Don’t Interpret That! How to address a family member’s request to limit information during an encounter

At our April 5 Interpreter Wellness Lunch and Learn, an interesting question was asked: What do you do when after the provider has delivered (most likely bad) news, a family member who understands English interrupts the flow of communication and tells you, the interpreter, “Don’t tell them that”?

Dr. VanDuivendyk’s answer is simple!

“What you’ve got to do is make sure that family knows, in a very loving way, that your role there is to interpret the conversation between the health care professional and the patient or family. So that releases you. But that sure kicks up a lot of feelings, doesn’t it! When one family member wants ‘Oh no, don’t tell mom, or grandmom,’ and the other one says, ‘oh yeah, we’ve got to tell them!'”

In our role as interpreters and as an important element of interpreter best practices, the interpreter acts as a medium for communication in the healthcare setting, not a source of information. Although we may provide cultural or linguistic mediation when necessary and appropriate, in this particular situation, Dr. VanDuivendyk states, “Interpreters… are off the hook.”

This has also been a topic of discussion throughout the industry, most recently discussed on the NCIHC Listserv and during the 2016 IMIA annual conference. The general consensus seems to be that it is ultimately the provider’s responsibility to make the decision whether or not to clue in the patient on bad news.

Within the healthcare community, each provider handles these types of situations differently. Part of providing equitable access is to allow the patient, their family, and the provider the opportunity to exercise their autonomy. One provider, for example, has been known to compartmentalize information and give the patient the opportunity to hear the information that they are prepared to hear. Another asks the patient privately regarding his/her preference.

If you encounter such a situation, consider using one or multiple of the following techniques:

  1. Hold a pre-session with the provider and if any ‘bad news’ is to be shared, discuss his/her preference for handling this type of situation
  2. Remind all participants (in the third person) that your role as the interpreter is to interpret everything that is said
  3. Defer back to the healthcare staff for direction

And remember, you may be able to avoid such situations by developing a concise and informative introduction in which you explain to the patient, family, and provider that everything said in the encounter will be interpreted!

Have you ever experienced something like this? Share your story in the comments.

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