California Legislates On Immigrant Medical Translation

Lee este artículo en español | 06-01-2009| Politics & Law • Translation & Cross-Cultural Relations

Beyond Words points us to the story:

California has set a precedent yet again in the world of interpreting by becoming the first state in the U.S. to pass a law requiring that health insurance organizations provide interpreting and translating services to patients with limited English proficiency (LEP).

Immigrant community associations supported the bill, which notes that:

“almost 40% of Californians speak a language other than English” and that ‘over 70 percent of providers reported that language barriers compromise patient’s understanding of treatment advice and make it harder for patients to explain their symptoms.‘

Cindy Ehnes, the director of the state Department of Managed Health Care, says this means that:

“Often these people who can’t speak English are told to go home unless they bring somebody who can. It was like being treated by a system as if they had no consequence”

Insurance companies opposed formal legislation around the new measures, believing it enough to continue with voluntary pilot projects in related areas.

The measures are expected to cost around $25 million a year, which will make some interpreters and translation agencies in California very happy during the great 2009 financial crisis.

Translation Quality Is Crucial

Insurance companies are surely worried about the cost, and perhaps rightly so from their point of view, but premiums and payouts might actually fall if interpreters helped to improve medical treatments, burdening the insurance companies with fewer claims.

The quality of translation is critical here, however, with medicine being similar to law in that a seemingly simple translation mistake or omission can have quite drastic consequences, as a 2003 study entitled ‘Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters‘ correctly concluded:

Most errors have potential clinical consequences, and those committed by ad hoc interpreters are significantly more likely to have potential clinical consequences than those committed by hospital interpreters.

This reality – that medical English (or medical Spanish or Chinese or Hindi) is technically an extremely difficult proposition for anyone trying to translate – should put paid to the arguments, heard more and more frequently nowadays in European countries with large immigrant populations, that immigrants should just learn the language of the country they have emigrated to.

Learning a language to the level required to effectively translate medical dialogue correctly between a doctor and patient, in stressful situations and under time-pressure, takes a long time and a lot of study – if you get your ‘niece who spent three months in London‘ to do it, you’re asking for trouble, however well-intentioned and willing she might be.

Individual Effort v. Legislation

Whilst we’re on the subject of individual effort, one thing is for an individual company to offer translation services in an effort to open up immigrant market segments, or for an individual hospital to do their best to provide a better service, but it is quite another for a government at any level to actively legislate translation into reality.

Quite apart from the practicalities of finding enough competent translators to service 40% of California’s population in several different languages, there is the matter of properly qualifying those interpreters and, in a country so wont to sue for the most trivial matters, what will now happen from a legal point of view when no interpreter is available or the interpreter isn’t qualified?

Nevertheless, it seems to me that California has taken a step in the right direction.