Question 4. What are the Legal and Ethical Implications of Medical Student Interpretation?
Ethical challenges have been raised regarding the use of medical students as interpreters. Hospital staff and policymakers were concerned about students’ lack of knowledge in the ethical principles and professional conducts of interpreting. 33 A key requirement of professional interpreters is maintaining professional detachment and impartiality. This can be challenging for medical students who are learning to be part of the healthcare team. The literature shows that students may see themselves as “patient helpers”, which reflects principles of patient-centered care taught in their education, but is inappropriate in the context of interpretation (due to inability to maintain professional detachment).42 Another ethical concern raised was the possibility of students working beyond the limits of their capacity. The power imbalance makes it difficult for students to refuse staff physicians’ requests. As a result, students may feel pressured to interpret even in situations which are not appropriate for their skill levels, especially when no other resources are available.25, 32Furthermore, Yang et al emphasized the need for patients to be fully informed and to give consent for the medical student to interpret. Finally, hospital stakeholders have raised the question of determining in which situations students should be allowed to interpret. Some expressed that they should not interpret in situations involving sensitive discussions about mental or sexual health.35 Variables such as the student’s fluency, patient’s comfort level, and unexpected questions could all add burden to the team. 33 Certain supervisors proposed that students should interpret during emergencies when professional interpreters are not available, while others suggested student involvement in low-risk situations where only simple messages are relayed. 25