Many cities are home to large immigrant communities. Immigrants enrich a city’s cultural and economic life and fill its streets with the sounds of another language. But a linguistic barrier between a first-generation immigrant and a healthcare services provider can have terrible consequences in an emergency. In some cases, the result of a misunderstanding can be a medical professional not having a clear, accurate idea of their patient’s symptoms. On other occasions, the result can be a patient not following their doctor’s instructions.
How can we overcome this communication barrier? Can a family member be an interpreter? In this post, we’ll take a look at the potential drawbacks of relying on ad-hoc interpreters. We’ll also take a look at the best alternatives that healthcare providers can adopt to lower the risks of miscommunication when Limited English Proficiency (LEP) patients are under their care.
The Risk of Ad-Hoc Interpreting
An ad-hoc interpreter is defined as a bilingual person who’s not formally trained as an interpreter but is spontaneously asked to interpret in an emergency situation. With this definition in mind, the risks of ad-hoc interpreting are quite obvious.
For starters, someone can be bilingual and still not have the high degree of fluency that is required to interpret. On the other hand, especially in medical settings, terminology can get confusing, and someone who’s not trained as a medical interpreter will probably have a really rough time understanding and translating these terms. A medical emergency can be stressful, and unlike medical interpreters, an ad-hoc interpreter is not trained to deal with that stress and perform a proper translation regardless.
In 1980, Florida teen Willie Ramirez suffered irreversible brain damage after experiencing an intracerebral hemorrhage that was treated as a drug overdose. Ramirez was taken to the emergency room after falling unconscious. Not knowing what might have triggered the episode, Willie’s Cuban mother said that her son was “intoxicado” (that he might have food poisoning). When medical professionals asked her to translate, she said her son was “intoxicated”. While “intoxicated” and “intoxicado” sound similar, their meanings are quite different. That mistranslation matched the prejudices that the medics had regarding the behavior of young Latin men. The result was a misdiagnosis. When the true cause of Willie’s state was discovered, it was too late. Ramirez lost his ability to walk, sued the hospital, and won.
Technically, any bilingual person can be an interpreter. But, is this recommendable? Not really. When health is at stake, any imprecisions can have irreparable consequences. Across the globe, legislation tends to be very strict regarding who can provide language assistance in a medical setting. For instance, Joydeep Grover, a consultant in emergency medicine and specialist medicolegal adviser for Medical Defence Shield explains:
“The [British General Medical Council]’s Good Medical Practice guidance expects doctors to make sure that arrangements are made, where possible, to meet patients’ language and communication needs. NHS England, in reference to primary care, states that, ‘The use of an inappropriately trained (or no) interpreter poses risks for both the patient and healthcare provider.’ And further, ‘The error rate of untrained interpreters (including family and friends) may make their use more high risk than not having an interpreter at all.’”
Can a Family Member Be an Interpreter?
What makes a great medical interpreter? Profound knowledge of the two languages at hand, profound knowledge of medical terminology, and a passive and neutral role that allows for precise and proper communication. A family member might be fluent in both languages involved, but they’re unlikely to know how to properly translate medical terminology (which they themselves might not understand), and they’ll even more unlikely to take a passive and somehow detached role in the situation. A family member will be emotionally involved and might avoid communicating bad news. They might also refuse to ask their relative potentially offensive questions, even if they’re medically relevant – for instance, whether they have consumed drugs or have any sort of condition that carries a stigma.
It’s best to rely on a professional. Especially, when health is at stake. And, as Gaurab Basu, MD, MPH, Vonessa Phillips Costa, and Priyank Jain, MD note in a 2017 article for the AMA Journal of Ethics:
“Access to language services is a required and foundational component of care for patients with limited English proficiency (LEP).”
In the US, LEP patients have the right to a qualified medical interpreter, and medical professionals have the ethical and legal responsibility to request medical interpreting services when necessary.
Medical Interpreting Services in an Emergency
Communication is a key component of quality care. If you’re a first-generation immigrant, don’t forget that you have the right to proper linguistic assistance in all medical settings. If you’re a medical practitioner working in a bilingual or multilingual area, it’s vital for you to know who to call for emergency linguistic services that guarantee clear communication and a proper diagnosis.
Many reputable language companies offer on-demand medical interpreting services. Some solutions are delivered through the company’s own platform, and some are delivered over the phone. If the company has accredited industry experience, all the better. Evaluate your options and pick the best linguistic partner for your practice, it’s worth it.