Decision-making in paediatric palliative care interpreting

Melissa Contreras-Nourse

doi:10.52034/lanstts.v20i.594

Abstract

The interpreting profession has long used metaphors or rule statements to describe and teach the ways in which practitioners make decisions (Dean & Pollard, 2011, 2018). Interpreting students are also often taught that the context of an encounter will dictate their decision-making by way of statements such as “it depends”. Such pedagogical statements can make talk between a practitioner and a medical professional about the responsibilities of an interpreter during medical encounters difficult. This study is based on the work of Dean and Pollard (2011, 2018) on value-based decision-making and is guided by the four principles of biomedical ethics (respect for autonomy, non-maleficence, beneficence and justice). It has sought to provide evidence of the existence, applicability and usability of these frameworks through a single case study of a real-life appointment in which a parent of a palliative care outpatient and a medical professional communicated during a consultation, aided by a medical interpreter.

Highlights

One of the weaknesses of context-based decision-making, as suggested by Dean and Pollard (2011), is that it is an “indirect and ineffective” pedagogical method
From the 66-minute recording the researcher selected five examples in which to look for specific evidence, using the critical incidence technique to support or deny the theoretical frameworks previously presented. These five decision-making junctures are what appear to be controls used by the Spanish medical interpreter, Silvia,iii during the appointment
The bilingual Nurse Case Manager (NCM) tells the parent that healing times vary between individuals

Summary

Introduction

One of the weaknesses of context-based decision-making, as suggested by Dean and Pollard (2011), is that it is an “indirect and ineffective” pedagogical method. Interpreters are expected to embrace various types of role metaphor as a means of understanding the decisions they make in their practice (Dean & Pollard, 2018). The work of medical interpreters is often referred to in the medical literature as following or embodying a “conduit model” (Juckett & Unger, 2014) This describes the paradigm according to which an interpreter is expected to perform, that is, they are expected to remain “in the background of clinical proceedings” whilst transmitting the content neutrally(Kirby et al, 2016, p. Their work proposed ways of improving interpreter education (e.g. learning how to work in teams), practice (e.g. adopting ethical principles) and research (e.g. connecting various issues seen in practice that are often studied separately)

Methods

Results

Discussion

Conclusion