07:42 PM EST Jan 23



By Blair Shewchuk
CBC News Online

In a heartbreaking story about a legal battle over the life and death of two children, CBC Radio's The World at Six reported the following on Sept. 22, 2000:

"British appeals court judges have ruled that surgeons may separate six week old conjoined twins. The operation will kill one child and give her sister a chance of living."

On the same night, CBC TV's The National used a different adjective:

"In London today two tiny girls were at the centre of a big court decision. The British Court of Appeal has ruled that doctors can perform an operation to separate Siamese twins."

CBC News Online, which posted several stories over the course of the day, used both terms. The older, more familiar word prompted a sharp response from someone in Ottawa:

Sept. 25, 2000

As an ethnic Canadian from South East Asia, I find it offensive that a national network such as CBC still uses the word "Siamese" to refer to a birth defect.

I am sure there are more appropriate terms for such a medical condition, as "Down's Syndrome" has replaced "Mongoloids".

Siamese are people from Siam or Thailand.

To refer to a whole a race as birth defects is offensive.


Modern dictionaries tend to describe more than they prescribe or proscribe — telling us what people say and write, rather than how we should.

But they sometimes issue warnings (such as "offensive") next to controversial expressions. Siamese twins does not appear to fall into this category.

The Canadian Oxford, Oxford English Dictionary, and Webster's all list Siamese twins as a synonym for conjoined without further comment.

Style Guides at many news organizations, including the Globe and Mail, endorse the term by showing staff how to spell it: Siamese twins, with a capital S. Journalists are not discouraged from using it.

The Canadian Press takes a slightly different approach. In its 1999 Guide for Writers and Editors, CP suggests using lowercase letters for many words that are based on proper names (including siamese twins and caesarean section), while recommending uppercase first letters for other "derivatives" (such as Pap smear and Achilles tendon).

Then in a much thinner companion volume (Caps and Spelling), Canadian Press expresses reservation about using Siamese twins at all. While it doesn't ban the term, the news agency does state a preference for either "joined twins" or a specific description, such as "babies born attached at the hips." This was not CP's position a decade ago. No explanation is given for the change.


The New York Times, on the other hand, likes the expression so much it's decided there is no need to limit the term to medicine. On Aug. 31, 1999 a headline above an editorial about the political relationship between China and Taiwan read: Siamese Twins.

Grammarians have picked up this practice, expanding the meaning without apology.

The 1998 New Fowler's Dictionary of Modern English Usage labels Siamese twins "a suitable term for pairs of words which are traditionally linked" – including airs and graces, leaps and bounds, rant and rave, and bag and baggage.

There can be no doubt that Siamese twins does carry "bag and baggage" journalists may well want to consider.

But caution should always be exercised before banning words. Consider mongoloid, which is cited in the e-mail complaint above.


The term mongol was first used to describe people with Down's syndrome (also known as Down syndrome) in 1866.

It wasn't because people in East Asia had this birth defect. Rather, it was because some westerners decided that an entire race of people shared some of the facial characteristics of people with Down's syndrome.

This use of mongoloid "is now unacceptable and considered offensive," according to the 1998 New Oxford English Dictionary.

Many newsrooms have heeded this advice. The Globe and Mail's 1998 Style Guide, for instance, is blunt about its ban: "Do not use the terms 'Mongoloid' and 'Mongolism' to refer to persons with Down syndrome." CBC has issued a similar warning to journalists.

It seems relevant that John Langson Down ( the 19th century doctor who first described the condition), once claimed that it is possible to classify "the feeble-minded by arranging them around various ethnic standards . . . . A very large number of congenital idiots are typical Mongols."

So it appears Mongolism, a racist term, has been renamed after a racist man. Is this really an improvement? Does it make the expression Down's syndrome unacceptable?


Siamese twins, which has been around for almost 200 years, is not based on prejudice. It is a description of fact.

In the 19th century, two Siamese men (Chang and Eng) became well known in many parts of the world for leading an active life, with wives and 21 children, despite being joined at the waist.

The twins, born in 1811, eventually moved to the United States and settled as farmers in North Carolina. They died in 1874, but the expression Siamese twins lived on. (In recent years, their story inspired Singapore's longest running and most profitable musical — the first English performance of its kind to be staged in China.)

Most doctors now use the term conjoined twins, but the jargon hasn't been embraced the way Down's syndrome was in the 1960s.

Part of the reason may be that Siam became Thailand in 1939. Perhaps many of us don't think of Siam as a place any more, so the adjective Siamese seems unobjectionable.

But if Chang and Eng had been born in Manitoba instead of Bang Mecklong, how we would we react to conjoined infants being called Canadian twins?


In his 1996 book Words Apart, Jonathon Green reviews more than 4,000 terms that fall into "the language of prejudice."

The author, a well known British lexicographer, tackles everything from hard-core racism to what he calls "teasing rather than torment" (such as Dutch courage, defined as bravery based on insobriety, and luck of the Irish, which can suggest good fortune that's not fair.)

Siamese twins isn't included in the 383 pages. The closest entry appears to be German measles, which has been a common term for rubella for more than a century.

It's named after a German physician (Friedrich Hoffmann), who identified the illness in 1740. The term seems appropriate since measles itself is based on an old German word for skin blemish, mas.

Rubella (which is Latin for "reddish") is a contagious disease that is milder than other types of measles but can cause fetal malformation if caught by pregnant women.

Describing a virus that can harm unborn children as "German" does not appear to have caused outrage over the years. Green, however, points out that the disease was temporarily renamed once. Allied forces called it "Victory measles" during the Second World War.

Of course English does not have a monopoly over potentially offensive medical labels. Rickets, for instance, is known in many parts of the world as the English disease, including Russia (angliyskaya boliezn), Hungary (angolkor), Sweden (engelska sjukan), and Germany (englische Krankheit).


It's virtually impossible to stop people from saying what they want on the street. In newsrooms, however, words are edited based on guidelines that have been agreed on.

In a story about Down's syndrome, the CBC would not refer to Mongolism for the reasons already outlined.

But Siamese twins does not have the same racist origins, so a request to ban it is more difficult to accept. The term isn't based on a sweeping statement about the physical appearance of a group of people. Chang and Eng were Siamese twins.

For several years, CBC Radio has recommended that its reporters and announcers avoid the expression. At the same time, senior editors have acknowledged that jargon such as "conjoined" is lofty, and quite possibly unfamiliar to many people.

Instead of trying to come up with a different adjective, radio journalists have been urged to use a verb — describing the medical condition of the people featured in the story in a simple, direct way. For instance: "Two brothers who were born joined at the head are recovering in a Toronto hospital after being separated Wednesday night."

This, as mentioned, is what the Canadian Press now prefers as well. But is sanitizing our sentences a sensible approach in this case?

We avoid using the verb gyp today because it's considered racist (implying that a group of itinerant people known as Gypsies are swindlers).

But should we also ban shyster because a few people feel it might be anti-semitic? (Scholars say there is no strong evidence linking it to Shakespeare's Jewish character "Shylock". Instead, some authorities believe it comes from a German word for defecation: scheiss.)

What would happen if agnostics started telling CBC announcers to stop using the word goodbye because it's short for "God Be With You", or if some religious groups attacked drat because it actually means "God rot"?

How should we treat German measles? With a dose of Latin? Should the CBC insist on rubella from now on, especially when referring to birth defects caused by the disease?

These are the types of questions worth asking before a decision is made to ban Siamese twins — a commonly used term that many may feel has harmless origins. To some, such a drastic move would have adjectives of its own, ranging from bold to Orwellian.

(September 29, 2000)

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