Thursday December 01, 2016

Why family members should never interpret at medical appointments

Young Joe is a certified medical interpreter in Vancouver.

Young Joe is a certified medical interpreter in Vancouver. (courtesy of Young Joe )

Listen 11:14

It happens every day in most large hospitals.

A patient comes in and they don't speak English, but they have a friend or a family member with them who can. 

In an effort to figure out what's wrong, and to get the patient the care they need, the friend or family member steps up and interprets for the patient and the hospital staff. 

It may be a familiar story, but according to Young Joe, a certified medical interpreter (one of the few in Canada), it's a scenario that often doesn't have a happy ending. 

"That should not happen," she tells Dr. Brian Goldman, host of White Coat, Black Art. 

Young says often family members, especially young children who are pressed into interpreting "omit, add, or change words" because they aren't comfortable relaying sensitive health information about their parents, or they want to protect them. 

Joe, who has worked as a certified medical interpreter in Vancouver for six years, says she wouldn't even interpret for her own mother. 

"It will be really hard for me to be impartial and neutral. I will have this protective bias for my mom. And I may think that I'm helping, but maybe I'm not."

"Having to act as a middle person between parents and doctors...is a really unfair burden for children." - Young Joe,certified medical interpreter

She says she has witnessed, and has had to intervene when interpretation by a family member has gone wrong.

In one case, a husband insisted on translating for his wife, who had transplant surgery. 

"(He) had a lot of power and authority over his wife, because she was so dependent on him for her post-transplant appointments. He didn't want to admit he was confused about medication names," she says.

The woman ended up taking the wrong medication, something Young Joe realized when she was called to their next appointment.

The patient's safety was at risk, but it could have also affected the cost of her care, Joe explains. 

"If I was not there to fix the problem, it could have prolonged the treatment. She could have gone to the ER, maybe unnecessary imaging would be done, more specialist visits,"  she says.

She also says using hospital staff who speak a second language is problematic. It may be hard for a resident to say no to their supervising doctor or to admit to them that they are not fully fluent. 

She would like to see governments introduce a policy directive that mandates the use of professional interpreters and bars the use of family, friends and staff.

"(In Australia) if they don't use a professional interpreter that is a breech of duty of care owed to the patient and it can lead to legal action," she says. 

She says in B.C., where she works, the policy is too soft, because it only "encourages" the use of interpreters with no real consequences for failing to do so.

She started the non-profit organization Bilinguals International to push for better training and regulations around the use of interpreters after witnessing a situation where a child was forced to interpret for an abusive father in a social services setting. 

"That was the last straw for me."