You’ve seen those commercials for Las Vegas, right? What happens in Vegas, stays in Vegas? It’s kinda the same in the hospital. Aside from that, I’ll let you draw your own parallels between Vegas and the hospital (the flashing lights, the noise, the altered mental states) but for now let’s explore privacy.
Whose privacy are we talking about? Why is it important? When we train medical interpreters, we introduce the issue of privacy with the Code of Ethics for medical interpreters. “Let’s talk about patient confidentiality,” I’ll tell the students. The eyes glaze over. “The law has something to say about it,” I’ll continue. “Hospital policy has something to say about it.” Their blank stares are telling me, gosh, Liz, we get it. It’s the law. It’s policy. It’s so black and white. It’s so boring. We need more coffee.
Interpreters are held to the same standards of confidentiality as all hospital staff. Pretty straightforward, yes? Maybe. Let’s dig deeper. Let’s say you’re interpreting for a patient who you are sure is lying. What if she’s telling her lies to the person filling out the paperwork for financial assistance? What if she’s lying to the doctor about her history? How does it feel to interpret what you believe to be lies? How’s that confidentiality looking now? (The students start to perk up.) What if, while the doc runs out for a quick sec to get her stethoscope, the patient reveals to you that her boyfriend hits her kids when they cry too much, but asks you not to tell the doc? And now? Is it OK to break confidentiality now? (The students want to talk about reporting child abuse. They’re awake!) And what if a fellow interpreter is openly telling a story that clearly violates patient confidentiality? Do you say something? Aha! Now I’m getting some real push back from the students! I don’t have to say anything, do I? After all, I’m not the one violating confidentiality. Right? Right?!
Not so black and white, eh? Especially when we start talking about lies, child abuse, and holding a peer accountable for ethical behavior.
As interpreters, the best way to prepare for these situations is to arm ourselves with as much information as we can about the Code of Ethics, the law, and hospital policy. Make friends with the Code of Ethics, I tell students. Get cozy with the principles. Wrap them around yourself like a blanket. Because that’s where we find the details that give us a jumping off point to discuss all of the scenarios above.
As for this interpreter, you won’t get any stories from me about that one guy who went to that one hospital for that one problem, and ohmygod it was so crazy. Those stories are, as you might have guessed, private. I want patients to know that they can come in and tell the doctor all about their depression, or the itching “down there”, or what their barf looks like, and when I interpret what they say, that is the last time I will utter those words. Those people and those experiences are a part of who I am now, and you won’t see them here. Nor will you see stories about that one interpreter I work with at that one hospital, because on many levels, that kind of privacy violation is nuts. And if I’m gonna do something totally nuts, I’ll do it in Vegas.