The Bioethics of Translation: Latinos and the Healthcare Challenges of COVID-19

Abstract

The Bioethics of Translation: Latinos and the Healthcare Challenges of COVID-19 Bryan Pilkington16 and Ana Campoverde17 COVID-19 has changed the way many people go about their daily lives and the manner in which they interact with each other. Many of the bioethical issues raised by the crisis, such as medical resource rationing and the responsibility to protect the vulnerable, have not arisen anew. Rather, they have merely been intensified by the pandemic’s magnitude. In bioethical discussions about the pandemic, a significant focus has been devoted to addressing medical equipment shortages such as the lack of personal protective equipment and ventilators and the ethical responsibility to protect others through mask-wearing. This focus suggests that reflection on two common bioethical themes—respect for justice in distribution and the sharing of full information—whether related to principles of justice and autonomy or located within discussion of human dignity, would be valuable. Recognizing how COVID-19 has disproportionally affected people by race or ethnicity is critical—and taking seriously the aforementioned paths of bioethics reflection, this essay departs from the usual discussions of resource allocation to concentrate on the Latino population and the importance of translation in two senses. It calls attention to the very practical need for translation resources in situations where language barriers exist between healthcare practitioners and patients. COVID-19 has intensified these challenges, as patients who are not proficient in the English language may experience delayed medical care or face other challenges.18 It points to the need to increase health literacy within a polarized cultural context where divergent claims on critical healthcare matters are offered by social and political authorities who lack the relevant scientific and [End Page 11] medical expertise. The dual need for translation resources and for the translation of broad information is felt heavily within the Latino community. The essay will first discuss the impact that COVID-19 has had on the Latino community. Second, given the deep importance of Catholicism within Latino communities, we turn attention to conceptual resources from within bioethics and the Catholic Intellectual Tradition that bear on resource allocation and information dissemination. Third, with sensitivity to Latino cultural practices, we offer grassroots recommendations, focusing on increased church-healthcare community partnerships. These partnerships would allow for greater information exchange, including more accurate information sharing, and the possibility of shifting some of the bioethical conversation from the allocation of resources that benefit a few to the allocation of resources that benefit the many. Impact of COVID-19 on the U.S. Latino Community Healthcare studies have long revealed that minority groups face health inequalities, sometimes with devastating results.19 The infection pattern of COVID-19 was not entirely surprising for health experts who work among the country’s most vulnerable populations. Research collected by the COVID Tracking Project, led by the Boston University Center for Antiracist Research, reports that Latinos have been disproportionately affected by the disease, with 58 per 100,000 deaths due to COVID-19 compared to 38 per 100,000 white people.20 This may be due to the fact that members of the Latino community are more likely to have occupations in the service industry and live in multigenerational households, two factors that increase the risk of COVID-19 exposure. Early reports paint a picture of the Latino population being one of the hardest hit communities by COVID-19, aggravating pre-existing disparities in healthcare access and health literacy. In 2015, the National Hispanic Council on Aging found that 41 [End Page 12] percent of Latino adults lack basic health literacy, a challenge further compounded by linguistic and cultural barriers.21 Research has found that across the United States, minority patients who are not proficient in English are left without adequate language resources, potentially reducing their access to quality healthcare and resulting in higher rates of adverse health outcomes compared to English speakers. Of the 67.3 million people in the United States who speak a foreign language at home, 41.5 million speak Spanish and 25.6 million speak English “less than very well.”22 To alleviate language barriers, the Affordable Care Act mandates that healthcare facilities provide qualified interpreters to patients...