Abstracts
Abstract
This article examines the part that healthcare interpreters play in cross-cultural medical ethics, and it argues that there are instances when the interpreter needs to assume an interventionist role. However, the interpreter cannot take on this role without developing expertise in the tendencies that distinguish general communication from culture to culture, in the ethical principles that govern medical communication in different communities, and in the development of professional relationships in healthcare. The article describes each of these three variables with reference to a case scenario, and it outlines a number of interventionist strategies that could be potentially open to the interpreter. It concludes with a note about the importance of the three variables for community interpreter training.
Keywords: community interpreting, informed consent, role of the interpreter, healthcare.
Résumé
L’interprétation dans le domaine des soins de santé et le consentement éclairé: quel est le rôle de l’interprète dans le choix du traitement? - Dans cet article, l’auteur fait le point sur le rôle de l’interprète communautaire face à des conflits d’éthique dans le domaine de la santé. Dans des circonstances bien définies, on propose à l’interprète un comportement plus interventionniste que de coutume. Mais avant d’intervenir plus activement, l’interprète doit développer ses compétences dans trois domaines : il doit se familiariser avec les facteurs servant à décrire la communication dans différentes cultures; il doit connaître les principes d’éthique médicale privilégiés par différentes collectivités; et il doit bien comprendre le fonctionnement de ses relations avec des professionnels de la santé. Après avoir décrit, à l’aide d’une étude de cas, chacune de ces trois compétences, l’auteur examine les stratégies interventionnistes disponibles à l’interprète et, en guise de conclusion, il souligne l’importance des idées présentées dans l’article pour la formation d’interprètes communautaires.
Mots-clés: interprétation communautaire, consentement éclairé, rôle de l’interprète, soins de santé.
Appendices
References
- ANGELELLI, Claudia (2004). Medical Interpreting and Cross-Cultural Communication. Cambridge, Cambridge University Press.
- Beauchamp, Tom L. (1997). “Informed Consent,” in Robert M. Veatch (ed.). Medical Ethics (2nd ed.). Sudbury, MA, Jones and Bartlett, pp. 185-208.
- ——— & Childress, James F. (1983). Principles of Biomedical Ethics (2nd ed.). New York, Oxford University Press.
- Clifford, Andrew (2006). “Is Fidelity Ethical? The Social Role of the Healthcare Interpreter.” TTR,17, 2, pp. 89-114.
- Cong, Yali (2004). “Doctor-Family-Patient Relationships: The Chinese Paradigm of Informed Consent.” Journal of Medicine and Philosophy, 29, 2, pp. 149-178.
- Culhane-Pera, Kathleen A. (2003). “‘Please Help Me’: A Physician Responds to a Hmong Woman’s End-of-Life Struggles,” in Kathleen A. Culhane-Pera, Dorothy E. Vawter, Phua Xiong, Barbara Babbitt & Mary M. Solberg (eds.). Healing by Heart: Clinical and Ethical Case Stories of Hmong Families and Western Providers. Nashville, Vanderbilt University Press, pp. 289-294.
- Fan, Ruiping & Li, Benfu (2004). “Truth Telling in Medicine: The Confucian View.” Journal of Medicine and Philosophy, 29, 2, pp. 179-193.
- Hall, Edward T. (1976). Beyond Culture. Garden City, NY, Anchor Press/Doubleday.
- Hofstede, Geert. (2001). Culture’s Consequences: Comparing Values, Behaviors, Institutions, and Organizations across Nations (2nd ed.). Thousand Oaks, CA, Sage Publications.
- Hui, Edwin. (1999). “Chinese Health Care Ethics,” in Harold Coward & Pinit Ratanakul (eds.). A Cross-Cultural Dialogue on Health Care Ethics. Waterloo, ON, Wilfred Laurier University Press, pp. 128-138.
- McGlynn, Katherine A., Tsao, Lilian, Hsing, Ann W., Devesa, Susan S. & Fraumeni, Joseph F. (2001). “International Trends and Patterns of Primary Liver Cancer.” International Journal of Cancer, 94, 2, pp. 290-296.
- METZGER, Melanie (1999). Sign Language Interpreting: Deconstructing the Myth of Neutrality. Washington, Gallaudet University Press.
- Nguyen, Mindie H., Whittemore, Alice S., Garcia, Ruel T., Tawfeek, Saraa A., Ning, Jing, Lam, Suzanna, Wright, Teresa L. & Keeffe, Emmet B. (2004). “Role of Ethnicity in Risk for Hepatocellular Carcinoma in Patients with Chronic Hepatitis C and Cirrhosis.” Clinical Gastroenterology and Hepatology, 2, 9, pp. 820-824.
- Solomon, Mildred (1997). “From What’s Neutral to What’s Meaningful: Reflections on a Study of Medical Interpreters.” The Journal of Clinical Ethics, 8, 1, pp. 88-93.
- Tai, Michael Cheng-tek & Tsai, Tsung-po (2003). “Who Makes the Decision? Patient’s Autonomy vs Paternalism in a Confucian Society.” Croatian Medical Journal, 44, 5, pp. 558-561.
- TSAI, D. F.-C. (2005). “The Bioethical Principles and Confucius’ Moral Philosophy.” Journal of Medical Ethics, 31, pp. 159-163.
- Veatch, Robert M. (1997a). “Autonomy and Communitarianism: The Ethics of Terminal Care in Cross-Cultural Perspective,” in K. Hoshino, (ed.). Japanese and Western Bioethics: Studies in Moral Diversity. Dordrecht, Kluwer Academic Publishers, pp. 119-129.
- ——— (1997b). “Medical Ethics: An Introduction,” in Robert M. Veatch, (ed.). Medical Ethics (2nd ed.). Sudbury, MA, Jones and Bartlett, pp. 1-27.
- ——— & Flack, Harley E. (1997). Case Studies in Allied Health Ethics. Upper Saddle River, NJ, Prentice Hall.
- Wadensjö, Cecilia (1998). Interpreting as Interaction. London, Longman.
- Yeung, Yuk Pang, Lo, Chung Mau, Liu, Chi Leung & Wong, Benjamin C. (2005). “Natural History of Untreated Nonsurgical Hepatocellular Carcinoma.” American Journal of Gastroenterology, 100, 9, 1999-2004.