How has the concept of the medical interpreters simply serving as a conduit of communication affected the relationship between the medical professionals and interpreters?
For many years now, interpreters and medical professionals have been taught that the role of the medical interpreter is to serve only as conduits of information. They are to remain invisible, unobtrusive, only conveying the information that is being spoken. As brought out in the previous blog, the role of the professional interpreter is much more expansive and complicated. According to the code of ethics, there are moments when the professional interpreter must facilitate cultural awareness; there are other moments when they must advocate on behalf of the patient. All of this requires professional discernment.
It has been my experience that when medical professionals only view the healthcare interpreters’ role as a channel of communication, they are not treated with respect that is due a professional. This does a great disservice to the patient. Suppressing the interpreter’s ability to facilitate a cultural misunderstanding can often lead to communication gridlock.
In many Spanish-speaking countries, what the doctors says goes. Doctors are highly educated professionals who know what is best. In the U.S., doctors often share with the patient different treatment options. The patient has the freedom to elect the best option for himself. On many occasions, I have observed the doctor explain the options. The doctor will then ask the patient for his opinion. The patient then replies by saying, “whatever you say!” Then the doctor explains it again for the patient to repeat what he said. It is like the eternal wheel of death that sometimes occurs on older dysfunctional computers. Both the doctor and patient become frustrated. They wonder if the interpreter is doing his job or if the patient understands the interpreter.
On many occasions, I have interrupted and simply explained to the doctor that in the patient’s culture, the doctor dictates treatment. The notion of the patient deciding is alien to the limited English proficient person. I then convey my statement in the patient’s language. The patient typically agrees with me. With the new understanding, the doctor clarifies that in the U.S., the patient needs to consider his options. Once the roadblock is cleared, the patient inquires as to his options to make a more informed decision.
What I just described was a communication barrier due to a lack of cultural understanding, not language. As an interpreter, it was my responsibility to clear the confusion. Many interpreters I know would never speak up because they have been chastised by healthcare professionals in the past. They continue rendering what each speaker states, while both sides grow impatient and agitated.
In the end, helping healthcare professionals to fully understand the expansive role and code of ethics for professional interpreters can contribute toward a more dignified relationship between healthcare providers and language professional. This will lead to a much better outcome for the patient.
The next healthcare blog will consider the controversial subject of the relationship of the patient and the interpreter.
