Medical interpreting, whether in a hospital, clinic, at the scene of an accident or in a family physician's office, is a professional service provided by professional individuals and language agencies. However, it can often be challenging for the interpreter, both mentally and emotionally, depending on the patient's condition, the situation in which the interpreter is needed and other factors that arise as part of the job. Health care professionals are faced with challenges in their own daily work as well. Nevertheless, it's important to remember that one's own professional challenges in a given situation may not be the same as those of another and vice versa. Doctors, nurses and administrators in medical settings each have their own capacity in performing their work, as do health care interpreters. Here are three things to avoid requesting of a health care interpreter.
"Could you please read/fill this out for the patient?" This question might seem innocent and one that is meant to help a process move along a little faster or more smoothly, but it's a common question asked of health care interpreters in health care facilities daily. Some patients cannot read well, write well or may even be illiterate, however it is important to remember that the interpreter is not responsible for filling out a patient's medical information and should never be asked to do so.
Consider this scenario. A patient arrives for an appointment and speaks little to no English. The interpreter introduces him/herself to the patient and the health care staff upon checking in. While the administrator behind the desk prepares the paperwork the patient needs to fill out, s/he asks the interpreter to explain the forms to the patient and help him/her fill them out. Ethically, the interpreter should know better and kindly inform the administrator of his/her role as an interpreter. The administration should provide someone from its staff to go over the forms with the patient, while the interpreter interprets the content. This way, if the patient has any questions or concerns, the staff can answer these, leaving the interpreter to do his/her job and avoid giving any medical advice, which is clearly not his/her role. This also deflects liability from the interpreter for doling out incorrect information or making a mistake on the patient's documentation.
"Can you hold this child's legs while we give her the booster?" This question might even sound humorous to someone reading, but it has happened and continues to happen often. Ask any parent or nurse. Giving a child a vaccination can be a stressful situation. A child is upset, sometimes crying, squirming, etc. But again, the interpreter's role is to interpret, not to assist in performing any medical act or procedure.
Many times, health care staff see the interpreter as an extension of their own staff. This is wonderful in terms of respect and professionalism, but it's important to know where to draw the line when it comes to overstepping an interpreter's role. This is all in addition to any liability issues that could result from an interpreter helping to restrain a patient. Ask another staff member to assist and leave the interpreter to interpret.
"Tell us your opinion of this patient's mental state." Many of you who are reading may already be shaking your head. How can an interpreter assess a patient's mental state? Yet, this question is often asked of interpreters in situations in which the patient's mental or emotional health is being assessed.
Consider this. Would it make sense to ask an English-speaking individual present for another English-speaking patient's visit what s/he thinks of the patient's mental state? What authority does this person have to assess another's mental condition? The same goes for an interpreter and the ethics we practice in our industry. Interpreters are not health care professionals, nor are they qualified to assess a patient's condition. Yes, they are professionals who are able to communicate in both languages with a high level of medical knowledge and terminology, but this does not make them colleagues in the same sense.
Interpreters' professional code of ethics also prohibits them from stepping out of the roles of the profession. The National Council on Interpreting in Health Care (NCIHC)'s Code of Ethics and Standards of Practice for Interpreters in Health Care clearly states, "The interpreter maintains the boundaries of the professional role, refraining from personal involvement." This allows the interpreter to remain unbiased as much as possible and avoid any involvement that could result in larger problems down the road.
Many health care professionals are unaware of interpreter ethics and standards, which is why it is crucial to take the time to learn about these aspects of the interpreter's role and what to expect of a professional service. For more information on National Standards of Practice or the Code of Ethics for Interpreters in Health Care, please visit the NCIHC webpage.