''I am not a robot!'' Interpreters' Views of Their Roles in Health Care Settings Elaine Hsieh Qual Health Res 2008 18: 1367 DOI: 10.1177/1049732308323840 The online version of this article can be found at: http://qhr.sagepub.com/content/18/10/1367
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“I am not a robot!” Interpreters’ Views of Their Roles in Health Care Settings Elaine Hsieh
University of Oklahoma, Norman, Oklahoma, USA
Qualitative Health Research Volume 18 Number 10 October 2008 1367-1383 © 2008 Sage Publications 10.1177/1049732308323840 http://qhr.sagepub.com hosted at http://online.sagepub.com
In this study, I examined interpreters’ self-perceived roles and their corresponding communicative goals and strategies. Twenty-six professional interpreters (of 17 languages), 4 patients, and 12 health care providers were recruited for this study, which involved participant observation of medical encounters and in-depth interviews. Constant comparative analysis was used to generate a typology of interpreters’ self-perceived roles, which are different from the roles they learned in their training. Different roles reflect differences in interpreters’ concern for other participants’ goals, institutional goals, and their own communicative goals. Interpreters’ desire to maintain neutrality during the medical encounters influences the communicative strategies they adopt when assuming other roles. I conclude the article with the theoretical and practical implications of interpreters’ self-perceived roles. Keywords: communication; communication, doctor–patient; conversation analysis; cultural competence; participant observation We learned that we don’t have to talk to patients. We learned that. We are not allowed, right? I don’t like that. I can tell you, “It’s not right.” We are not robots. We have training; I know why we are here. But I say that because it’s not true, I am not a robot. —Rachel, Russian interpreter
Recent reviews on bilingual health care have noted that professional medical interpreters can significantly improve the quality of care for patients with limited English proficiency (Flores, 2005; Karliner, Jacobs, Chen, & Mutha, 2007). Interpreters often manage the communicative contexts by shifting between various roles to achieve optimal care (Angelelli, 2004a; Davidson, 2001). The Cross Cultural Health Care Program (CCHCP), a leading training program for professional interpreters in the United States, proposed four roles for medical interpreters: conduit, clarifier, cultural broker, and advocate (Roat, Putsch, & Lucero, 1997). The CCHCP noted, “The ‘appropriate’ role for the interpreter is the least invasive role Author’s Note: The author gratefully acknowledges the valuable feedback from Drs. Dale Brashers and Eric Kramer. Correspondence should be directed to Elaine Hsieh, Department of Communication, University of Oklahoma, 610 Elm Ave. #101, Norman, OK, 73019, USA; e-mail: firstname.lastname@example.org.
that will assure effective communication and care” (Roat et al., 1997, p. 18). In other words, all roles are legitimate depending on the situation. However, reviews of training programs and codes of ethics from various institutions have found that interpreter-asconduit remains a prevalent ideology for medical interpreters (Dysart-Gale, 2005; Kaufert & Putsch, 1997). Conduit is an interpreting model that conceptualizes interpreters as robots (i.e., nonthinking, nonfeeling, and yet highly skilled translation machines),...