The interpreter’s job is focused on cultural differences, thus the need for the medical interpreter to mediate between cultures. As we are working in a Western medicine environment, we should be aware of the assumptions of Western medicine.
For instance, Western medicine tends to see mankind as dominating over nature, while other cultures can focus on the need to find a harmony between natural forces and human beings. Western medicine is more centred around action and quickness of action, as we know that for the Western culture time is money. However, other cultures may think that the best approach in some situations is to wait and see how things develop.
The most important thing for an interpreter and for any provider working in a multicultural environment is not to be judgemental. The validity of an approach often depends on the specific case at hand. To be able not to be judgemental, the first stage, called pre-competence, is a stage in which we understand that cultural differences exist. The next steps will take us through various levels of competence until we are fully proficient in the cultural frameworks we are dealing with.
The Berlin and Fowkes model called LEARN is a framework for doctors to have fruitful discussions with patients. The model is based on reciprocal listening to the other’s perception of the problem and discussing the difference and similarities between the provider’s perception and the patient’s perception, so that appropriate treatment may be negotiated. Even the idea of negotiating treatment might sound strange for a lot of cultures, where it is basically the doctor who takes the final decision on the patient’s treatment, whereas in the US the final decision is made by the patient. A good method to understand if the patient has actually understood what the doctor said is to ask the patient to “teach back”, or explain what he understood in their own words. This is also a good method for an interpreter to ask for clarification. In fact, instead of asking for a repetition, the interpreter can just check if he or she has understood by repeating what the provider said and checking that it is correct.
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