When coming for an appointment or a medical procedure, patients are often accompanied by a family member, a friend or a caregiver. The people accompanying a patient play an important role: moral and physical support, an extra set of ears, an advocate and an ally. And sometimes, family members and friends play another role – they provide language assistance. While asking a family member to interpret might seem like the perfect solution – after all, it’s free of charge and easy to arrange – doing so might be not only unethical, but also dangerous. 


Professional interpreters abide by a code of ethics, which typically includes tenets specifying, among other things, the need for accuracy. Accuracy involves interpreting everything – whether profanity, a silly joke, a critical remark or a serious diagnosis. Family members, with very best of intentions, don’t always accurately interpret what is being said. For example, they might be tempted to soften the message when the patient is critical of medical providers. Doing so takes away from the patient’s autonomy and silences their voice. Additionally, in some cultures it is undesirable to share bad news with the patient as it is believed that it might make the patient depressed and ultimately worse off. As a result,  a cancer diagnosis and suggested treatment options may be reduced to “You’re just a little sick and will get better after taking some pills.”


Professional medical interpreters undergo basic training in order to qualify for national certifying exams. Once interpreters get certified, they are required to receive continuing education. This ensures that interpreters working in healthcare settings have a solid understanding of medical terminology in all their working languages. However, there is no guarantee that family members will be able to use complex medical terminology in both languages. As a result, instead of the exact words the patient uses to describe their past medical diagnoses and procedures, or the detailed explanation a medical provider gives as they present treatment options, the parties might be receiving abbreviated versions or summaries. Why might this be dangerous? From the point of view of the patient, they have a right to be informed of their care and have to understand exactly what a particular treatment involves in order to consent to it. By definition, consent must be informed and given voluntarily. This might not be the case if a patient is agreeing to a procedure while not receiving the full extent of the information. From the provider’s point of view, making an accurate diagnosis and ensuring adherence to treatment requires being able to communicate with the patient directly (with certain exceptions related to a patient’s age and mental capacity). However, this might not be possible if a physician is working off somebody else’s words, which may be inaccurate due to the lack of medical vocabulary needed to explain something, mistaken assumptions or even malicious intent (imagine someone who is perpetrating abuse interpreting for their victim). 


To sum up, there are many ethical and legal consequences that can arise from using ad-hoc interpreters such as family members. To mitigate these consequences, it is always best to use professional interpreters who have been trained in all aspects of interpreting in healthcare settings such as being fluent in medical terminology and maintaining confidentiality, accuracy, and role boundaries. 

As Covid-19 continues to spread, refugees and asylum seekers around the world are left in a uniquely vulnerable position. Crowded living conditions, lack of clean water, and overburdened medical systems are just a few of the challenge millions of people are facing. Even those who have resettled in nations such as the United States still struggle with language barriers as they try to navigate complex healthcare systems. Fortunately, remote interpreting can help them safely receive medical care and other services they need to thrive in their adopted countries.


Healthcare and Remote Interpreting for Refugees


The United States accepts some of the world’s most vulnerable refugees, including the elderly and those with acute medical needs. Thanks to Video Remote Interpreting (VRI), healthcare professionals can assist refugees via telemedicine without putting patients, interpreters, or themselves at risk for COVID-19. Patients who have been hospitalized can speak through an interpreter virtually, which allows both parties to maintain social distancing.


Yet refugees may not only need care for their physical health, but their mental health as well. Refugees who have experienced trauma may benefit from speaking with a psychologist or other mental health professional. VRI also lets patients safely seek psychiatric care with the help of an interpreter.


The Advantages of Remote Interpreting


In addition to social distancing, remote interpreting offers several advantages for refugees, their advocates, and government entities who serve them. These include the ability to hire an interpreter who:


  • Speaks a rare language when no one is available locally. A refugee from a country such as the Democratic Republic of the Congo may speak one of 242 different languages, making it difficult to find an interpreter who speaks theirs.


  • Can work on short notice. Refugees not only need an interpreter when they receive medical care, but for visits with social services and legal hearings. When appointments get rescheduled, it can leave refugees without anyone to assist them.


  • Has experience working with refugees. While every refugee has a unique story, all have gone through the devastating experience of fleeing their homeland. Many have fled due to genocide or have been victims of torture and abuse. An interpreter who understand the psychological effects these experiences can have will be better equipped to assist both the refugee and the other parties involved.


A More Affordable Solution


Remote interpreting offers another major advantage for organizations and government entities that assist refugees: reduced costs. By hiring a remote interpreter, you can eliminate wait times and the travel expenses that are associated with bringing someone onsite. For organizations that are already stretched financially, this can help keep costs within budget constraints. While onsite interpreting has its own benefits, remote interpreting can fill the gaps when it isn’t possible due to a variety of situations.


For more information about remote interpreting options, contact Boostlingo today.


Dear Boostlingo Family,


I wanted to say thank you and share something positive with you that I hope you can find encouraging or that you might find it even useful for other interpreters.


I am a conference interpreter, so being used to working mostly from the booth, I wasn’t that often in direct contact with the people benefiting from the service until I started taking calls with Boostlingo’s platform. I have to say that being in direct contact with people, especially in the current difficult circumstances, struggling in some way or another because of the language barrier, has been very rewarding. I love being part of a job that brings people together, that tears down these gaps and barriers and helps some that couldn’t communicate properly or benefit from a service, feel at ease, looked after and understood. I’ve recently had some very touching experiences with people that are in very difficult situations and being a little part of the solution and help that was offered to them was really beautiful. So I wanted to say thanks for the opportunity to be part of the team and the work on OPI and VRI.


I specialise in medical, legal, education and court, so most of what happens during these calls is obviously confidential but I’d like to share with you just the general feeling of what has been happening in several during these calls. Most of the calls are in a medical setting, with people feeling bad and with health workers under so much pressure and stress I could tell the huge difference it made in both patients and health care providers being treated with patience and efficiency. Lots of those calls or videoconferences started with a very tense atmosphere and ended up with doctors, nurses and patients feeling a lot more relaxed, smiling and reassured. Many of the situations have been quite extreme due to the Covid-19 crisis, but still several requestors took a moment to say how much the service had helped them and expressed their appreciation. In a particular family session with a social worker and a family going through very difficult circumstances, both ended the conversation saying how happy they were that they could have such a fluid conversation, understand each other like talking directly and connecting at an emotional level. The social worker congratulated me for the service that made possible what they thought was an amazing therapy session. The mother of the family almost cried when she said that she wanted to thank the interpreter because she’d never had such a session before. Although they were of course the ones that made all the conversation and the therapy came from the qualified health professionals, they all felt that it worked better just because they were treated with patience, not interrupted and the conversation was interpreted in a way that conveyed not only the message but also the feelings and emotions of the original speaker. Hearing them say that and feeling the much happier and relaxed tone of voices by the end of a very long and difficult to interpret session was a real gift. It really puts into perspective the human and caring side of our work that can otherwise get buried by the routine or the calls when people are a bit rude or aggressive.


In another call a person from the education system was offering help to families of the children in their school, offering assistance even with food, medicines, paperwork for community services and checking up on them. The person started the call very stressed having to call lots and lots of different numbers and feeling that she couldn’t probably get through half of what she had to do. We called so many numbers of different families for them that I lost track of how many numbers I dialed just for that service. But just a few calls into it, I could tell she was relaxing and feeling that this way it would be a lot easier than what she had thought before. We both finished the call incredibly satisfied about how much had been done and how smooth some of these very difficult conversations had been. By the end of a long list of third party phone calls the teacher felt that she’d managed to contact everybody, assess the situations properly and even got many days of appointments ready for picking up food and delivering it, organized and made easier with addresses, specific time appointments and all the necessary details. She also thanked us for the service and said that we’d been amazing that day and that she didn’t think she could make it before she got on the phone.


Raquel Maquieira Sans
Interpreter- 3TBox Team