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The words that are used to describe diseases and conditions change over time and reflect not only advances in medical knowledge but also prevailing social and cultural values. The etymology of the term “handicapped” suggests that it has its origins in a sport that involved an element of luck, whereby competitors deposited forfeit money in a cap or hand1; from this came the use of the term to refer to the equalising of chances in a competition or race. That particular origin therefore had a positive slant. However, another suggested derivation is that it refers to “cap in hand” begging, and that by this route it became a somewhat derogatory label for people with various impediments. In the USA since the Americans with Disabilities Act this label is no longer officially recommended for use as it is seen as “overlaid with stereotypes, patronizing attitudes, and other emotional connotations”.2 However, the term is still in everyday use in the US. In the UK, the term “disabled” is the more commonly used term, labelling people, services, and facilities. However, when referring to individuals, the more neutral term “impairment” (referring to the description of a condition rather than the exclusionary barriers that society can impose) is preferred by the disability movement.
Getting the words right is more than a matter of political correctness3; words are the tip of the iceberg of our deeply held values.