Medical Interpreting: A Review of the Literature

Developed by J. Moore and L. Swabey
CATIE, College of St. Catherine/NCIEC
DRAFT ~ 2007

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Introduction | Deaf Patient Perspectives | NonDeaf Patient Perspectives | Settings and Types | Challenges and Issues | Interpreting Role | Preparing to Interpret | Summary and Implications | References | Bibliography | Download PDF

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Settings and Types of Medical Interpreting

The majority of medical diagnoses are made based on a medical history taken during a conversation between doctor and patient (Harmer, 1999, p. 73). According to Byrne and Long (1976, as cited in Angelelli, 2004, p. 75), a typical medical consultation consists of six phases: establishing the doctor-patient relationship, finding out the reason for the visit, a verbal and/or physical examination, consideration of the patient’s condition, explanation of the treatment or further investigation, and termination. Interpreters are a vital part of this process.

Aside from their involvement in initial medical consultations, interpreters are needed in a variety of places in health care systems. The Registry of Interpreters for the Deaf (RID) Standard Practice Paper “Interpreting in Health Care Settings” (www.rid.org) lists the following examples of areas in which interpreters may work:  taking a medical history, giving diagnoses, performing medical procedures, explaining treatments and prescriptions, providing patient education, describing discharge and follow up care, and admitting to emergency department or urgent care. Napier (2006) listed the following: initial medical consultations, physical checkups, emergency department visits, surgery, and informed consent.  Both Frishberg (1990, p. 118) and Humphrey and Alcorn (2001) discussed settings in which medical interpreters are used, the latter dividing medical settings into two categories: medical appointments, and laboratory or hospital procedures (p. 13.30). Moxham (2005) discussed the ramifications of specific medical situations such as childbirth, dentistry, eye exams, home health care visits, medical school training, nursing home care, physical or occupational therapy, radiology, and surgery. In-patient, outpatient, urgent care, and emergency departments are also usual settings for interpreters.

In addition to listing typical health-related settings, Stewart et al. (2004) reminded readers that due to increased opportunities for Deaf people, interpreting may also be done between a Deaf health care professional and a non-deaf patient, or in the education and training of Deaf health care professionals. Health-related occupations in which Deaf people are involved include general medicine, nursing, dentistry, physical therapy, chiropractic, podiatry, osteopathy, and veterinary medicine. Woodard (2007), for instance, discussed the provision of oral interpreting service to a Deaf medical resident (p. 8).

A few articles address interpreting in specialty areas of medicine in more detail. Martinez (1999) discussed preparation required for interpreting childbirth, proposing a series of questions an interpreter should ask him/herself as well as some for the Deaf patient (pp. 10-11). Reporting in the April 2003 RID Views, Cumsky Weiss and Schornstein described their experiences working as a Deaf-hearing team of interpreters for childbirth. The mother-to-be requested the team, as she felt she would be more comfortable with the ease of communication a Deaf interpreter could provide. The article details the process of interpreting the birth, and explains some of the logistics the interpreters faced in terms of ways to interpret effectively without hindering the operations of medical equipment and personnel (p. 6).

Bailey and Rockhill (1997) discussed interpreting in hospice, pointing out the importance of understanding the hospice philosophy and the interpreter’s role in this setting as a member of the hospice team (pp. 41-50). Under the category of hospice interpreting, some situations are similar to those in other medical settings, including visits from nurses, doctors or social workers; medical exams; physical therapy; counseling; and physical therapy. However, interpreters in this setting also must face the patient’s death, the pronouncement of death and the preparation of the body. The article describes Sign Language Associates’ Hospice Services, and the specialized education necessary before interpreters work in this setting. Training covers the hospice philosophy, the process of death and dying, the hospice process, family dynamics, grief, stress during terminal illness, medical considerations, the interpreter’s role, safety and emotional considerations, and personal feelings and values related to death and dying.

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