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.
A bilingual person accompanies a patient to an appointment. While in the lobby, the patient tells the interpreter; “Can you do me a favor, every time I see this doctor I get nervous and forget to ask him questions and tell him everything wrong with me. Can you please tell him that I have pain in my lower back and the pain goes all the way down to my feet? My right leg is numb. Sometimes I have spasms. I feel a burning sensation.” The patient goes on explaining every symptom that he feels and wants you to tell the doctor.
Any good-hearted bilingual person wanting to help out this patient would attentively take note of everything the patient says so that he could make sure the doctor receives all the information and the patient receives great care, right? Not so fast. Taking this action might seem right, but it is unethical and isn’t in the best interest of the patient. Why?
The job of the interpreter is not to speak for the patient but to enable the parties to hear precisely what has been spoken.
- Interpreter renders all messages accurately and completely without adding, omitting, paraphrasing, or substituting.
- The interpreter advises parties that everything said will be interpreted.
To eliminate the effect of interpreter bias or preference:
- The interpreter does not allow personal judgments or cultural values to influence objectivity.
To acknowledge the inherent dignity of all parties in the interpreted encounter.
- The interpreter promotes direct communication among all parties in an encounter.
To clarify the scope and limits of the interpreting role, in order to avoid conflict of interest.
- The interpreter limits personal involvement with all parties during the interpreting assignment.
- The interpreter limits his or her professional activity to interpreting within an encounter.
There is a reason for these guidelines. The interpreter must be transparent in order for there to be trust and clear communication. Doctors have no way of knowing if the interpreter is making things up or changing the message of the patient if the interpreter is saying say four paragraphs to the patient’s ten words. Appointments have been canceled and new interpreters hired because interpreter have added to what is stated.
So what can an interpreter do when the patient wants to explain everything beforehand?
- Explain the ethical reasons beforehand why he cannot speak for the patient but only repeat everything being said at the session.
- Encourage the patient to write down his concerns so that he doesn’t forget to ask the doctor.
- Assure the patient that everything will be accurately interpreted.
Future posts will consider other scenarios that test ethics.