Interpreting and the Politics of Recognition by Stone Christopher Leeson Lorraine & Lorraine Leeson

Author:Stone, Christopher,Leeson, Lorraine & Lorraine Leeson
Language: eng
Format: epub
Publisher: Taylor & Francis (CAM)

Why is interpreter provision not seen as an ethical issue?

Despite the large body of research that demonstrates the risks inherent in not providing competent interpreters as summarised in Bowen et al. (2010) quoted above, many health professionals around the world continue to try to manage without such interpreters. For example, MacFarlane et al. (2009: 2012) interviewed 7 Serbo-Croat and 19 Russian speakers with limited English proficiency about their experiences of accessing primary healthcare in Galway (Ireland) and found that:

Broadly speaking, participants’ general practitioners accepted the use of informal interpreters. Indeed, a few said they have been sent away by their doctors to find someone to help them communicate once it became clear how limited their English was.

Even if the general practitioners are not aware of the research on medical interpreting, it is curious that they do not appear to be concerned about patient confidentiality and suprising that they do not see professional medical interpreter provision as an ethical issue.

Research carried out by Holm (1998) may provide us with some answers. He interviewed 42 healthcare professionals in Denmark and asked them to discuss the ethical issues in 13 different scenarios. He cautions against relying on codes of ethics when analysing ethical decision making because “there is no justification for believing that all the prescriptions in professional codes exemplify ideal ethical values” (1998: 81). He also cites evidence that the codes “play only a very limited role in the ethical reasoning of professionals” and many codes are “fairly short and non-specific” (1998: 81, 82). He found that the people he interviewed rarely referred to codes of ethics and when they did they sometimes quoted the codes incorrectly. Holm suggests that ethical problems were not identified by healthcare professionals because in some cases they were “insensitive to the ethically relevant features” (1998: 101), because problems were identified as administrative or technical issues rather than as ethical issues, or because the professional had a firm solution in mind and did not identify a problem (1998: 102). Pressure of work may mean that professionals do not have time to identify or consider ethical issues. Another issue was lack of time to recognise and deal with problems. Also, “in some work settings it is seen as psychologically necessary not to see all problems” (1998: 102). Some of the respondents spoke about “ethical burn-out” where, faced with too many ethical problems, they stopped identifying such issues, “because there were too many to cope with” and one stated: “Yes, I think, I think that you can have periods where you, like, choose to say, well, I can’t handle the ethical, now I just have to do it like it is” (1998: 111).

According to Holm (1998: 174), “[w]ork pressure over longer periods of time is also likely to lead to routinisation of perception or to ethical burnout”. Molewijk et al. (2015: unpaginated) in their study of focus group participants who worked in an acute ward in mental health care, reported that “the burden of being confronted with dilemmas all the time is so heavy that it causes an extra high turn-over rate among specialists”.

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