Workshops
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Workshop
C-3: Developing an interpreter code of ethics and implications for practice
National
Code of Ethics and Standards of Practice for Interpreters in Health Care:
Development and Implications
The National Council on Interpreting in Health Care (NCIHC) is a multidisciplinary
national organization that promotes culturally competent professional
health care interpreting as a means to support equal access to health
care for individuals with limited English proficiency. As part of its
work for the past two years, the Standards, Training and Certification
(STC) Committee of the NCIHC created a National Code of Ethics for Interpreters
in Health Care. In addition, the STC committee has received joint funding
from The Commonwealth Fund and the California Endowment to implement a
national consensus-building process to develop a set of standards of practice
for interpreters working in health care settings.
With the completion of a nationally vetted code of ethics, a national
set of standards of practice is the next logical step in the creation
of a framework for consistent, quality health care interpreting in the
U.S. Currently, no such nationally accepted standard of practice exists,
contributing to great variability in the quality and practice of medical
interpreting. Commonly accepted standards of practice will lead to more
professional practice among interpreters and to greater consistency in
interpreter training, as well as laying the groundwork for subsequent
interpreter certification on a national level.
In this NCIHC presentation, the co-chairs of the Standards, Training
and Certification Committee will describe the steps that the NCIHC undertook
to arrive at the Code of Ethics for Interpreters in Health Care and highlight
the discussions that arose during this process. The new code will be shared
with participants. The presentation will also discuss the STC committee’s
ongoing work on standards of practice for interpreters in health care.
Karin Ruschke has dedicated her career to bridging language and
cultural differences in the healthcare setting. As founder of International
Language Services, Karin directs the expansion of interpreting services
within the Chicago healthcare provider community. International Language
Services is a full-service agency providing on-site interpretation, translation
services, and training to clients nationwide. Ms. Ruschke has played an
integral role in raising the awareness of standards for medical interpreters.
She currently serves as Co-Chair of the Training, Standards and Certification
Committee of the National Council on Interpreting in Health Care. This
committee has recently completed a national Code of Ethics for interpreters
in healthcare and is currently working on creating standards of practice.
Ms. Ruschke graduated from the Monterey Institute of International Studies
with a MA in Translation.
Karin Ruschke, MA in Translation
President
International Language Services
2707 N. Halsted
Chicago, IL 60614
773-525-8590
773-525-8591
kruschke@sbcglobal.net
Shiva Bidar-Sielaff is the Manager of Interpreter Services and
Minority Community Relations at the University of Wisconsin Hospital &
Clinics. On a national level, Ms. Bidar-Sielaff has worked extensively
on issues of equal access to health care for limited English proficient
(LEP) individuals. She is the Co-chair of the Standards, Training and
Certification Committee of the National Council on Interpreting in Health
Care. Ms. Bidar-Sielaff is very involved in promoting equal access to
health care for LEP population in Dane County. Ms. Bidar-Sielaff is the
Vice-Chair of the Dane County Latino Health Council and an active member
of the Latino Support Network. In April 2000, she was awarded the Dane
County Public Health Leadership Award for Multicultural Health Care. Ms.
Bidar-Sielaff obtained her BA for the School of Interpreters, University
of Hainaut, in Mons, Belgium, and her MA from the Monterey Institute of
International Studies in Monterey, California.
Shiva Bidar-Sielaff, MA
Manager of Interpreter Services and Minority Community Relations
University of Wisconsin Hospital & Clinics
600 Highland Ave Mail Code 2460
Madison, WI 53792
s.bidarsielaff@hosp.wisc.edu
“No
thank you. I really can’t …Or shouldn’t?”
Issues of Gift Giving and Reciprocity within the Interpreter Role
The role of the medical interpreter involves more than just being a
conduit or transparent facilitator of communication. In addition to language,
there are cultural commonalities which link the interpreter and the patient
during an encounter. While both the patient and provider are appreciative
of good, effective communication, patients often expresses their appreciation
in the form of gifts.
The National Code of Ethics for Interpreters in Health Care, Principle
9, states “The interpreter must at all times act in a professional
and ethical manner”. Commentary on this principle, modeled after
that in the American Medical Association’s Code of Ethics, specifically
addresses the cultural and ethical complexities of accepting gifts from
patients. It is essential that interpreter training, whether it be multi-semester
in an academic institution, 40-hours in a community setting or three hours
orientation, include ample, interactive discussion of acceptance of gifts.
Equally important are institutional policies which need to balance ethical
as well as cultural considerations and must be made explicit to interpreters
upon their employment. Absent adequate training and institutional support,
interpreters are left without guidance as they make challenging professional
decisions regarding acceptance of gifts.
When a patient offers a gift, the interpreter is faced with a difficult
decision. Is the gift a simple acknowledgment, which the interpreter is
able to accept without violating either institutional policy or the professional
Code of Ethics? Or, is the gift an expectation of reciprocity, an attempt
to manipulate the interpreter in order to receive additional services
or personal favors? Can the interpreter decline the offer without offending
the patient or appearing culturally insensitive? Is it possible for the
interpreter to refuse while ensuring that neither s/he nor the patient
will lose face? Finally, how do interpreter training and institutional
employment policies support or impede the interpreter’s decision-making?
How institutions and interpreters navigate these challenging ethical
decisions is the topic of our interactive workshop, which will:
- Examine the National Code of Ethics principle on professionalism
and gift-giving
- Explore the challenge of developing culturally appropriate training
and employment policies on the ethical acceptance of gifts
- Utilize case studies from the Latino and East African communities
to distinguish gifts of acknowledgement from expectations of reciprocity
- Foster audience discussion and consideration of this difficult issue
Priscilla Mendenhall is currently Director of Education &
Training for the Northern Virginia Area Health Education Center. In this
capacity, she is responsible for the agency’s interpreter training,
cultural competence programs and curriculum development activities. Over
the past six years, Ms. Mendenhall has supervised more than thirty-five
interpreter training courses which have brought more than seven hundred
and fifty bilingual individuals into the field of professional interpretation.
She is co-author/editor of the 20-hour Introduction to Community Interpreting
curriculum as well as the 40-hour Interpreting in Health and Community
Settings course. Ms. Mendenhall is an experienced trainer. She co-teaches
interpreters and has conducted workshops in Communicating Through An
Interpreter for more than 1,500 health and human service providers.
Priscilla Mendenhall is an active member of the Policy and Research Committee
of the National Council on Interpreting in Health Care. In this role,
she represents the Council at the National Language Access in Health Care
Coalition. She is Chair of the Northern Virginia Coalition for Refugees
and Immigrants and a founding member of the Mid-Atlantic Interpreters
Association. Ms. Mendenhall is a resident of Washington, D.C. and has
lived in Switzerland, Vietnam, Laos, Thailand, France, Italy, Quebec and
Madagascar.
Priscilla Mendenhall
Title: Director, Education and Training
Organization: Northern Virginia Area Health Education Center
Phone: 703-549-7060
Fax: 703-549-7002
Priscilla@nvahec.org
Wilma Alvarado-Little, a medical interpreter and trainer with
19 years of experience in the health care field, serves on the Board of
Directors for the Chicago Area Interpreter Referral Service, which provides
interpreter services for the deaf and hard of hearing populations. Former
manager of Interpreter Services at Children’s Memorial Hospital in
Chicago where she implemented the interpreter program, she has worked
closely with the Chicago Health Outreach Immigrant and Refugee Health
Task Force. Currently the Co-chair of the Board of the National Council
on Interpretation in Health Care, she is also a member of the ASTM Language
Subcommittee, the Massachusetts Medical Interpreters Association, the
Guatemala Scholars Network, the Latin American Studies Association and
the American Translators Association. Ms. Alvarado-Little consults on
the implementation of hospital and community-based interpreter programs
and the role of the medical interpreter. She has been involved with the
Chicago area media in presenting public information on the importance
of the role and use of trained medical interpreters in providing quality
health care services.
Wilma Alvarado-Little, MA
270 W. Lawrence St.
Albany, NY 12208
Phone: 773-301-6438
Fax: 518-459-3443
interpreter@walvarado-little.net
Seyoum Berhe is Director of the Arlington Diocese Office of Resettlement,
an affiliate of the United States Catholic Conference of Bishops. In addition
to his resettlement responsibilities, he is a practicing interpreter and
translator in Amharic, Tigrigna and Saho. Mr. Berhe is also an experienced
trainer, having conducted interpreter training and cultural competence
programs for the past decade. As a consultant, he has actively participated
in the development of several interpreter training curricula with a particular
focus on standards of practice which respect the needs of smaller language
communities. Mr. Berhe has a Masters Degree in Education Administration.
He is active in various communities in the Washington Metropolitan Area
and serves on the board of several community-based organizations.
Seyoum Berhe
Director
Organization: Arlington Diocese Office of Resettlement
Phone: 703-524-2154
Fax: 703-524-2741
sberhe@arlingtonrefugeeservices.org
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