual goal, which is to avoid whatever current or feared suffering the person associates with being alive. Someone might prefer death over facing a stressful situation, or might prefer death now to lifelong pain, or might prefer death through one means (e.g., suicide) over death another means (e.g., dying naturally of cancer), but basically nobody actually wants to be dead for its own sake.

Therefore it is misleading to say that we shouldn't imply that all suicidal people wanted to be dead, because that indicates that a non-trivial fraction of people actually do want to be dead (for its own sake), and in practice, we shouldn't imply that any suicidal people actually want to be dead. WhatamIdoing (talk) 16:47, 16 December 2023 (UTC)[reply]

I think it depends how you interpret "want to be dead". Apparently the owners of sports facilities know that when someone goes for a swim they may be both hungry afterwards and minded to reward themselves and purchase an unhealthy snack from a vending machine. Nobody said "Tonight I want to burn 225 calories with a 30 minute swim then consume 225 empty calories eating a Mars bar afterwards." And nobody wrote in their diary "Today was a great day for the diet and I achieved all I wanted. I cancelled out all the benefit of my swim by consuming a sugary snack that's bad for my teeth and made me feel a bit sick for a while". But at the time, they did want the Mars bar.
And then there's the whole controversial assisted suicide matter, which is based on the wishes that the person does really want to be dead now. Arguing that really, underneath, all of us want to live happy healthy lives forever, doesn't seem to meet hard reality and acceptance that you can't always get what you (really) want. Or put another way, this would never be anyone's first choice, but being someone's second choice isn't quite the same thing as saying they didn't want it.
I'm not arguing the text should be changed, but just pointing out that it really depends on how someone views "want" whether they will interpret it how you intended or interpret it differently and thus view the sentence as wrong. I wonder if there is another way of saying what you want to say without saying "wanted to". -- Colin°Talk 08:48, 20 December 2023 (UTC)[reply]
Choosing the lesser of two evils isn't really the same as wanting either.
I don't know of a way to have the same effect without talking about what the person wants. "Don't screw up articles by pretending the person was really looking forward to the whole 'being dead'/Heaven/Nirvana/reincarnation/non-existence part"? WhatamIdoing (talk) 15:28, 20 December 2023 (UTC)[reply]
I think a choice is "want". It doesn't have to be a nice "want" and people can disagree if that "want" is desirable or optimal or rationale. Someone with the genes for breast cancer might want to have a double mastectomy and even long for the operation to go ahead so they can stop worrying about getting cancer. Doesn't mean they'd rather not have been born with those genes and get to keep their breasts. -- Colin°Talk 16:07, 20 December 2023 (UTC)[reply]
WhatamIdoing (talk) 18:23, 20 December 2023 (UTC)[reply]
Dionysus offered Midas his choice of whatever reward he wanted. Midas said he wanted everything he touched to turn to gold. The untold version of this tale has Dionysus saying, no Midas, you don't really truly want that. That's a stupid idea. What you want is huge wealth gained with trivial ease. What I'll give you is this instead.... But the known version has Midas given exactly what he wanted, which ends badly.
One of your links says "I can tell you from my experience, suicidal people do not truly want to die, but see it as the only option to end the pain they are in." (my emphasis). Simply saying "want" isn't specific enough. Further I don't think any of your links cover assisted suicide in terminal illness (you are going to die, and you want some control over how and when) or terrorist suicide bombing or self-immolation.
I think we can cover the point you want to make but I don't think it is encyclopaedic to play rhetorical games with language the way these article titles do. The point with those titles is to surprise the reader, and that's not our game. -- Colin°Talk 19:14, 20 December 2023 (UTC)[reply]
Concur with Colin. And the premise is dubious. If someone dreadfully resented being alive, they would probably suicide ("successfully" seems like the wrong word to use here), and they could not be asked how they felt about it after the fact or how certain they were leading up to it. That is, the available data on the question has a built-in and severe bias of only being able to poll those who were semi-serious about it and made a try that they lived through (i.e. were not so absolutely determined in their demise to arrange its near-absolute certainty), along with the much larger pool of those who went through some suicidal-leaning motions but were really seeking help. The vast majority of everyone in both of the survivor groups would be "didn't really want to be dead" respondents, and there might not be any people among the respondents who were "determined but incompetent at suicide" who really did feel they wanted to be dead (or too few of them to make any statistical dent). So, I'm having a hard time seeing a way to address the question encyclopedically, since it seems like it will require either OR or endorsing dubious claims simply because they've been made. Maybe the most we could do is say that so-and-so has claimed that no people really want to be dead, but we'd not have a reason do that unless there is sufficient independent RS coverage of the claim being made that it would actually be WP:DUE to include it.  — SMcCandlish ¢ 😼  23:08, 8 January 2024 (UTC)[reply]
I don't think the data bears that out. I'm thinking of a particular suicide pattern in my region that is known for its high death rate. Survivors end up with serious, immediately life-threatening injuries and never fully recover from the physical damage. I remember that they tracked down about 20 of survivors (which is most of them), and all but one was glad they had not died during the suicide attempt. One of them said that the very instant that he realized it was too late to reverse the attempt, and that he really was going to die, he realized that he had made a horrible mistake and that he wanted to live.
In larger studies, less than 10% of survivors end up dying by suicide. If they really wanted to be dead, why would 90% of them die years later from other causes?
I think the mental difficulty here is a directional thing. A person who is running between two points could be described as running "to" the destination or "from" the source. So imagine someone who is really running: a teenager is in a really appalling, abusive home situation, and decides to run away from home. The teenager ends up homeless. Do we say that the teenager:
  • wanted to get away from the abuse, or
  • wanted to become homeless?
The same logic applies with suicide: People who attempt suicide want to get away from something they believe is intolerable. We should not describe them as trying to get towards death when they are really trying to get away from the thing they fear. WhatamIdoing (talk) 01:18, 9 January 2024 (UTC)[reply]
SMcCandlish, I suspect those who work in this field have thought through the statistical groupings and we aren't really debating the seriousness of intent. My argument really is that even the briefest and most unthinking intent is still a "want". People want to do all sorts of things, in the moment. I get an itch and I want to scratch it. There's not much conscious thought going on in that "want". That word stretches all the way from one end of the scale to the other, so isn't helpful if someone's argument is based on "want" being at the "solve world hunger" or "live healthily forever" end of the utopian dream.
WAID, I don't think your comparison with homelessness is fair. Correct me if I'm wrong but someone who harms themself but didn't actually intend to die is an accidental death, not a suicide. It is the very definition of the word and our suicide article leads with "Suicide is the act of intentionally causing one's own death". If you didn't "want" to die, in that moment, then it was an accidental death.
Perhaps the issue is the other advice about commenting on motive or indicating this is a solution. That the word "want" can end up being a sign you are doing that, and so best avoided. -- Colin°Talk 10:53, 9 January 2024 (UTC)[reply]
That's a good point and I think I agree with it, but it doesn't invalidate my own; they are not at cross purposes. Those who work in this field very often have an advocacy viewpoint. (It's advocacy that is doing a good thing in the world, but it is nevertheless advocacy of a position and can't be reported as bare fact about the suicidal.) The numbers above support my point: "all but one was glad they had not died during the suicide attempt" necessarily means one was not glad and did/does want to die (or is at least self-convinced of this, and I'm not sure there is an objectively meaningful distinction). "less than 10% of [suicide-attempt] survivors end up dying by [later re-attempted] suicide" is a bit less dispositive (someone might attempt suicide more than once despite not really "wanting" to die), but it certainly cannot be used as evidence they don't really want to die when it points strongly in the other direction. I'm now even more firmly of the view that this idea is an advoacy catchphrase, not a scientific fact that we can claim about those who attempt or contemplate suicide (though a moderated claim, like "very few" instead "nobody" or "approximately nobody" might be supportable as a factual claim). There's also the side issue that there is increasing scientific doubt that we have anywhere near as much free will as we think we do, at least when it comes to important decisions; for an organism whose most overriding instinct is self-preservation, which is strongly determinative of a lack of true desire to be dead among the vast majority suicide attempters, this suggests that a self-declared and long-considered determination to be dead among a small number of individuals is something quite potent. I would think this primarily pertains to terminally ill persons with very high levels of constant pain; I am palpably reminded of my step-grandfather who in the final month or so of his cirrhosis repeatedly begged his hospice nurse to off him; if he'd been capable by that point of getting up on his own, I'm certain he would have brought his condition to a rapid end. I doubt this "really want to be dead" category much ever pertains to people in emotional turmoil, having difficulty coping with life struggles, etc. I'm not a subject matter expert, but have personally witnessed someone who badly wanted to be dead, and the entire voluntary euthanasia debate would not exist if there were not plenty more such cases.  — SMcCandlish ¢ 😼  11:38, 9 January 2024 (UTC)[reply]
I think possibly we can agree that readers (which includes us) have different interpretations of "want to be dead" which is complicating the point we might want to make. Which comes back to my earlier request that maybe there is another way of expressing the point WAID is trying to make. The MOS guidance isn't a headline designed to puzzle the reader into reading an article on suicide regret. But there is value in guiding editors away from lazy tropes and terrible word choices that may encourage a reader when all we really want to do is accurately report someone's death in the same neutral way we might report them dying in a road accident. -- Colin°Talk 18:54, 9 January 2024 (UTC)[reply]
Perhaps we should go back to the wording: Editors should not assume that people who attempt suicide actually want to be dead. This statement is consistent with all of the available evidence. Even if you know for certain that a particular individual is sorry she didn't die during an attempt, you should still not assume that she want(ed) to be dead. You might well be talking to a person who is now so disabled as a result of the suicide attempt that she thinks that dying would have spared her a lot of trouble, but that's not the same as wanting to achieve the state of death.
Can you see the difference between "wanting to be dead" and "wanting to die" (or "wanting to stop living")? An elderly nun with a deep longing for Heaven might actually "want to be dead". An pious Hindu who desires to be reincarnated as soon as possible might actually "want to be dead". A person who says this all sucks and I'm done with it is not someone who actually wants to be dead. That's a person who "wants to stop living" (under these circumstances, at least), not a person who is reveling in the opportunity to be dead. WhatamIdoing (talk) 19:14, 9 January 2024 (UTC)[reply]
Returning to the "should not assume" wording would help, as would the changing "actually want to be dead" to "really wanted to die" tweak suggested below. (That's very different from WP stating as fact that zero or near-zero suicides and attempters really wanted to be dead, which is ultimately OR even if some sources assert this on bases that can't really be proven.) But I don't agree with the hair-splitting you're going for just above; the nun and the Hindu clearly don't want to "be dead" at all, under any definition; they want to enter their eternal life with God in the former case, and enter their next life in the latter, both of which are instances of wanting "to die" in the short term (wanting the current life to end) for the prospect of more and presumably better life afterward, not wanting at all "to be dead", which is being in a state of non-life; so it seems to me that you have their cases backwards. A terminally ill atheist (who is also irreligious in any other way that might not literally involve god[s] but might involve afterlife or rebirth) who is in a lot of constant pain may very well "want to be dead" since for them "wants to stop living" resolves to exactly the same thing, and they've had a long time to mull that over. (I say that as an atheist who has thought on this matter, though fortunately I am not one in such a condition.) That's not to say no distinction can be drawn between "wants to stop living" and "wants to be dead" in other circumstances ("my spouse left me and I'm miserable", "I can't give up this addiction", "all my children died in a car wreck", and other sources of profound depression or despair in which someone might feel life is no longer worth living).  — SMcCandlish ¢ 😼  21:24, 22 January 2024 (UTC)[reply]
The text says that it's a common error to assume that people want to be dead. I think that's both an accurate statement and information editors can use. WhatamIdoing (talk) 15:49, 23 January 2024 (UTC)[reply]
Thank you WAID, this is an interesting topic that I know very little about. Your one-word removal seems justified based on what you've said and the sources you pasted just above. This is not really a major change to the guideline; I'm not sure it merits more discussion here. At a quick glance, this distinction isn't really covered at Suicide. Perhaps those interested in the topic could have a more in-depth discussion of how to cover this distinction at that article's talk page. Ajpolino (talk) 19:17, 20 December 2023 (UTC)[reply]
Just to clarify, WAID didn't really remove that word from the guidance. It was more that it got recently added by another editor, so WAID was restoring the original text (which WAID wrote). I wonder if changing "actually want to be dead" to "really wanted to die" would help, but I think the point WAID is trying to make is more complex than the words here allow and only really touches on the "suicidal behaviour" issue and not other aspects of suicide like assisted suicide in terminal illness or political/terror suicide. The problem really for a guideline is that you need to get your point across in order for our editors to put it into practice, and at the moment the text I think fails in that and just ends up surprising anyone who reads it, which is fine for a clickbait headline. -- Colin°Talk 10:23, 21 December 2023 (UTC)[reply]
Even in the case of medical aid in dying and suicide bombers, being dead isn't the goal. It's the method to achieve a different goal: I want to avoid incontinence*, and since nobody's offering me ways to live a happy and healthy life, I choose dying now to avoid embarrassment later. Or, for the political bomber, I want to hurt them, and the only way I can think of to do that will kill me in the process (except that the suicide bomber isn't usually the one who plans this; they're often a vulnerable person who is manipulated or forced into it by others). When Boko Haram tells a kidnapped girl that she has a choice between having sex with their soldiers or blowing herself up,[3] she doesn't want to be dead. She's not thinking "How lovely, I get to go to Heaven today – I really can't wait to slough off this mortal coil and proceed to the afterlife".
[*] Not a joke. Fecal incontinence is a feared condition among adults,[4] and the fear of future incontinence is one of the most common reasons given in US applications for medical aid in dying – significantly more common than fear of future intolerable pain.[5] WhatamIdoing (talk) 18:25, 21 December 2023 (UTC)[reply]
Perhaps talking about a "goal" would help then. Steps one consciously takes to achieve a goal, whether sensible or foolish, willing or reluctant, are still "want to" steps. Want can be a fleeting, in the moment, feeling. It's the wrong word if you are actually carefully discussing goals or long term aims, etc. The writers of these pieces are playing rhetorical games because "want" is ambiguous and they want to surprise the reader, who only considered the immediate step, with thinking about the long term goal, which may not align. I don't think that should be how a guideline is written. Anyway, I'm now in danger of repeating myself so.. -- Colin°Talk 08:26, 22 December 2023 (UTC)[reply]
Language like "goal" and "steps one consciously takes" imply some level of considered thought, which is not always the case. However, a non-trivial fraction of suicide attempts, particularly among teenagers and young adults, happen less than five minutes after the first thought of suicide. This is why even slight increases in the effort needed to access a method (e.g., a chest-high barrier on a bridge instead of a waist-high one) or a brief interruption (I just read a story about a woman who is alive now because a stranger asked her to take their picture) permanently prevent most suicide deaths.
If at any point you have ideas about how else to indicate that suicide attempts are not really aimed at achieving the afterlife (or oblivion, for the worldwide minority that does not subscribe to any religion), I'd love to hear them. WhatamIdoing (talk) 06:05, 23 December 2023 (UTC)[reply]

"Notable cases" wording

Some poor "some editors" wording in this:

Articles on medical conditions sometimes include lists of notable cases of the disease. For the person to be included in such a list there must be significant coverage of them having the condition, not simply a mention in passing or them self-disclosing on social media. One restriction that some editors favor is to include only those individuals who have lastingly affected the popular perception of a condition, such as through public awareness campaigns that have received enduring media coverage.

is attracting unconstructive edits to harp on "some editors" and make it out to be just some random and disputed opinion to ignore at will, which is not the intent here. I think this should be revised to the following:

Articles on medical conditions sometimes include lists of notable cases of the disease. For the person to be included in such a list there must be significant coverage of them having the condition, not simply a mention in passing or them self-disclosing on social media. At such an article, a consensus may be reached on a criterion to include only those individuals who have lastingly affected the popular perception of a condition, such as through public awareness campaigns that have received enduring media coverage.

This is what we really mean: this is an article-by-article determination. It is not a WP:BATTLEGROUND between WP:FACTIONs.  — SMcCandlish ¢ 😼  22:53, 8 January 2024 (UTC)[reply]

At the time Colin wrote that (17.5 years ago), it was unclear whether that criterion was generally supported. You can read the relevant discussions here and a few scattered comments lower on that page. WhatamIdoing (talk) 01:29, 9 January 2024 (UTC)[reply]
@ SMcCandlish. If an edit can be so thought-provoking that an editor bothers to start a discussion to address to it’s concern, I don’t think it’s really *that unconstructive*. Sometimes I *do* find some reverts unconstructive though.
To clarify … I didn’t “harp on” anything. I made two edits because my edits were repeatedly reverted; and like you, I find the current wording has room for improvement. Perhaps I should have “harped on” words like “restriction” as well.
I’m not sure why you are citing WP:BATTLEGROUND and WP:FACTIONs. I hope I don’t have to cite WP:AGF again.
That said, I do appreciate your efforts in trying to improve the wording. Thanks and regards, --Dustfreeworld (talk) 06:41, 9 January 2024 (UTC)[reply]
Sure, text can always be improved. But wrt style I would favour MOS being more descriptive of helpful solutions editors might pick and less "here is the behaviour we expect editors in dispute to follow". We shouldn't have MOS reminding editors to get consensus when describing each and any matter of editorial choice. Those things belong on other P&G pages. If we are to revise this area, then it might be good to look at some relevant articles and see what pattern arises. For example, I suspect for something rare where there are only a few cases documented in easily accessible literature online, then possibly editors are fine with a low threshold for inclusion.
Btw, from your link "criterion", I think you are thinking about the wrong thing. Here we are talking about "articles on medical conditions" and the "Society and culture" content section of such articles. Not about list articles like List of polio survivors. Such lists were often seen as a solution: get this big list of names out of my article on X disease, and have only the briefest few sentences here. -- Colin°Talk 11:08, 9 January 2024 (UTC)[reply]
Well, we can address this with some other wording/link; the point is that this "some editors" wording is basically an anti-guideline, a "we throw up our hands and refuse to advise anything" line item, which with this wording enshrines dispute (which may be generally illusory outside of this specific case), encourages the manufacture of more dispute where there generally hasn't been much, and even subtly favors one side in the dispute by suggesting that the other is just "some editors" whose opinion can be ignored. MoS should never have things like that in it (it always leads to problems and needs to be either removed entirely, or clarified to advise something one way or another, or explicitly stated to be a matter for editorial discretion on a per-article basis – not phrased as "this group of editors versus that one").  — SMcCandlish ¢ 😼  20:57, 22 January 2024 (UTC)[reply]
I don't think it's an anti-guideline. You probably remember the fights (long ago) over what the ==References== section should be called; the solution at Wikipedia:Manual of Style/Layout#Notes and references was to say what was popular, rather than what we recommended. It solved the problem, and between that and the Article Wizard using the most popular form, we have ended up with largely predictable section headings.
Here, we are indicating that a group of editors – perhaps it is a minority, but, if so, it is a mention-worthy minority – recommend a particular approach. We are indicating the level of consensus and popularity, without demanding that everyone do the same thing in all articles.
It might be valuable to figure out whether/how much sentiment has changed since then, but I don't think it is a problem to provide information about one or more options when editors are unwilling to impose a clear rule on all (relevant) articles. WhatamIdoing (talk) 05:14, 23 January 2024 (UTC)[reply]
I see the word "dispute" three times in SMcCandlish's post but they also note "there generally hasn't been much". I also point out the text is 17.5 years old, as WAID noted further up, so perhaps it is helping avoid dispute. Your suggested change alters the text from a "here's an idea that works for some people" to "Even though the text on this article is stable for decades, MOS now insists you argue about it and gain explicit evidence of consensus, while at the same time MOS only offers one option for you to pick". I don't know. It seems you are looking for problems. -- Colin°Talk 11:06, 23 January 2024 (UTC)[reply]

Possessives in condition names

There seems to be at least a vague consensus both on- and off-site to avoid possessives in names of conditions, i.e. that Down's syndrome and Asperger's syndrome are now an obsolete style. I know I have encountered advice to this effect in multiple offsite style guides, and it's weird to me that MOS:MED doesn't cover it. I'm also occasionally running into article titles like Milroy's disease which seem like they should move, but there's not an entirely clear basis on which to RM them.  — SMcCandlish ¢ 😼  20:46, 22 January 2024 (UTC)[reply]

Previous discussions have suggested that this may be an WP:ENGVAR issue, with British English preferring the non-possessive and American English using the possessive.
Also, @Asto77 may be interested in this, based on the suggestion in Talk:Sjögren syndrome#Article name needs to change surely? WhatamIdoing (talk) 05:04, 23 January 2024 (UTC)[reply]
As someone from the UK, I've never heard of any British preference. For example I think you'll have trouble finding any UK site mentioning Alzheimer's disease without the 's. I've always maintained this is a pronunciation thing where the difficulty of clearly distinguishing the 's in a term where the second word begins with an 's' (Like "Down's syndrome") means it gets dropped in speech. Some people then rationalise this with invented ideas like Down never had his syndrome so how can he own it. Well, I think, if you are so upset with Down's "ownership" then call it trisomy 21 and do away with the owner. Dropping the 's doesn't change the fact that it is some guy's name.
As the linked discussion notes, when people drop the second word and say that someone has Asperger's or has Down's or has Alzheimer's then magically the possessive is universal. Try finding someone who says they "have Asperger" or were "diagnosed with Asperger". Doesn't work. (Of course Asperger's is a legacy diagnosis anyway, in a small way due to not wanting to be associated with this person).
I think this is a good example of a dispute where editors should agree there are more important things for them to do and argue about and leave it to some international committee to decide. I think the current text for our article titles is good advice. If multiple forms of a name are in use without a very clear direction of travel, then find an authority and agree to follow that. -- Colin°Talk 11:29, 23 January 2024 (UTC)[reply]
Agreed. One advantage of "finder" names is that they are far more memorable, at least for the general public, than the usually rather longer proper scientific name. Johnbod (talk) 14:45, 23 January 2024 (UTC)[reply]
I don't think the post was about whether to use an eponym or a technical name, but just whether we include the 's in the eponymous name. Technical names aren't always a direct substitute for eponyms, as sometimes they find that the eponymous name has more than one cause, and the disease gets split, or that several eponyms are the same disease. But again I think this sort of argument is best left to committees, making it "somebody else's problem".
There is some commentary on this issue at List of eponymous diseases. As with many things in science, often the person who gets all the credit wasn't always the first. -- Colin°Talk 09:09, 24 January 2024 (UTC)[reply]
We arguably touch on it where the MOS mentions the ICD as one source of reconciling title disputes for med articles. Whilst I've updated the MOS to refer to ICD-11; WHO began dropping the 's from some code descriptions as far back as the 2010 version of ICD-10. Little pob (talk) 15:42, 24 January 2024 (UTC)[reply]
So far, I'm finding a) no evidence this is an ENGVAR matter, and various US publishers and medical organizations advising against the possessive (plus considerable RS evidence that to the extent there's a national/continental lean on the matter, it is exactly the opposite of that claimed above); and b) general opposition to the possessive in international and national (including US) professional bodies in the field, which is by no means recent but dating back at least as far as the 1970s. The US National Insititutes of Health (inluding the National Library of Medicine) has opposed possessive usage since 1974, the Canadian National Institutes of Health since 1975, the World Health Organization in since 2004 (including in its International Classification of Diseases), and the American Medical Association since 2007 (including in their AMA Manual of Style at § 3.2.22). Scientific Style and Format, one of the style guides our MoS is actually based on, is against the possessive. Various publishers are making to no-possessive rule part of their style guides, e.g. Journal of Medical Internet Research[6], Applied Radiology [7], etc., including many Springer Nature journals apparently (according to editing service AJE.com [8]; I haven't gone digging in all the individual journal style sheets and submission guidelines). Also Dorland's Illustrated Medical Dictionary since 2011, and Stedman's Medical Dictionary are against the possessive use. See also medical information projects essentially aligned with WP's goals, like the radiology-focused Radiopaedia [9], and Eponymictionary [10] which consistently avoid the possessive form (though WhoNamedIt veers back and forth between styles [11] like WP presently does, including cases like "Münchhausen's syndrome" that do not comport with actual usage [12]). Encyclopaedia Britannica has gone non-possessive [13], including with terms that WP is still putting a -'s on unnecessarily. Also anti-possessive are the American College of Clinical Pharmacy [14] and the Centers for Disease Control and Prevention [15]. The shift appears to have started over 70 years ago with the founding of the the National Down Syndrome Society without the "Down's" that then dominated in common practice, and it was no accident. Statistical analysis of modern papers in PubMed show the -'s forms to be rapidly disappearing from professional literature [16] (in American ones faster than in European).

Editorials against the possessive are pretty common, e.g. the one already cited above and [17][18][19][20] (though two [21][22] I have not yet found full-text access to, including via WP:TWL). There are also some polemical counter-essays that rely on traditionalism notions or appeals to what non-medical writers prefer, e.g. this one which only cares what general-audience dictionaries like, and this one with right-wing dogwhistling like "a really silly example of political correctness run amok" (despite this not being a political question); another here includes some rationale why Pascal's principle and similar terms for eponymous laws, procedures, devices, and so on, should still be possessive (though it tries to over-apply this to non-parallel cases like diseases, syndromes, and other conditions), but also concludes with a similar rant against gender-neutrality and in favor of traditionalism and against the natural process of language change. Some essay and other material on this subject is simply neutrally observational that both styles exist but that their conflict/inconsistency is problematic in various ways: [23][24][25][26][27][28][29]. Most dictionaries are very slow to produce new editions or otherwise update their material (though most of those updated within the last generation or so include both possessive and non-possessive forms for the conditions with names commonly encountered in everyday English), and some general-audience style guides are as also slow to update. But the Associated Press Stylebook (dominant guide for American news writing) has made the no-possessive switch. I've not yet checked Mosby's Medical Dictionary or Taber's Cyclopedic Medical Dictionary yet, nor gone over various other mainstream style guides on this question, like Chicago and New Hart's/Oxford current edition; Chicago 16th preferred no possessive, but also said that the possessive form "may be preferred in a general context" (§ 8.143).

So, regarding actual medical usage, "leave it to some international committee to decide .... best left to committees, making it 'somebody else's problem'" essentially has already happened for almost exactly 50 years, with a now generally dominant no-'s result (though some terms seem more resistant to it) that has become our problem. The fact that it was discussed before, some time ago, on WP doesn't mean it should never be discussed again nor emerge with a clear resolution to say something about it in MOS:MED. A literal "some international committee" is basically a red herring: "there is no central body regulating the use of [medical] eponyms. Any changes in designation or use thus must reflect a naturally occurring, emerging, and broadly based consensus ... in effect a reflection of a decision by a [medical] 'court' of opinion." [30]. While not every journal and other medical publisher is in exact agreement on this (and actually British ones that retain the possessive are more common that American ones; so much for the "possessive is an Americanism" ENGVAR claim, also refuted here and here, citing multiple sources), and the decline rate in possessive form of one syndrome versus another is not constant [31], it's clear that the possessive usage has greatly declined since the 1970s. At what point is all of this evidence of a shift, at least within literature competent on the subject, "enough"? I'm often critical of attempts to impose specialist-source writing conventions on Wikipedia, but those concerns do not apply when the best-practice usage in such source material does not actually conflict with a non-specialist writing norm (e.g., we have no problem at all adopting the italics and capitalized-genus format for Homo sapiens and E. coli, nor the space-between-unit-figures-and-symbols standard, and standardized symbols, for 3 mm and 560 cu ft). Here, there is no particular norm but completely random usage in non-specialist sources; the avoidance of the possessive form will not be an "astonishment" for readers, and there is no compelling reason not to standardize (while there are good reasons to do so).

Using the shorter form on WP would not only better agree with the modern source material it would also align better with WP:CONCISE policy. There's also a WP:CONSISTENT argument to make: not only does using a possessive in a few "hold-out" cases like Milroy's disease and Parkinson's disease conflict with most such other articles, various terms of this sort (especially those named after multiple parties such as Tay–Sachs disease and Chédiak–Higashi syndrome) are virtually unattested in possessive form, so normalizing in the opposite direction would not actually be possible. Also, it's worth noting that the Austrlian Government Style Manual [32] draws a distinction we might find useful here, and which seems to encapsulate where the actual usage is going anyway: "If it is a disease named after people who had the disease, use the possessive case. Lou Gehrig's disease, Legionnaire's disease. If it is a disease or anatomical part named after the person who discovered, studied or described it, don't use the possessive case. Alzheimer disease, Down syndrome, Henle loop." And all the material in all the works agree that ones named after places (Ebola virus disease, St. Louis encephalitis, and Lyme disease) never take a possessive. Same with ones named metaphorically after historical, literary, or mythological figures (Marie Antoinette syndrome, Pickwick syndrome, Oedipus complex). PS: Some bodies and works (including Mendelian Inheritance in Man) go further, and suggest replacing all medical eponyms entirely (and there are published debates on the idea [33]), but this seems a bridge too far, especially for WP, which is bound to a pretty strong extent by WP:COMMONNAME. However, that is not a style policy, and whether to possessivize something would seem to be a style question (plus a redirect should always exist from the -'s form and from the curly -’s form as well).  — SMcCandlish ¢ 😼  23:44, 26 January 2024 (UTC)[reply]

I think this is a good analysis, but I don't think it strikes at the core of the issue, which is that people (including editors) feel strongly about the Right™ Way, and if we pass a law on high that says all right-thinking editors will obviously want to do it our way, they won't. Sjögren syndrome has already been moved to the non-possessive twice, and there are complaints on the talk page about it using the "wrong" form. Down syndrome has been argued over since the second-ever comment on the talk page in 2004 (not to mention 1, 2, 3, 4 [the RM], 5, 6, and probably more), and despite having what you'd call the "right" answer, it does not appear to make people happy. WhatamIdoing (talk) 00:46, 27 January 2024 (UTC)[reply]
There are always "complaints ... about ... using the 'wrong' form", when it comes to every style issue and every style guide and every publication, and it never actually comes down to "right-thinking", which is just subjective preference. It is never a reason for a publication's style guide to fail to settle a glaring consistency problem one way or another, even arbitrarily, though in this case it's not arbitrary, as professional usage is strongly moving away from the possessive (for half a century now), and it's more concise anyway. If they only down side is "someone somewhere might not like it", that's always true of every such decision and never prevents us making the decision.  — SMcCandlish ¢ 😼  04:46, 15 February 2024 (UTC)[reply]
You say "professional usage is strongly moving away from the possessive". Do you have any evidence for that, outside of "--- syndrome" disorders like Down's. The stats below show that really isn't true for the two "--- disease" conditions I looked at. Pretty much every article on the topic cites the National Down Syndrome Society's request to drop the possessive because "the syndrome does not actually belong to anyone". And any study of trends tends to pick Down's. There's never any other compelling reason given compared to all the other arguments we get about medical language being dehumanising or offensive or archaic or jargon.
It's a pretty weak argument. Consider if we are all at the beach and decide to skim stones. We look around and each pick one. WAID says "Colin's stone looks the best for skimming". We all skim the stones. I say "But WAID's stone did the most hops and went furthest". None of us owned the stones, and all of us lost the stones forever. They never belonged to us either, we just held them for mere seconds. We also might talk about Colin's employer or WAID's terrible journey to work on Monday. Those don't belong to us either.
I don't know why the Society isn't more concerned to use a proper name for the condition, rather than naming it after someone who thought "the Mongolian type of idiot" and "Mongolian defectives" was ok. Or get upset that so many conditions or parts of bodies are named after European white men. An 's doesn't change that. -- Colin°Talk 12:24, 15 February 2024 (UTC)[reply]
About never prevents us making the decision:
First, yes, it does; see Wikipedia:Main Page design for many examples of "someone somewhere might not like it" stopping the Wikipedia community from making a decision.
Second, the Wikipedia community did make a decision, namely to follow the most popular choice in the sources rather than imposing standardization on a non-standardized reality. WhatamIdoing (talk) 17:02, 15 February 2024 (UTC)[reply]
Reading more on this I find this post which refers to Webster's dictionary for explanation of how some grammarians have "fooled" themselves over so-called possessive form. The dictionary gives examples of 's being used in situations where possession/ownership/belonging is not the purpose. For these diseases, the so-called possessive form is being used to indicate "named after", not ownership. They no more own their disease than "a week's pay" is owned by the week or the "land's end" belongs to the land. I really do think the argument that Down didn't own the disease is someone getting upset over exactly this misunderstanding, that 's only ever indicates possession.
I agree that there is pressure from WP:CONSISTENT to have a consistent grammatical form for eponymous diseases. Some style guides and publishers have decided that consistency is important, so it isn't a daft idea. But other publications are happy for articles and papers to be inconsistent in this regard so that isn't a daft idea either. On the other hand there is pressure from WP:COMMONNAME to pick the name most commonly used in our English-language reliable sources, per article. I don't think WP:CONCISE is seriously relevant at all, which is about whether to eliminate words, not punctuation, and no style guide is advocating for this on the grounds that it saves a letter and an apostrophe.
There's a practical issue for some articles. At our Parkinson's disease article, the word "Parkinson's" (without "disease") appears 43 times. At Alzheimer's disease, the word "Alzheimer's" (without "disease") appears 71 times. So it is extremely common for the text to use the shortened form, which simply does not work without a possessive.
Other examples of well known diseases (exact text in title/abstract in last 5 years):
I see that the earlier linked Whose name is it anyway? Varying patterns of possessive usage in eponymous neurodegenerative diseases largely confirms my stats observations below, though their analysis ends in 2013. -- Colin°Talk 18:56, 15 February 2024 (UTC)[reply]

Stats

A PubMed search for article title + abstract text for exact string match. For example: "down's syndrome" in 1983.

Table of stats
Non-possessive vs Possessive
Year Parkinson Parkinson's ratio Alzheimer Alzheimer's ratio Down Downs ratio
1983 14 181 12.9 24 156 6.5 62 157 2.5
1984 21 277 13.2 16 200 12.5 62 143 2.3
1985 17 270 15.9 20 316 15.8 94 145 1.5
1986 27 342 12.7 35 462 13.2 93 187 2.0
1987 33 491 14.9 36 499 13.9 125 176 1.4
1988 33 429 13.0 67 606 9.0 131 210 1.6
1989 53 538 10.2 77 870 11.3 151 211 1.4
1990 52 606 11.7 99 825 8.3 243 208 0.9
1991 41 673 16.4 102 955 9.4 170 228 1.3
1992 53 707 13.3 115 1,041 9.1 195 213 1.1
1993 61 764 12.5 145 1,128 7.8 212 252 1.2
1994 61 768 12.6 170 1,419 8.3 183 218 1.2
1995 61 931 15.3 191 1,460 7.6 247 229 0.9
1996 47 963 20.5 234 1,771 7.6 249 255 1.0
1997 93 1,181 12.7 308 1,856 6.0 246 199 0.8
1998 87 1,216 14.0 313 2,043 6.5 274 198 0.7
1999 123 1,344 10.9 309 2,016 6.5 321 207 0.6
2000 115 1,518 13.2 310 2,306 7.4 285 174 0.6
2001 123 1,484 12.1 323 2,355 7.3 391 182 0.5
2002 174 1,734 10.0 367 2,540 6.9 336 188 0.6
2003 209 2,023 9.7 395 2,629 6.7 364 156 0.4
2004 291 2,100 7.2 543 3,122 5.7 378 137 0.4
2005 347 2,146 6.2 590 3,323 5.6 460 130 0.3
2006 431 2,618 6.1 766 3,637 4.7 517 167 0.3
2007 456 2,845 6.2 687 3,772 5.5 533 139 0.3
2008 479 3,082 6.4 751 4,079 5.4 538 149 0.3
2009 578 3,306 5.7 832 4,450 5.3 524 132 0.3
2010 633 3,766 5.9 933 5,233 5.6 606 127 0.2
2011 631 4,135 6.6 882 5,611 6.4 668 119 0.2
2012 688 4,500 6.5 1,025 6,334 6.2 729 126 0.2
2013 786 4,869 6.2 1,081 6,875 6.4 792 144 0.2
2014 791 5,054 6.4 1,017 7,474 7.3 840 130 0.2
2015 890 5,534 6.2 1,022 7,918 7.7 789 105 0.1
2016 975 5,918 6.1 1,079 8,310 7.7 777 96 0.1
2017 993 6,234 6.3 1,172 8,930 7.6 822 81 0.1
2018 979 6,413 6.6 1,092 9,388 8.6 814 69 0.1
2019 953 6,807 7.1 1,166 10,103 8.7 828 78 0.1
2020 1,083 7,982 7.4 1,242 11,667 9.4 948 73 0.1
2021 1,035 8,805 8.5 1,186 13,055 11.0 1,064 95 0.1
2022 893 8,743 9.8 1,182 13,444 11.4 1,048 82 0.1
2023 873 8,575 9.8 1,112 14,177 12.7 980 78 0.1
Ratio of possessive vs non-possessive

These show that for PubMed article titles and abstracts:

  • The possessive form of "Parkinson's disease" averaged around 13x more popular than "Parkinson disease" in the 80s an 90s then declined to 6x more popular in the 00s but has crept up again to be nearly 10x more popular in 2023.
  • The possessive form of "Alzheimer's disease" had a peak of 16x more popular than "Alzheimer disease" in the mid 80s then declined to 4.7x more popular in the mid 00s but has crept up again to be nearly 13x more popular in 2023. (Not sure what was going on with the 1983 figure, which seems to be an anomaly).
  • The possessive form of "Down's syndrome" in 1983 was about 2.5x more common than "Down syndrome" but declined to reach parity around 1996 and is currently about 12.5x less common.

Here are also the Ngram stats:

The ngram results show the possessive is way ahead of the non-possessive for all three conditions and the only chart showing some meaningful variation is the one for Down's syndrome where the possessive is becoming steadily less popular but still a long way to go.

Personally, I dislike searches like these as it is so easy to make mistakes or misinterpret the results. Please let me know if they are misinterpreted or incorrect. I remain unmoved from my position that the differences are almost entirely to do with pronunciation and uncertainty about how to form a possessive rather than invented reasons like whether the person had it or the doctor had it. Other examples mentioned above are Tay–Sachs, where the the second guy is called Sachs and very few people on planet Earth are sure how to make that possessive or enjoy saying it. And similarly, Chédiak–Higashi syndrome is a disease named after two people, and even fewer people on planet Earth are confident to make that possessive, and many might even assume it is a place name. The general trend with diseases is to avoid and sometimes replace those named after people or places. For example, Ebola would not get that name in 2023. Worrying about whether there's an apostrophe in a name that still clearly refers to the doctor/patient generates a remarkable amount of publications. Don't doctors have more important things to do, like treating patients?

SMcCandlish research contains a lot of useful links but there are two dozen sources cited, which disagree, most of which acknowledge this is an ongoing area of dispute. Consistency of article titles might be an argument for picking one style over another. It would be more persuasive if the usage patterns for possessive vs non-possessive, particularly for ...disease, were similar, or that there was a consistent trend away from the possessive for ...disease forms. But currently there's really no love for Parkinson disease or Alzheimer disease on either side of the Atlantic, and if anything, it is getting rarer. I wonder if this is a result of SEO practices when writing papers, that there's a strong pressure to pick the more popular search term. Also note that I only searched for the full name of these diseases/syndromes. Searching for the abbreviated form (e.g., "Parkinson" without "--- disease") is left to the reader (I had a go and it didn't surprise me at all that the possessive form was very popular and non-possessive rare, but there are contaminants from other uses of that name). -- Colin°Talk 16:48, 13 February 2024 (UTC)[reply]

Thank you for this, Colin. This is a very good illustration. My conclusion is that while there may be a consistent pattern for some diseases, sources do not have a consistent pattern across all diseases. We therefore should be willing to have both "Down" and "Alzheimer's", without trying to force either of them to conform to the pattern preferred for the other. WhatamIdoing (talk) 17:14, 13 February 2024 (UTC)[reply]

Suicidal/self-harm action description

"Do not describe suicide or other self-harm actions as being successful, unsuccessful, or failed. This is unclear and judgmental."

Ironically, this is unclear and judgmental.

How about: "This is unclear about whether the action was fatal, and implies intent that may not be known." LesbianTiamat (talk) 10:57, 9 February 2024 (UTC)[reply]

This isn't about the person's intent. Declaring the outcome (whatever it was) to be successful, unsuccessful, or failed is passing judgment on what the correct/best/good/desirable outcome is.
This particular bit of advice falls under the heading "Language choices sometimes carry connotations that are not obvious to every editor. A term or phrase that sounds normal to you might sound stigmatising, offensive, or biased to someone else." Not everyone will find every point in that list to be obvious, or even sensible. It exists to let editors know that other people have other views. Generally, I find that most editors don't want the choice of language ("How dare they call that 'successful'!) to be the main thing that people remember from an article they're writing. Following that advice might help people focus on the article's contents instead of on wording choices. WhatamIdoing (talk) 23:43, 9 February 2024 (UTC)[reply]
Well said. I try to make similar points pretty frequently, along the lines that if what you've written causes a mental revolt in the reader about the wording, especially along offense-taking lines, then your writing has failed.  — SMcCandlish ¢ 😼  04:50, 15 February 2024 (UTC)[reply]
WhatamIdoing, SMcCandlish thought you may be interested in The Finnish miracle: how the country halved its suicide rate – and saved countless lives. I thought of you guys when I read this bit:

Just a few decades ago, the word “suicide” was also almost unsayable – and unprintable. Soon after it opened in 1972, Mieli’s crisis centre in Helsinki changed its name from “suicide prevention centre” to “crisis prevention centre” because there were objections to publishing the word in the phone book. For many older Finnish people, Sihvola says, “suicide” is still a difficult word to say; as with the word “bear” – as in the animal – there is a sense that saying it will bring it closer.

Colin°Talk 20:27, 22 February 2024 (UTC)[reply]
Observance of correlation is never proof of causation, and is often coincidental, though it is interesting, and in association with a lot more data might be food for thought. But for one thing, there's a linguistic absurdity here: English isn't used in Finland (except here and there as a second language), so suicide was not the word in question, but some Finnish word (probably itsemurha) that is usually translated into English as suicide. There may be shades of meaning and implication (possible multiple of them) pertaining to that word (or some other – what was the actual name of the institution in question?) in the Finnish language and its philological history.  — SMcCandlish ¢ 😼  21:52, 22 February 2024 (UTC)[reply]
That might be the case, but it's more likely that they have a naming is calling superstition (which is widespread). See also the reticence of English speakers to use the word cancer just one generation ago. People used euphemisms like wikt:big C, or they whispered it.
It would be interesting to see whether Attempted Suicide Short Intervention Programme is notable, or at least if it's worth mentioning as an example of secondary prevention or in suicide prevention. It should be mentioned in Suicide in Finland.
The line "The highest proportion of attempts are still among middle-aged men" has reminded me that we need to check the main suicide-related articles to see whether we have too much "angsty impulsive teen" stereotype. WhatamIdoing (talk) 01:34, 23 February 2024 (UTC)[reply]
I read it as when they wrote 'the word "suicide"' they meant whatever the Finish word was, not the English word. It made me wonder if there are words like that in English. And also whether other cultures have the same attitude to euphemisms as we do (or even if we are consistent). Like I sense we consider them foolish nonsense to be avoided in technical or professional writing but in other cultures they might think professional writing required some of them in order to avoid being outrageously rude or distractingly offensive. -- Colin°Talk 08:54, 23 February 2024 (UTC)[reply]
I think that one's own settled euphemisms are not always obvious. It's just the way you write. We resist some of them (e.g., WP:PASSEDAWAY) but not others (e.g., the articles containing some variation on "use the toilet" instead of defecate or urinate). WhatamIdoing (talk) 16:23, 23 February 2024 (UTC)[reply]
Feminine hygiene appears to be a contentious euphemism that remains the article name. Discussions on renaming this seem stalled on COMMONNAME arguments (COMMONNAME is not necessarily encyclopaedic) and not giving an inch in the gender-neutral debate. Outside of the weirdness that is Wikipedia, I can't find anyone arguing for keeping this euphemism from a bygone sexist age. A quick PubMed search of article title/abstract in the last 10 years had "Menstrual Hygiene" eight times more popular than "Feminine Hygiene". UK supermarkets have dropped the term in favour of "Period products". -- Colin°Talk 16:58, 23 February 2024 (UTC)[reply]
I wonder if editors would have better success in finding a title for that article if they first decided whether it should be "products" or "hygiene" (which would include not only commercial products, but also non-product-oriented activities like washing). WhatamIdoing (talk) 17:40, 23 February 2024 (UTC)[reply]

Does Major depressive disorder, a featured article violate WP:MEDSAY?

I have noticed that this article contains a long excerpt from Digital media use and mental health, which lists many systematic reviews and describes them in detail, for example:

  • In April 2013, the Journal of Adolescent Health published a systematic review of 33 studies of adolescent girls that found a positive association between screen time and depression.
  • In June 2016, Adolescent Research Review published a systematic review of 12 studies of subjects aged 11 to 21 years that concluded that while internet technology may provide adolescents opportunities to seek emotional and social support, the research reviewed did not establish that internet technology lowers rates of adolescent depression.
  • In December 2017, Adolescent Research Review published a systematic review of 11 studies comprising 12,646 child and adolescent subjects that found a small but statistically significant correlation between social media use and depressive symptoms.

Do you think these violate WP:MEDSAY? Bendegúz Ács (talk) 18:55, 26 March 2024 (UTC)[reply]

@Bendegúz Ács, yes, I do think that is the kind of stylistic problem that MEDSAY says not to put in articles. I've blanked about 10% of the article for being out of compliance with WP:MEDDATE (this is a heavily researched area, so sources should be from the last five or so years), which will cut down on the stylistic work that needs to be done.
Overall, I wonder whether a complete re-write would be ideal. It might be easier to start over than to try to transform the existing catalog of published papers into an encyclopedia article. WhatamIdoing (talk) 20:34, 26 March 2024 (UTC)[reply]
I also find this article to be full of excessive undue details that make it hard to read, so I agree that a complete rewrite may be the best way to deal with it. What worries me more than Digital media use and mental health is that so much of its subpar content is excerpted in Major depressive disorder, which is a featured article, supposedly "[one] of the best articles Wikipedia has to offer". There is a call for a review of that status in the article's talk page from 2022, and based solely on the issue I found, I could agree that it's needed. Considering that I don't have too much interest in investing more time in fixing the article, do you think the best course of action in this case is to submit it to a review? Bendegúz Ács (talk) 18:07, 27 March 2024 (UTC)[reply]