Ethical Dilemma: “Dr, does Lily still need to continue with the antibiotics?”
I was in a deep sleep and still dreaming, when all of a sudden, I was awakened by a familiar buzzing sound by my bedside table. I reached out for it thinking; “Who would want to call me at this time?”
It was a call from one of my interpreting agencies. It was 3:05 am in the morning. Who would be the client? Was it Border Security? The Police? I was imagining many scenarios while following the automated voice request.
The call was connected. “This is from Smith Children’s Hospital Emergency Department. I am Michael, the doctor,” I heard the professional voice on the end of the line say.
“Hi Dr. This is Yu, the Mandarin interpreter,” I answered.
Dr. Michael thanked me for taking the phone call during the middle of the night and told me that a young child, Lily, and her father were at the emergency department. Dr Michael (The English-speaking client), and Lily’s dad (the Mandarin-speaking client) shared one phone. I understood that the phone would be passed from the Dr to Lily’s dad and vice versa. This would not be very convenient for them.
From the interpreting work, I learned that Lily had been having a high temperature for more than 6 days. She first had a cold and runny nose, then her temperature varied between 37 and 38 degrees. Lily had been given Panadol by her dad when her temperature was high. Whenever she took Panadol, her temperature would drop and was well controlled. Lily used to have asthma. In the past few days, she had asthma for one or two days but then the asthma would subside.
Lily was brought to the emergency department after her father took her to see a GP in the afternoon. Lily’s GP prescribed her antibiotics even though there were no associated symptoms. After taking the antibiotics, Lily’s temperature rose to 39 degrees. Her father rushed her to the Emergency Department.
" In a case like this, should I adhere strictly to these ethical principles? Or do the actions come under clarifying potential miscommunications?"
After asking all the questions about Lily and having an overall examination, Dr Michael said: “I have completed all the checkups for Lily today and the last thing for Lily to do is to collect her urine. I will give her dad a tube for urine collection. Once the urine result comes in and if it is fine, Lily can go home today.”
Dr Michael was going to pass the phone to Lily’s dad for me to interpret what he had just said. I said: “Before you pass the phone to Lily’s dad, may I ask you a question? This is based on the interpreting work that I conducted today.”
“Please go ahead.” Dr. Michael said.
I said, “Just now Lily’s dad mentioned that Lily took antibiotics and her temperature soared to 39 degrees °C . Does she still need to continue with the antibiotics?”
“That is a really good question.” Dr Michael answered.
Just as I had informed the Dr, I also told Lily’s dad that I had asked the Dr about the antibiotics question, before I interpreted the antibiotics segments into Mandarin.
The two main reasons I asked the doctor the antibiotic question were:
- the frequent swap of the handset between Dr. Michael and Lily’s dad and the meaningful and complete interpreting segments, and
- the concluding remarks Dr. Michael gave implied that the medical consultation was ending.
It was three o’clock in the morning. Either the doctor or the patient/family could be tired. If Lily’s dad did not ask whether Lily needs to continue with the antibiotics, Lily would have continued with the medication. Would it bring any harm to the little girl?
As an interpreter, I need to be impartial and accurate. But in a case like this, should I adhere strictly to these ethical principles? Or do the actions come under clarifying potential miscommunications and accurately conveying the Dr's instructions to the Mandarin-speaking client? When there are some issues that were not fully covered by the English-speaking professional for the Mandarin-speaking client, who has the right to ask such questions? This posed challenges not just for the medical field, but also for the interpreting profession.
If you were the interpreter for this job, and you noticed that not all the issues were covered by the doctor, what would you do?
(This is a fictional account to represent an ethical issue. Any resemblance to actual persons is unintentional.)
For more information about how to handle those ethical dilemmas, make sure you familiar with the AUSIT Code of Ethics, which all NAATI interpreters are bound by.
Note from the Editor: Several guides on working with interpreters in healthcare stress the importance of briefing usually after the assignment to clarify any issues about the communication. But where appropriate it can be done during the interpreting assignment. The most important strategy for interpreters to adopt is to make sure she/he ensures that the question (to clarify the doctors message) was interpreted to the patient as well or vice versa.
About the author: Dr. Yu Zhao is a committee member of the Chinese Interpreters and Translators Association of Australia (CITAA). Yu’s wide experience ensures that she is culturally adaptive in her interpreting work. Her background in Psychology, Education, Sociology and Management allows her to be culturally sensitive. She enjoys her professional interpreting service with the CALD (culturally and linguistically diverse) clients. Yu is currently working as an academic at the University of Melbourne. What she sees, hears, and experiences as an interpreter also informs her approach and interest in researching the current Australian industrial landscape.