When Good People Are Unethical: Cultural Awareness

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 thinking he is doing a good deed.


Mr. Eddie Santiago was contracted to interpret for Mr. Toño Rosario at his doctor’s appointment. When Mr. Rosario was called into the appointment, his many brothers followed him. The nurse then asked them all to leave, causing Mr. Rosario much anxiety.

As the doctor began to explain the medical options that he had, Mr. Rosario would reply, “Whatever you say doctor.” Again, the doctor repeated the options, and a very frustrated patient again replied, “You are the doctor!”

Now very frustrated, the doctor looks over at the interpreter and asked, “Is he understanding? Are you interpreting correctly?” The interpreter responded that yes the patient understands and that he is interpreting everything correctly.

What happened in this scenario is common. Although the interpreter conveyed everything correctly, there was a communication breakdown due to cultural differences. Let’s look at how cultural awareness can help.

Cultural Awareness

The objective in the National Standards of Practice for Interpreters in Health Care in this case is to facilitate communication across cultural differences. Interpreters strive to develop awareness of the cultures encountered in the performance of interpreting duties.

The interpreter strives to understand the cultures associated with the languages he or she interprets, including biomedical culture

  • An interpreter learns about the traditional remedies some patients may use


The interpreter alerts all parties to any significant cultural misunderstanding that arises

  • If a provider asks a patient who is fasting for religious reasons to take an oral medication, an interpreter may call attention to the potential conflict

In this example, the interpreter was unprofessional. In many Hispanic cultures, the patient often brings many family members who all consult together. Also, it is also common for many Hispanic patients to accept whatever the doctor recommends. They find it confusing when doctors in the United States provide them with options and leave it up to them to decide. Had the interpreter paused and explained these differences to both the patient and doctor, perhaps family members would have been allowed to stay, and the doctor would have explained things better to the patient.

Professional interpreters can help overcome communication breakdowns that aren’t related to language but culture.  Untrained bilingual people, although well-meaning, typically fall right into this trap.

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