Inadequate interpreting during medical examinations or medical interviews is a major cause of misdiagnosis among non-English-speaking patients. The use of untrained, non-professional or unethical interpreters can significantly undermine equal treatment. It is the responsibility of medical facilities and the professional interpreter community to assure equal language access, especially in a medical setting.
In 2016, the Federal Department of Health and Human Services (DHHS) formally adopted changes to the Affordable Care Act (ACA) that broadly prohibit discrimination in health care or health coverage, specifically on the basis of race or national origin. Compliance with the new provisions means that service providers must emphasize accuracy when interpreting for non-English speakers. Compliance means that service providers can no longer use unqualified interpreters such as untrained bilingual staff, adult family members, friends, or minor children. Qualified interpreters are required, to ensure non-English speakers are interacting with medical staff exactly as English speakers would.
Both unprofessional interpreting in hospitals and the use of interpreters of convenience, who are not held to professional standards, is widespread. A 2014 documentary on National Public Radio points to several critical instances where inadequate or unprofessional interpreting in hospitals had serious medical consequences for non-English speakers; consequences that clearly violated principles of equal treatment. In essence, medical staff prevented limited English proficiency (LEP) patients from being clearly understood.
One young athlete nearly died, and developed permanent brain damage, when the Spanish word “intoxicado”, which means ingested something toxic, was interpreted as intoxicated. In addition, many hospitals use telephonic interpreting with patients, which can cause problems for those who are hard-of-hearing. For some elderly patients with dementia or Alzheimer’s, interpreting over-the-phone can also cause confusion instead of clarity. To aid in complete and accurate interpreting, it’s invaluable for the interpreter to have additional cues to meaning such as body language. Compliance with the ACA requires the use of in-person interpreters who can see and interact with those for whom they interpret.
And while compliance is becoming more widespread, professional interpreters are not always available in sufficient numbers (depending on the location), and medical facilities may be required to use another method for communicating with patients, such as telephonic interpreting. It is still also possible that an available bilingual person be pressed into service, due to the pressures of time and circumstance.
Healthcare interpreting can be a significant potential source of confidentiality violations. The details of medical services sought by a patient could have profound implications with regards to their professional life, legal status, or eligibility for occupational and financial opportunities. The misuse or sharing of confidential medical information can cause great professional, personal, and financial damage to the patients and their families. Patients and institutions relying on interpreting services must feel confident that these important private details will not be made public, and that documents will not be stolen or leaked into improper channels.
Because of this, he the Federal Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality and security of healthcare information. Compliance with HIPAA mandates that interpreters will use protected health information (PHI) only as required for the purposes of interpreting, as directed by the client. If the interpreter is required by law or court order to disclose any such information, the client must be notified in a timely manner, so that he or she can seek a protective order or other judicial relief. Interpreters must work to mitigate any harmful effects resulting from use or disclosure of PHI. Any instance of disclosure of PHI must be promptly reported to the client.
In addition, professional interpreters pledge to a Code of Ethics, in which you find the same binding principle in the Hippocratic Oath for medical professionals: “Do no harm.”
Affordable Language Services will provide highly trained professionals on site for your specific needs. We can send skilled interpreters in over 130 languages in person to your location anywhere across the United States, even on short notice. Please contact us to learn more.