Introduction
One of the responsibilities of a healthcare professional is to communicate with a patient, especially when it comes to making health decisions. Among other things, having meaningful conversations with a patient helps to gain informed consent, which is the foundation of ethical medical practice. However, transmitting information is not always possible when a healthcare professional interacts with non-English speakers and their families. The inability to gain consent from such patients compromises the principle of autonomy. This essay will discuss the issue of medical consent in non-English speakers and measures that medical facilities might undertake such as hiring professional interpreters.
Literature Research Synopsis
Zong and Batalova state that today, more than 25 million American residents have limited English proficiency, which makes accessing healthcare services complicated. Literature on the topic of language discordance is fairly limited. It mainly focuses on the threats presented by the lack of expertise in managing bilingual spaces as well as existing problem-solving methods and strategies. Raynor found that more than half of patients (62%) with limited English proficiency left the last appointment with some questions unanswered by their provider. Moreover, about half of them were not even sure why they needed to see that specialist. Raynor concluded that the language barrier was the main reason behind misunderstanding, especially concerning medication and treatment plans.
Parsons, Baker, Smith-Gorvie, and Hudak pointed out two key approaches to overcoming language discordance: “get by” and “get help.” The former meant doing everything possible to resolve the situation while the latter implied outsourcing the problem. Choosing one of the approaches was not dictated by any standardized guidelines – in actuality, none of the hospitals that partook in the study had them. Moreover, health workers had to evaluate the threshold of problem complexity beyond which they would need help on their own, making the situation even more complicated. Even though hospitals were located in a fairly international city – Toronto, medical facilities have yet to figure out how to handle communication with non-English speaking patients.
If a health worker decides to “get help,” he or she might want to consider phone interpretation services. Lee et al. showed that phone interpretation systems were effective in communicating the particularities of invasive procedures to patients. Participants in the intervention group reported better health outcomes than those who did not have access to phone interpretation services. While the results seem optimistic, their implications might be challenging to implement. Due to the shortage of medical interpreters, hospitals are not always capable of installing interpretation systems. For instance, Diño St. Luke’s hospital, Texas, only had ten interpreters at its disposal – barely enough for the population of 40,000 Spanish speakers. Moreover, hospitals experience high turnover rates as interpreters cannot always keep up with the ever increasing workload.
Conclusion and Implications
The topic of language discordance in clinical settings is not being researched enough. Existing studies have outlined the scope of the issue – the US has a growing non-English speaking population that struggle accessing health care. There are some conclusions made regarding the outcomes: non-English speaking patients do not understand the objectives of treatment and do not always follow through with procedures and medication. The question arises as to what strategies medical facilities should adopt in order to solve this issue. Future research should focus on methods appropriate for the field of radiology since it encompasses procedures with relatively high health risks. Once best evidence-based practices are established, it will be possible to develop comprehensive guidelines on language discordance and therapeutic communication.
References
Diño, G. (2017). Demand in the US for Legal and Healthcare Interpreters Gets Increasing Media Attention. Slator. Web.
Lee, J. S., Pérez-Stable, E. J., Gregorich, S. E., Crawford, M. H., Green, A., Livaudais-Toman, J., & Karliner, L. S. (2017). Increased access to professional interpreters in the hospital improves informed consent for patients with limited english proficiency. Journal of General Internal Medicine, 32(8), 863-870.
Parsons, J. A., Baker, N. A., Smith-Gorvie, T., & Hudak, P. L. (2014). To ‘get by’ or ‘get help’? A qualitative study of physicians’ challenges and dilemmas when patients have limited English proficiency. BMJ Open, 4(6), e004613.
Raynor, E. M. (2016). Factors affecting care in non-English-speaking patients and families. Clinical Pediatrics, 55(2), 145-149.
Zong, J., & Batalova, J. (2015). The limited English proficient population in the United States. Migration Policy Institute. Web.