Dr Liza Macdonald FRCR MA

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Consultation through
an interpreter

  Getting The Best out of Your Doctor




Consultation through an interpreter


If you don't speak good English talking to a doctor can be quite a problem(as well as reading this website I'm sorry to say!).
If you are reading this section you probably want to help a friend or relative.
Wherever possible when there are serious matters to discuss it may in fact be wiser to use a professional independent interpreter who has no emotional involvement that can complicate the translation of some issues.
A family member when asked to translate for a consultation may not be comfortable with what is being said. They may for example try to conceal bad news in an attempt to protect their family member.
For example if a patient has been diagnosed with cancer some families prefer to conceal this diagnosis from the patient especially when elderly. The family may believe that the patient will be so distressed by the diagnosis that he or she will simply give up and refuse treatment. In the UK the rule is that the patient and doctor work out together how to share information and the family need to abide by the patient's decision.

A major difficulty in working through interpreters can be that the patient simply does not know how accurately their words are being translated or even whether accurate words exist in translation. Confidential or embarrassing issues which may be fundamental to the health problem can simply be withheld or not translated.

Further problems can arise between generations. Some older immigrant members of our community have not learnt English and may bring with them to the consultation a junior member of the family who is more likely to speak the language. Previously confidential issues may emerge to the distress both of the relative and the patient. Health issues can be discussed which may have implications for the interpreter too. Information about disease, which is communicated genetically or by infection of close contacts, may be very difficult for a family member to handle. The responsibility of some difficult information may be too much to cope with.

The generation gap can also cause problems with embarrassment over some intimate questioning. It is clearly inappropriate to discuss, for example, the exact details of gynaecological symptoms for an elderly lady when the consultation is being interpreted by her grandson. This type of conversation is much better conducted through an independent interpreter. However, there are communities from many parts of the world speaking rare languages for whom interpretation outside their own community poses great difficulty.

The other major issue in working through interpreters is that of confidentiality. Professional interpreters employed by hospitals are required to conform to a professional undertaking to preserve confidentiality and this in theory forms part of the contract of all healthcare workers. If you are acting as an interpreter for a relative you will need to be aware that a medical consultation is privileged and that the information discussed is confidential. You will need to be careful only to share the information with anyone your relative chooses.

Practical Tips: Conducting Consultations through an Interpreter

When you and your family arrive at a consultation with an interpreter it is sensible to make clear for the doctor who speaks English and who does not. Separately it is wise to make clear who understands English although they may not be able to speak the language. It is worth your explaining briefly to the interpreter what you understand their role to mean. You expect them to translate accurately as far as possible without either summarising or elaborating on your words. The general duty of confidentiality should be mentioned with the expectation that secrets will be preserved within the confines of the consultation.

When using an interpreter it is important for the patient to address their questions directly to the doctor rather than to the interpreter. It is natural to look at and speak to the person who understands but it is important to show that you want to talk to the doctor and not the interpreter. It is helpful to keep your sentences short.

Written information in the patient's mother tongue or local dialect can be enormously helpful, enabling the patient to come to terms with medical information in their own way and helping them prepare for a further consultation when necessary

It may also be tempting if you are interpreting for a friend to want to be more than their spokesman but also their advocate. If you add your own views it may be helpful but equally you may be overstepping your role with the risk of interfering too much. Good interpreters however are an invaluable source of cultural information and you can smooth out misunderstandings and help to successfully create a good working relationship.

Practical Tips: Consultations Through an Interpreter

1. Make it clear who speaks English
2. Make it clear who understands English
3. Agree that medical confidentiality applies
4. Address yourself to the doctor directly and not to the interpreter
5. Keep sentences short

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