Healthcare Interpreter in Hospital of California

In California, starting in 2009, health care interpreters working with commercial insurance plans are required by law to be trained in interpreting ethics and conduct, as set out in the standards promulgated by the California Healthcare Interpreting Association. These standards include confidentiality, accuracy and completeness, and cultural responsiveness with an emphasis on the interpreter's role as a 'cultural clarifier' who acts to identify and signal areas of potential confusion or affront to both patients and clinicians. National adoption of similar standards, operationalized through training and certification, may greatly aid all parties in interpreted encounters by ensuring basic linguistic competence and establishing a common understanding of the interpreter's role, including when and what types of alterations are acceptable. Effective communication between patients, clinicians, and other professionals in a health care setting is a central component of providing high quality care (Hasnain-Wynia, 5).

National standards and certification will not eliminate the need for the 'prior conversations' between physicians and interpreters that Hsieh and others have found so useful in negotiating the preferred role of an interpreter in a specific encounter, but they will serve to frame both parties' expectations at the start of such discussions. Furthermore, interpreters and clinicians will be able to assure patients that, just like physicians and nurses, all professional interpreters have been trained and pledged to protect confidentiality. Short videos explaining patients' rights to request language assistance and the role and training of interpreters could readily be incorporated into a health plan's, or health system's, patient education materials.

Two of the studies in this issue of Patient Education and Counseling offer fascinating glimpses into the dynamics of interpreted interactions, while a third reviews a novel curriculum for teaching clinicians about interpreter use. These articles highlight the need for national standards and certification of healthcare interpreters to improve the clarity and consistency of communication across language barriers (Karliner, 727). Such national standards may be needed in many different countries, but the present editorial will view this issue from a U.S. perspective.

Making the Case for Professionally Trained Healthcare Interpreters and Standards of Practice

Historically, the task of interpreting for patients who speak limited English (LEP) was delegated to any available self-declared bilingual individual present, regardless of their actual language ability or relationship to the patient. Ad hoc untrained interpreters typically include family members of the patient, including children; volunteers from other parts of the health organization; or any other individuals from the cultural/linguistic community of the patient who happen to be available on-site or available by telephone. As Charles (2002, 8) asserted that “The evaluation tool treats translation in the same context and with the same emphasis as interpreter services, evaluating not only the availability of the material but the process through which new material is identified for translation and made available to patients”. Even when ad-hoc interpreters may be ready to step in, asking people who have not received healthcare interpreter training to perform this task compromises some fundamental ethical aspects of healthcare between providers ...