Culture and Role Boundaries

By 09/26/2013 General 3 Comments

By Ghada Darwich (Arabic Interpreter)

See-ming Lee

Photo credit: See-ming Lee, Flickr

As an Arabic medical interpreter, my daily task is to connect between two different worlds in a medical setting using not only my language skills but cultural competence. Unfortunately, some of the Arabic cultural influences I must negotiate challenge the ethical imperative to maintain role boundaries.

Limited English Proficient (LEP) patients seeking medical care in the U.S. often find themselves feeling helpless and in need of assistance that reaches beyond the clinical setting. For these patients, the interpreter seems to be the most obvious answer to their needs. They perceive us as brothers, sisters, daughters and sons. I always get referred to as “sister” or “daughter”. I refer to my patients as “brother”, “sister”, “aunt” or “uncle”. This is the Arabic version of “Mr.” and “Mrs.”, just on a more personal level. The feeling of brotherhood and kinship is the reason for patients reaching out to interpreters for help and favors. However, as an interpreter I cannot accommodate all of those needs. So the question remains, how can one stay professional and polite when handling such situations?

First of all, learn your role as an interpreter. Know your capabilities as well as your limitations. This avoids confusion and hesitation and gives you the confidence to act appropriately and professionally in any situation. Never hesitate to help, if doing so falls within your capabilities and role as interpreter.

Know the role of the providers involved. Who is in charge of the various services at the different healthcare institutions? Most hospitals and clinics have staff members that specialize in different services for patients, such as social workers, chaplains and volunteers. These can assist when needed. Referring them to the appropriate personnel and providing information on the available services, is a big help for patients who have no background information on American healthcare institutions. Many large hospitals have an international services department that is the primary place to direct patients.

My role as an Interpreter, without crossing any lines, is to connect the patient with the appropriate staff using my knowledge of the healthcare system and cultural and linguistic skills.


  • Very nice article Ghada. If it is OK with you I will share it on my blog.Feel free to share the articles I have too on yours! As a fellow Interpreter I invite you to browse thru them. The link to it is on my webpage link.

  • Ghada Darwich says:

    Thanks lizette. You sure can. I’m happy you found it useful. I will get on your block soon.

  • Earl Rogers says:

    I agree, Ghada. I have, over the last 12 years, spent a lot of time studying and interacting with people from different countries. I live in a rural setting, and many providers here have never been anywhere outside of the United States, and do not have (and in some cases, do not want) any knowledge of their patient’s cultural norms. The Hispanic population here in eastern NC is made up mainly of people from Mexico, Guatemala, and Honduras. As I’m sure you are aware, they all speak Spanish, but beyond that their cultures are unique. I have had the privilege to work as an interpreter in both Honduras and Mexico, so I had an advantage there. I learned as much as possible about Guatemala by spending time with Guatemalans and reading books about their culture. I, enjoy being able to help the patient and provider communicate better.

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