When Good People are Unethical – Confidentiality

January 6, 2017 JAlfonso 1 comment

Imagine this. Instead of hiring a professional interpreter who is familiar with 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 believing he is doing a good deed.
Example 4
While at a medical appointment, the doctor only allows the patient and the interpreter into the examination room. The rest of the family is instructed to wait outside. During the examination, the doctor discusses the patient’s past drug and sexual history. The patient is given a referral for further testing. After the test, the doctor plans to follow up with the patient to discuss the results.
When the patient leaves the room, the family is very anxious to find out what happened. The patient responds by saying nothing and that she needs another test. In desperation, the father approaches the interpreter in the lobby and begs him to please tell him what went on. After all, he is the father and deserves to know, right?
Many honest-hearted people unfamiliar with the code of ethics for healthcare interpreters might conclude that it would be fine to reveal that information to the father. However, below are some compelling reasons why that would be the wrong action to take.
Confidentiality:
The objective in the NCIHC National Standards of Practice for Interpreters in Health Care is to honor the private and personal nature of the health care interaction and maintain trust among all parties. For this reason, interpreters treat as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. Confidentiality guidelines are as follows.

  • The interpreter maintains confidentiality and does not disclose information outside the treating team, except with the patient’s consent or if required by law.
    o For example, an interpreter does not discuss a patient’s case with family or community members without the patient’s consent.
  • The interpreter protects written patient information in his or her possession
    o For example, an interpreter does not leave notes on an interpreting session in public view.

In this example, the interpreter could be held liable for revealing confidential information to the family member. Many organizations use scripted, diplomatic excuses in order to avoid sharing any information with family, friends, or coworkers. The liability could be amplified if the breach of confidentiality were done in a lobby where others in the community could overhear.
HIPAA guidelines instruct all parties to keep information in the strictest confidence. Indeed, the fines for violating HIPAA laws are exorbitant and would probably bankrupt a well meaning bilingual paraprofessional. There are reasons for these guidelines. Confidentiality is essential in order to build and maintain trust. Untrained bilingual people, friends, and especially family members are typically unqualified. Not only do they lack technical vocabulary and language skills, but they also are unaware of ethical principles and are likely to break confidentiality.
Bilingual persons may mean well and wish to help. Nevertheless, if they fail to observe confidentiality, the results can be devastating. Future posts will consider other circumstances where good people can unknowingly behave unethically.

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