9. Advocacy

Principle: Healthcare Interpreters may engage in acts of advocacy when there is objective and verifiable evidence of risk for serious, imminent, avoidable, physical or emotional harm to a person that remains unaddressed.

Objective: To prevent or remove harm.

Description: Advocacy is defined as:
  • the act of supporting and speaking on behalf of another person, group, idea, or a way of doing something, and
  • persuading someone with the authority to act, to improve the situation or resolve a problem. This persuasion goes beyond simply informing those in authority that a problem exists.

Standards of Practice

9.1 Healthcare Interpreters may speak in their own voice, during an interpreted encounter, to protect an individual from immediate, serious avoidable harm if they observe it.

Prompts:

  • Is the information that alerted me to the potential for serious imminent harm to the patient objective and verifiable?
  • Is my assessment unbiased by my own feelings and opinions?
  • Am I reasonably certain no one else will recognize and correct the potential for serious harm before harm occurs?
  • Have I confirmed the information with the patient as well as the patient's understanding of the implications for their health and well-being?
  • Have I exhausted all the interventions I have at my disposal to transparently alert the parties to the potential for imminent harm without having to advocate?
  • Is the potential for serious harm still there?
  • Can I advocate professionally, framing the issue in terms of shared goals and respecting each participant and their sphere of expertise?
  • If I work remotely, is there a reporting system to contact a designated on-site person who can prevent "never events" if I get disconnected?

See more examples, commentary, and decision tree

9.2 Interpreters may advocate outside interpreted encounters on behalf of a party or group to correct mistreatment or abuse.

Prompts:

  • Did something happen during the encounter that I could not address in the moment that still needs to be addressed?
  • Am I seeing a pattern that should be corrected? Is a particular clinic or provider consistently making choices that do not support the patients' best interests?

Examples:

  • Interpreters promote an environment of respect by reporting when a patient's rights are violated.
  • Interpreters follow organizational guidelines for reporting systemic issues.
  • Interpreters tactfully persuade clinicians, who speak a little bit of the patients' language, to continue working with interpreters because the healthcare setting is not the place to practice their language skills without backup.
  • Interpreters who observe a barrier to healthcare present a persuasive argument to their supervisor to take action to correct the issue.
  • Interpreters may write to their congressmen in support of good language access policies.

See more examples, commentary, and decision tree

Examples

Checking with the patient

A surgeon was brusque to the point of severe rudeness. The interpreter conveyed the surgeon's tone. Eventually the interpreter asked the patient if the interpreter should say anything to the surgeon. The patient said, "No, it doesn't matter, I want excellent surgical skill from a surgeon, a lack of social skill doesn't bother me." The interpreter felt better knowing the surgeon's rudeness did not bother the patient.