Major nonconformity: a significant nonconformity of one or more pharmacovigilance processes that could potentially adversely affect the rights, safety and well-being of patients.

Would it be logical to use the word and here despite the fact that each of the listed objects can be affected on itself, without the others being affected?

I was told by a native speaker (later supported by a native speaker in a different chatroom) of English that

If all three may ever be affected at the same time, you have to use and.

Is this really so? Would it be logically wrong to use or?

P.S. I found a related question on ELU: conjunction use: “and” or “or” in list of examples, and another one

  • It wouldn't be wrong to use or. It can be used to indicate an alternative, usually only before the last term of a series. Apr 11, 2020 at 18:02

2 Answers 2


The cooordinating conjunctions 'or' and 'and', when placed before the final item in a list of more than two items, are considered as if they had also been placed between the preceding items. You can have cake, bread, or crackers (you can have one of these); you can have beer, wine, and coffee (you can have one or more of these). If you follow the Oxford Comma convention, place a comma before the conjunction.

Coordinating conjunctions


It might be said elsewhere in the document that "patients' rights, safety and well-being must be protected", and in that sentence, the "and" is obviously necessary. The phrase may be taken as a fixed one, and I don't think it's wrong in this use, especially since there is overlap between the terms.

On the other hand, if "or" were used in this negative phrase (we must not violate "patients' rights, safety or well-being", then that would not be logically wrong, regardless of whether the items are violated at the same time.

So, I agree that "or" could be used in your sample sentence, but I can't imagine anyone interpreting the original sentence to mean that they could get away with violations, if they only affected one of the three items.

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