1. Ethics and Boundaries Interpreter/Translation Training August 20, 2015 SF Public Library José Martín, LMFT, CHT Consultant/Lecturer/Professor National Board of Certification for Medical Interpreters, Testing Committee Member

2. What is Ethics? Study of right and wrong conduct Focus on moral situations Originated from religious guidelines It is not laws It is not mores

3. Origin of personal ethical system Parents Church School Society Media

4. Why do we need ethics? To control Id impulses To provide guidelines for living To address injustice To help society regulate itself

5. Primary Tenet of Ethics DO NO HARM

6. Elements of Ethics Rational Based on facts, ideals, obligations, and consequences Moral imperative

7. Three Criteria for Ethical Analysis Obligations Ideals Consequences

8. Ethical Analysis Study the Details of the case Identify the Relevant criteria Determine Possible courses of action Decide which action is the Most Ethical course to take

9. Considering Moral Ideals Prudence Justice Temperance Courage

10. Considering Consequences Dealing with probability Making the analysis thorough When harm is unavoidable The greater good

11. Errors to Avoid Double standard Unwarranted assumptions Oversimplifications Hasty conclusions

12. Ideals in Professional Ethics Codes Truthfulness Honesty Integrity Social Responsibility Fairness Prudence Justice Temperance

13. Ethical Principles For Healthcare Interpreters Ethical Principle 1- Confidentiality Ethical Principle 2- Impartiality Ethical Principle 3-Respect for Individuals and Their Communities

14. Ethical Principles For Healthcare Interpreters Ethical Principle 4-Professionalism and Integrity Ethical Principle 5-Accuracy and Completeness Ethical Principle 6-Cultural Responsiveness Ethical Decision Making for Healthcare Interpreters

15. IMIA Guide on Medical Interpreter Ethical Conduct 1. Confidentiality Do not disclose assignment-related information unless with the expressed permission of all parties or if required by law. 2. Accuracy Select the language and mode of interpretation that best conveys the content and spirit of client messages. Use skillful unobtrusive interventions to avoid interfering with the flow of communication. 3. Professionalism Refrain from accepting assignments beyond professional skills, language fluency or level of training. Do not engage in interpretations relating to issues outside of health care services unless qualified to do so. Refrain from using position to gain favors from clients.

16. IMIA Guide on Medical Interpreter Ethical Conduct 4. Impartiality Refrain from assignments involving close family or personal relationships. Do not interject personal opinions or counsel patients. 5. Use Advocacy and Cultural Interface Roles Appropriately Engage in client advocacy and cultural interface roles only when appropriate and necessary for communication purposes. 6. Professional Development Keep abreast of evolving languages and medical terminology. Participate in continuing education programs. Maintain ties with relevant professional organizations.

17. Confidentiality Tenets covered : Do not disclose assignment-related information unless with the expressed permission of all parties or if required by law. In health care settings, preserving the anonymity and privacy of patient information is crucial. Ensuring confidentiality responds to patients’ core need for privacy, prevents discrimination and ethical dilemmas, and is mandated by federal laws. The interpreter treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure.

18. Accuracy Tenets covered: Interpreters will select the language and mode of interpretation that most accurately conveys the content and spirit of the messages of their clients. Interpreters will use skillful unobtrusive interventions so as not to interfere with the flow of communication in a triadic medical setting. The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context.

19. Professionalism Tenets covered: Interpreters will refrain from accepting assignments beyond their professional skills, language fluency, or level of training. Interpreters will not engage in interpretations that relate to issues outside the provision of health care services unless qualified to do so. Interpreters will refrain from using their position to gain favors from clients.

20. Impartiality Tenets covered: Interpreters will refrain from accepting an assignment when family or close personal relationships affect impartiality. Interpreters will not interject personal opinions or counsel patients. The interpreter strives to maintain impartiality and refrains from counseling, advising or projecting personal biases or beliefs.

21. RESPECT Tenets covered: The interpreter uses professional, culturally appropriate ways of showing respect. For example, in greetings, an interpreter uses appropriate titles for both patient and provider. The interpreter promotes direct communication among all parties in the encounter. For example, an interpreter may tell the patient and provider to address each other, rather than the interpreter. The interpreter promotes patient autonomy. For example, an interpreter directs a patient who asks him or her for a ride home to appropriate resources within the institution.

22. Use Advocacy and Cultural Interface Roles Appropriately Tenets covered : Interpreters will engage in patient advocacy and in cultural interface role of exploring cultural differences/practices to clients when appropriate and necessary for communication purposes, using professional judgment. The interpreter maintains the boundaries of the professional role, refraining from personal involvement.

23. Professional Development Tenets covered: Interpreters will keep abreast of their evolving languages and medical terminology. Interpreters will participate in continuing education programs as available. Interpreters will seek to maintain ties with relevant professional organizations in order to be up-to-date with the latest professional standards and protocols. The interpreter continually strives to develop awareness of her/his own and other (including biomedical) cultures encountered in the performance of their professional duties.

24. ROLE BOUNDARIES Tenets covered: The interpreter limits personal involvement with all parties during the interpreting assignment. For example, an interpreter does not share or elicit overly personal information in conversations with a patient. The interpreter limits his or her professional activity to interpreting within an encounter. For example, an interpreter never advises a patient on health care questions, but redirects the patient to ask the provider. The interpreter with an additional role adheres to all interpreting standards of practice while interpreting. For example, an interpreter who is also a nurse does not confer with another provider in the patient's presence, without reporting what is said.

25. ADVOCACY Tenets covered:. The interpreter may speak out to protect an individual from serious harm. For example, an interpreter may intervene on behalf of a patient with a life-threatening allergy, if the condition has been overlooked.. The interpreter may advocate on behalf of a party or group to correct mistreatment or abuse. For example, an interpreter may alert his or her supervisor to patterns of disrespect towards patients.