Author(s): Yuliya Speroff, Medical Interpreter Supervisor, Harborview Medical Center

Date Authored: January 25, 2023

Medical interpreters play an essential role in ensuring patients receive quality care by helping reduce communication barriers between practitioner and patient. Sometimes, however, a patient may want to use a bilingual family member for medical interpretation. There are many reasons why this is not a good practice. 

International Medicine Clinic, Harborview Medical Center

The most immediate danger of family member interpretation is the risk of misinterpretation of vital information related to the patient’s symptoms and health. This could happen due to lack of knowledge of medical terminology, or if a family member feels like their loved one should be protected from bad news, such as being diagnosed with a serious disease. In contrast, professional medical interpreters are familiar with medical terminology in all their working languages and can employ their knowledge of interpreting protocols and best practices for clarifying unfamiliar terms and dealing with other challenges that arise during an interpreting encounter.

Another important point is that professional medical interpreters adhere to a code of ethics and standards of practice, requiring an interpreter to repeat everything that is being said, without adding, omitting or changing the message. Professional medical interpreters are neutral and objective, and do not have the same emotional ties or biases that family members may have. This allows them to provide accurate and unbiased interpretation, which is especially important when discussing sensitive medical information.

Some other helpful points that can be brought up in the discussion with the patient and their family member about including a professional interpreter in the appointment are:

  • The services of a professional medical interpreter are provided at no cost to the patients and their family members.
  • Everything that transpires during the appointment where an interpreter is present remains fully confidential and will not be disclosed without the patient’s permission. An interpreter is bound by the same confidentiality requirements as other members of the care team, in addition to ethical obligation to maintain patient’s confidentiality.
  • Allowing a professional interpreter to facilitate communication between the patient and their provider can take the burden off family members and allow them to focus on supporting their loved one
  • The interpreter is there for the provider as well as for the patients.

There are also legal and regulatory requirements for healthcare facilities to provide language access for patients with limited English proficiency: 

  1. Title VI of the Civil Rights Act of 1964 requires recipients of Federal financial assistance to take reasonable steps to make their programs, services, and activities accessible by eligible persons with limited English proficiency. 
  2. Section 1557 is the civil rights provision of the Affordable Care Act of 2010. It prohibits discrimination on the grounds of race, color, national origin, sex, age, or disability in certain health programs and activities. The prohibition on national origin discrimination requires covered entities to take reasonable steps to provide meaningful access to each individual with limited English proficiency who their program might serve. 
  3. The Americans with Disabilities Act (ADA) requires covered entities must provide aids and services when needed to communicate effectively with people who have communication disabilities. 
  4. The Joint Commissions sets standards for effective communication, cultural competence, and patient- and family-centered care. This includes identifying and addressing patient communication needs. 

See attached PDF for this list of legal and regulatory requirements in an easy-to-print and share format.