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Who Should Be Used As An Interpreter?
If possible, a professional medical interpreter who understands the regional and cultural nuances of the patient’s language should be used.
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Why not use a family member?
(Imagine going with your own parents or grandparents to any physician visit – then imagine the physician speaks a different language!)
Family members are likely to have several conflicts if used as interpreters.- Patients may not be comfortable disclosing personal information or certain symptoms to interpreting family members.
- The interpreting family member may not feel able to provide certain information to the physician (e.g. the interpreter may seek to shield the patient from embarrassment, may minimize or be unduly optimistic about symptoms, or may be caught in a conflict if the patient gives information that the interpreter knows to be inaccurate).
- There may be conflicts between the patient and the family member that jeopardize the entire encounter – the interpreter may even have a motive to give inaccurate information to the physician!
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”Just any convenient bilingual person is not sufficient”3
Even if someone speaks the same language as the patient, they may have significant problems in communication because of language, cultural, or social problems.
Bilingual individuals from a different country or region than the patient may not only have differences in dialect or accent, they may have significant problems in understanding the full meaning and implications of the patient’s story. This can occur even with “English” speakers and is exacerbated in the elderly who may use older terms and metaphors. For example an elderly Scottish lady describing her husband’s death from a stroke would say “He died of a shock” and would use the term “being sick” specifically to refer to vomiting - and what do you think she would be complaining of if she presented with being “trahelled” or “scunnert”?
Interpreters may hold substantial biases, prejudices or fixed beliefs about individuals of the patient’s nationality that could interfere with the validity of the translation. (Remember, countries in Central and South America have gone to war with one another, conflicts are common between regions of the same country, and people from different locations or social groups hold stereotypical views of others. For example, most Mexicans in Wichita are from three northern states: people from one of these states are regarded by the others as superstitious, primitive, and believers in ghosts and spirits).
Finally, even if they come from the same region, a social gap between the patient and interpreter can cause significant problems. A patient may not trust an interpreter who appears to be affluent, scruffily dressed, or “Americanized”. Conversely, an interpreter who has little respect for the patient may not fully articulate their symptoms/concerns to the physician or appropriately convey the medical management plan to the patient.
