TRUST AND HEALTH-CARE INTERPRETING: TOWARD RELATIONSHIP-CENTRED CARE IN CROSS-LINGUISTIC HEALTH CARE ENCOUNTERS

[Introduction and objective] Language barriers are an increasingly critical issue in health care. Interpreters play an important role in overcoming them. In Australia, interpreting is undergoing professionalisation, with credentialing, ongoing assessment and the development of a national code of ethics. In contrast to ethical guidelines for healthcare interpreters in Europe and the USA, the Australian Code omits the issue of trust. It prohibits advocacy while focusing on impartiality and the accuracy of language rendition. This study investigated patients’ views on trust in cross-cultural medical encounters. [Method] I interviewed 16 Japanese-speaking and 15 English-speaking informants who had experienced Japanese-English medical encounters, and Australian doctors who had used professional interpreters. Data were inductively analysed to explore patients’ experiences of receiving language and cultural support and how professional interpreters are used in the clinic. [Results and conclusions] Japanese informants valued trust relationships and expect trust-based communication interventions with family advocates. Japanese patients felt less constrained and more confident when speaking through their partners rather than through a professional interpreter, even when there were acknowledged shortcomings in the partner’s language capability. English-speaking patients also affirmed the importance of trust. Much of the discourse advocating professional interpreters cites the risks of misinterpretation or confidentiality breaches with non-professional interpreters. However, interpreters who abide strictly by the Australian code of ethics sometimes fail to render patients’ real messages. This study suggests that healthcare interpreters should be more engaged with the needs of patients, and that true professionalism lies in their ability to enhance, not undermine, relationship-centred care.