Uploaded byTerena Bell
Death Threats, Interfering Daughters & Other Worse Case Scenarios
The document outlines the ethical considerations for medical interpreters, emphasizing the importance of confidentiality, accuracy, impartiality, and respect in various challenging situations. It provides real-life scenarios illustrating the dilemmas interpreters may face while adhering to the National Council on Interpreting in Health Care's code of ethics. The presentation encourages interpreters to advocate for patients' well-being when necessary, while maintaining professional boundaries and continuously improving their skills.
More Related Content
Similar to Death Threats, Interfering Daughters & Other Worse Case Scenarios
Death Threats, Interfering Daughters & Other Worse Case Scenarios
- 1. Death Threats, InterferingDaughters, and Other Worst-Case Scenarios 2010 CCHMC Conference on Medical Interpreting 21-22 August 2010 Terena Bell, CEO
- 2. Or, The NationalCouncil on Interpreting in Health Care Code of Ethics: Daily Application
- 3. Getting the Legalitiesout of the Way DISCLAIMER: Terena Bell does not work for the National Council on Interpreting in Health Care, nor does she speak on its behalf. The following presentation is simply a user’s fresh look at how to apply the NCIHC’s Code of Ethics while interpreting in difficult or unusual situations. It has not been endorsed by the NCIHC accordingly. A full copy of the NCIHC code of ethics may be downloaded at http://data.memberclicks.com/site/ncihc/ NCIHC%20National%20Code%20of%20Ethics.pdf. All of the case examples provided in this presentation are real-life situations in which professional interpreters have found themselves while on-the-job. Examples are being used with interpreter and/or client permission.
- 4. Thanks To “AHealth Care Interpreter’s Best Friend: The National Code of Ethics for Interpreters in Health Care” Shiva Bidar-Sielaff & Karin Ruschke Presented by Jorge U Ungo American Translators Association 49th Annual Conference
- 5. Code of Ethicsfor Interpreters in Health Care • The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. • The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context. • The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs. • The interpreter maintains the boundaries of the professional role, refraining from personal involvement. Complete Code of Ethics document available at http://data.memberclicks.com/site/ncihc/NCIHC%20National%20Code%20of%20Ethics.pdf.
- 6. Code of Ethicsfor Interpreters in Health Care, Cont. • The interpreter continuously strives to develop awareness of his/her own and other (including biomedical) cultures encountered in the performance of their professional duties. • The interpreter treats all parties with respect. • When the patient’s health, well-being, or dignity is at risk, the interpreter may be justified in acting as an advocate. Advocacy is understood as an action taken on behalf of an individual that goes beyond facilitating communication, with the intention of supporting good health outcomes. Advocacy must only be undertaken after careful and thoughtful analysis of the situation and if other less intrusive actions have not resolved the problem. • The interpreter strives to continually further his/her knowledge and skills. • The interpreter must at all times act in a professional and ethical manner. Complete Code of Ethics document available at http://data.memberclicks.com/site/ncihc/NCIHC%20National%20Code%20of%20Ethics.pdf.
- 7. In a word… Original Language The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. Summarization CONFIDENTIALITY
- 8. In a word… Original Language The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context. Summarization ACCURACY
- 9. In a word… Original Language The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs. Summarization IMPARTIALITY
- 10. In a word… Original Language The interpreter maintains the boundaries of the professional role, refraining from personal involvement. Summarization NEUTRALITY
- 11. In a word… Original Language The interpreter continuously strives to develop awareness of his/her own and other (including biomedical) cultures encountered in the performance of their professional duties. Summarization CULTURAL-AWARENESS
- 12. In a word… Original Language The interpreter treats all parties with respect. Summarization RESPECT
- 13. In a word… Original Language When the patient’s health, well-being, or dignity is at risk, the interpreter may be justified in acting as an advocate. Advocacy is understood as an action taken on behalf of an individual that goes beyond facilitating communication, with the intention of supporting good health outcomes. Advocacy must only be undertaken after careful and thoughtful analysis of the situation and if other less intrusive actions have not resolved the problem. Summarization ADVOCACY
- 14. In a word… Original Language The interpreter strives to continually further his/her knowledge and skills. Summarization SELF-IMPROVEMENT
- 15. In a word… Original Language The interpreter must at all times act in a professional and ethical manner. Summarization PROFESSIONALISM
- 16. • The interpretertreats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure. • The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context. • The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs. • The interpreter maintains the boundaries of the professional role, refraining from personal involvement. • The interpreter continuously strives to develop awareness of his/her own and other (including biomedical) cultures encountered in the performance of their professional duties. • The interpreter treats all parties with respect. • When the patient’s health, well-being, or dignity is at risk, the interpreter may be justified in acting as an advocate. Advocacy is understood as an action taken on behalf of an individual that goes beyond facilitating communication, with the intention of supporting good health outcomes. Advocacy must only be undertaken after careful and thoughtful analysis of the situation and if other less intrusive actions have not resolved the problem. • The interpreter strives to continually further his/her knowledge and skills. • The interpreter must at all times act in a professional and ethical manner. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 17. Points to Keepin Mind Which part of the code applies? Could this situation have been prevented? How would you handle it?
- 18. And now forthe death threats, interfering daughters, and other worst-case scenarios.
- 19. Hospital - Louisville,Ky You’re interpreting for a man who may or may not have cancer. While waiting for the test results, the man’s son approaches you and, leaning in closely, whispers that no matter what the results say, if you tell his father that he has cancer, he will follow you home and kill you. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 20. Hospital - Louisville,Ky You are consecutive interpreting in a language whose culture considers interrupting to be very offensive. After the doctor has spoken, you turn to interpret, but before you have the chance, the patient’s daughter jumps in and does the interpreting on her own. Knowing that the patient has requested a professional interpreter and does not want his daughter interpreting, you try to speak sooner next time. Now, however, the daughter is interrupting you as you interpret, simply acting as though you are not there and speaking so loudly that only she can be heard. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 21. Private Practice -Louisville, Ky You are a Spanish interpreter in a city where many trained, Spanish interpreters are available. After arriving on-site for your appointment, you realize that while you did not recognize the patient’s name before, you do happen to know him after all. His child and your child are friends. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 22. Health Clinic -Louisville, Ky As an individual, you are pro-life. Your personal religious views do not advocate or allow you to help or otherwise aid in any abortion-related activities. Very quickly, however, you learn that an assignment you have arrived to interpret for is, in fact, a pre-abortion counseling session. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 23. Home Visit- RuralSouth Carolina A little girl with developmental issues desperately needs corrective surgery. But despite the doctor’s urging, the father says he doesn’t want her to have the operation. The doctor keeps asking why, but the father won’t answer. Upset, the doctor steps outside to calm down, leaving you alone with the family. While the doctor is out, the father and mother have a private conversation you can easily hear. The mother wants the girl to have the surgery; however, the father is ordering her to keep quiet, because if the girl has the surgery, she will heal and the family will lose the government assistance and disability benefits that they receive for the child. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 24. Private Practice -Bardstown, Ky The patient needs a ride home. His ride hasn’t shown and you are in a rural town without public transit. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 25. Hospital - Chicago,Illinois You are working in a pediatric facility with a family that has just lost their only child. You know from working with the family during prior appointments that religious burial is necessary for the child to enter their heaven. But during the session where you are interpreting, the mother declines burial information offered by the hospital and agrees that the hospital may dispense of the body as it sees fit. The mother seems discontent with her decision, however, and you strongly suspect that the family does not have the financial means to pay for burial. From your previous job, you are familiar with an area program which provides free or low-cost burials to lower SES families. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 26. Health Clinic -Raleigh, North Carolina An elderly lady has been diagnosed with skin cancer and is embarrassed to go out in public because of what the cancer has done to her appearance. The family wants the doctor to fix it. While the doctor does not have anything he can give her as a cancer cure, he does have some cream he can give her that would help with her appearance. He’s afraid, however, that the family will misunderstand and think that this cream is also a cure. Not sure how to handle the situation, the doctor asks you if he should give it to her. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 27. Health Clinic -Louisville, Ky During a well-child checkup, the nurse on duty asks you to help her physically restrain a child so that she can give the child a booster shot. CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 28. Hospital - Bensalem,PA You are interpreting for a woman who is waiting to hear if she has cancer. The doctor comes into the room and says, “I have your results.” As a gut reaction, the patient reaches out and grabs your hand. Do you hold it or do you let it go? What if she were waiting for AIDS results instead? CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 29. Physical Therapy Center- Louisville, Ky After completing an assignment for a patient injured on the job, you receive a phone call from the patient’s insurance company. The company believes their insured is committing insurance fraud and that a friend of the insured is attending the appointments instead. Their representative asks you to complete a single page form with questions such as “How tall was the patient,” “What kind of car did the patient drive,” and “What color eyes does the patient have?” CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 30. Health Clinic -Kansas City, Mo You are an interpreter working in a language of limited diffusion and the only professionally-trained interpreter for your language pair in town. In your home culture, all family concerns must be reported directly to the father for him to make all decisions. You are interpreting for a single woman in her early 20’s who has contracted an STD. In this culture, sex before marriage is punishable by stoning. Knowing his daughter is ill, the father has taken her to the doctor; however, provider regulations do not allow him to be in the room while the examination is taking place. When the patient learns she has an STD, he is therefore not in the room and she begs you not to tell him. You know her father is going to press you for information about her condition because he feels he has a cultural right to know and he is particularly strict. In fact, earlier that day, while you took a bathroom break, you had to walk by the father and he stopped you. At that time, he told you that he thought his daughter was having sex and that he wanted you to find out if this was true. If you did not tell him, as an elder, he swore to have you socially outcast from the community. He promised that he would personally see to it that no one in the community ever spoke to you again. His exact words, translated, were “You will be dead to us.” CONFIDENTIALITY ACCURACY IMPARTIALITY NEUTRALITY CULTURAL-AWARENESS RESPECT ADVOCACY SELF-IMPROVEMENT PROFESSIONALISM
- 31. For More Information www.ncihc.org www.ineverylanguage.com
Editor's Notes
- #20 First, the death threat: Accuracy, Self-imrpovement, Professionalism
- #21 Professionalism, respect, impartiality, cultural awareness, advocacy??
- #22 neutrality
- #23 Impartiality, respect, professionalism
- #24 Neutrality, Confidentiality or accuracy-which one?, advocacy or impartiality—which one?
- #25 Neutrality
- #26 Advocacy or impartiality?
- #27 Advocacy? Yes or no. More like cultural awareness. Also professionalism? Definintely neutrality.
- #28 Neutrality!
- #29 Some boundries are very clear, such as we don't push wheelchairs, help move patients or help hold them down. We also completely avoid being left alone with them, and decline requests or gestures to carry or babysit children, etc. We know to take into account issues such as contact precautions and contagious diseases as well. In other words, we don't touch or assist in any way that increases the medical interpreter's risk and liability, added to the fact that there are others in the system, whose job it is to already assist with some of the tasks mentioned, who are covered by insurance that corresponds to the level of risk involved in their jobs. Our medical interpreters are only covered by errors and omissions insurance. I/we also believe kissing and hugging could be misconstrued (as is the case with any kind of casual contact in legal interpreting that is perceived as a conflict of interest) although culturally, it is sometimes very difficult to avoid over the long term. However, if a patient reaches out to you to hold your hand momentarily before a surgery, or a child walks up to you to give you a hug or a sticker and you pat them on the head as a gesture that accompanies a 'thank you,' is this forbidden? Obviously we would never pick up a child, however tempting. Several medical interpreters I work with, hold this belief in the extreme (no head patting, no consoling hand squeeze), and we're not sure: 1.Where they got this idea and 2. If it is correct? Correct me if I am wrong, but that I am aware, BENIGN touch (and I know this can be interpreted subjectively) is not forbidden, nor is it written in the hospital policies I am familiar with, or the "Bridging the Gap" manual, although as stated, we don't initiate it, provoke it, and should generally avoid any physical contact. I just want to know if this is clearly and objectively written down and addressed anywhere, with regard to medical interpreters.
- #30 Neutraility, impartiality, CONFIDENTIALITY
- #31 Cultural awareness, Advocacy?, respect, confidentiality, neutrality, impartiality