Imagine this, instead of hiring a professional interpreter who is familiar and cognizant of the code of ethics, an untrained bilingual person is hired to simply cover the assignment.  Without proper knowledge and training, the bilingual person serving as an “interpreter” will most likely unconsciously commit serious ethical violations while at the same time thinking he is doing a good deed.

Example 3

A bilingual person, friend or even a family member accompanies a patient to a doctor’s appointment. The doctor is happy to have someone who can speak the language.  During the appointment, there are a couple of issues that call into question the interpreting experience.  For instance, although the person interpreting has a great command of both languages, he isn’t familiar with the technical terminology being used by the doctor. Too embarrassed to constantly interrupt the doctor, he just briefly tells the patient what he thinks the doctor is saying. To complicate matters further, the doctor begins to ask some possibly embarrassing questions, such as his drug or sexual history. In this case, the person interpreting doesn’t do a bad job, but the patient doesn’t feel comfortable revealing such personal information in front of a friend or family member. One might reason that even if there are some drawbacks, professional interpreters aren’t worth the cost.  Not so fast, let us look examine closely the ethical reasons why accurate professional interpreters are so important.

ACCURACY

The job of the interpreter is not to speak for the patient but rather to enable the parties to hear precisely what has been spoken a language the persons understand. Interpreters strive to render the message accurately, conveying the content and spirit of the original message, taking into consideration the cultural context.

• Interpreter renders all messages accurately and completely without adding, omitting, paraphrasing, or substituting. Everything must be repeated even if:
  • They constantly repeat the same thing;
  • The patient begins to speak about things that are completely irrelevant to the subject;
  • Interpreters must even repeat rude or vulgar language said by the medical professionals or the patient.

 

• The interpreter replicates the register, style, and tone of the speaker.
  • The interpreter must use the same medical terminology used by the doctor even if the patient doesn’t understand.
  • Likewise, it isn’t the interpreter’s role to upgrade or explain the language to the patient.

Especially in the case of mental health professionals, certain questions are phrased for a specific purpose. Perhaps in addition to the patient’s mental state, the doctor is trying to ascertain the patient’s educational level and other factors. Altering the message by the doctor or patient can result in an error in the diagnosis.  A skilled, certified medical or healthcare interpreter will:

• advise parties that everything stated will be interpreted;
  • By explaining the process, the professional interpreter puts everyone at ease and sets up the expectation that at times there will be interruptions to ensure accuracy;

• manage the flow of communication;
  • Interpreter can’t be afraid to ask for others to pause or slow down their rate of speech;
• correct errors in interpretation;
  • Everyone makes mistakes; capable interpreters are accustomed to immediately correcting them once recognized;
  • One mistake can dramatically effect the outcome of a patient so even if a mistake is embarrassing, the error must be corrected;
• maintain transparency.
  • This requires the interpreter to admit when something is said that they don’t understand and seek clarification.

I just shared six ethical guidelines on accuracy alone that are familiar to all professional and certified healthcare interpreters. There are reasons for these guidelines. The interpreter must be accurate and transparent to foster trust and clear communication. Doctors have no way of knowing if the interpreter makes things up or changes the message of the patient.  Untrained bilingual people, friends, and especially family are typically unqualified. Not only do they lack technical vocabulary and language skills, but they also are unaware of ethical principles. They are likely to edit or abbreviate the message which can end in tragic results.

A good bilingual person might mean well and wish to help.  If they are not accurate in all six areas previously mentioned, the results can be devastating. Future posts will consider other circumstances where good people can be unethical without even knowing it.