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Overview of Ethics and Ethical Issues in Interpretation
Every professional group has a code of ethics.
Developing an agreed-upon set of guidelines is essential to the professionalization
of any new field. Thus, as medical interpretation has grown around the country
so too have ethical guidelines. Although codes for medical interpreters
have often emerged independently in various institutions and locales, they
have much in common and express similar core values. These core values include:
confidentiality, fidelity (or accuracy), and respect (for patients and providers
alike). In addition, most codes give interpreters the responsibility and
right to turn down or leave assignments they feel unable to handle in a
professional manner, including interpreting for close friends or relatives,
interpreting in situations which pose a conflict with the interpreter's
own internal values, and interpreting in situations for which they feel
untrained or unqualified.
Elements that do vary among different codes of
ethics usually result from the definition of the interpreter's role. While
most guidelines acknowledge that interpreters should be neutral and not
impart personal opinions or advice, there are varying views on the interpreters'
responsibility to add information on culture or to act as advocate for the
clients. An institution's particular code of ethics will reflect
these views.
It is critical for a new interpretation program
to have the interpreter's role and the code of ethics clearly spelled out
right from the start. This information will help direct the selection of
interpreters, as well as the orientation and training programs designed
for them. Interpreters and providers alike must have a clear and common
understanding of the role and ethical guidelines in order to avoid conflict
and confusion. At the same time, it is important to seek feedback from interpreters
on their ability to follow through on these expectations. What makes sense
for one cultural group may not for another. Asking interpreters what a particular
rule means for them individually and within their culture will help to clarify
the code, support the interpreters in their efforts to comply, and adapt
the code when it doesn't work.
Consulting with experts in the area of medical
ethics may also be helpful in determining appropriate codes of ethics for
interpreters. You may want to consult such experts at your institution.
Lacking this, there are a number of organizations that specialize in the
field of bioethics, many attached to medical schools and universities, such
as the Center for Biomedical
Ethics, University of Minnesota. Many of them
can be found through an internet search using keywords such as biomedical
ethics, bioethics, or health care ethics.
Examples of four different codes of ethics follow.
They are from the Registry of Interpreters for the Deaf (RID), the Massachusetts
Medical Interpreters Association (MMIA), the American Medical Interpreters
Translators Association (AMITAS), and the Boston Area Health Education Center.
RID's code is of interest for historical reasons as it has formed the foundation
for most medical interpreter codes of ethics. It is especially helpful in
giving explanatory guidelines for each element of the code. One interesting
element is its point about "requesting compensation for services
in a professional and judicious manner. This reflects issues that have arisen
in the community of sign language interpreters as many work free-lance rather
than as salaried employees. MMIA's code of ethics is unique as a product
of a process that defined Standards of Practice for interpreters in Massachusetts.
It is also unusual in the way it explicitly defines "respecting patient
privacy and "maintaining a professional distance, and in addressing
an interpreter's responsibility to deal with discrimination. The code from
AMITAS is useful in the way it is divided up into separate sections that
deal with patient and provider relationships. Finally, the Code of Ethics
from the Boston Area Health Education Center is concise and straight-forward,
yet covers all the main points of the others.
Questions for our readers:
- What has been your experience in interpreting
situations that provoke ethical dilemmas? Can you give us specific examples,
including what/who provoked the situations (provider, interpreter, patient,
other) and how they were resolved?
- Have you developed a code of ethics for interpreters
in your institution? How does it differ from the examples included here?
- Does your organization have a designated staff
person available to help deal with ethical issues?
- Do you know of any organizations dealing with
issues of ethics and medical interpretation?
Respond by email
(RCCHC@aol.com) and we will share your answers in an upcoming online forum. |
