DID YOU KNOW....



Are good intentions good enough? Informed consent without trained
interpreters.



OBJECTIVE: To examine the informed consent process when trained language
interpreters are unavailable.



BACKGROUND: Ensuring sufficient patient understanding for informed
consent is especially challenging for patients with Limited English
Proficiency (LEP). While US law requires provision of competent
translation for LEP patients, such services are commonly unavailable.



DESIGN AND PARTICIPANTS: Qualitative data was collected in 8 prenatal
genetics clinics in Texas, including interviews and observations with 16
clinicians, and 30 Latina patients. Using content analysis techniques,
we examined whether the basic criteria for informed consent
(voluntariness, discussion of alternatives, adequate information, and
competence) were evident for each of these patients, contrasting LEP
patients with patients not needing an interpreter. We present case
examples of difficulties related to each of these criteria, and compare
informed consent scores for consultations requiring interpretation and
those which did not.



RESULTS: We describe multiple communication problems related to the use
of untrained interpreters, or reliance on clinicians' own limited
Spanish. These LEP patients appear to be consistently disadvantaged in
each of the criteria we examined, and informed consent scores were
notably lower for consultations which occurred across a language
barrier.



CONCLUSIONS: In the absence of adequate Spanish interpretation, it was
uncertain whether these LEP patients were provided the quality and
content of information needed to assure that they are genuinely
informed. We offer some low-cost practice suggestions that might
mitigate these problems, and improve the quality of language
interpretation, which is essential to assuring informed choice in health
care for LEP patients.





J Gen Intern Med. 2007 May;22(5):598-605. Epub 2007 Mar 2.

Are good intentions good enough? Informed consent without trained
interpreters.

Hunt LM, de Voogd KB.

Department of Anthropology, Michigan State University, East Lansing, MI
48824, USA. huntli@...







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