Medical Translation Services
and Understanding the Importance of
Informed Consent

Informed Consent Translation Services

We’ve blogged about the importance of professional medical translation services focused on multilingual translation of Informed Consent Forms (ICF). The healthcare field is highly regulated. Hospitals, doctors and other healthcare organizations receive guidance from multiple regulatory agencies as well as in-house attorneys. This is done in order to protect both the patient and the healthcare organization.

A key part of healthcare and any medical procedure is informed consent. A person must understand his or her medical options and the potential dangers associated with a medical procedure. The options must be clearly presented to the patient and explained in a way that the patient understands.

Many times, prior to a procedure, the patient signs an informed consent form. The informed consent form is an acknowledgement by the patient that he or she understands the procedure and the potential risks. Attorneys usually draft the language in an informed consent form in order to limit the liability of the medical organization.

Translations of Informed Consent for Foreign Language Speakers

Language can be a challenge in this process, both in explaining the procedure to the patient and in drafting of an informed consent form. According to recent US Census Bureau data, 20% of people in the United States speak a non-English language at home. In the Western United States, the figure jumps to 32%. The percentage is 42% in California. While Spanish is the main second language spoken in the United States, there are others.

In recent years, medical facilities have tried to address language barriers, but more can be done. According to the Institute of Medicine, “Individuals whose care is inhibited due to a communication barrier. … may be at risk for poor outcomes.” A recent review of malpractice lawsuits found that 2.5% were due to poor foreign language interpretations or language barriers. In most cases, a child or relative was used to provide the translation rather than a trained professional foreign language translator.

That is never a good idea. Medical terminology can be complicated and thus difficult to provide a foreign language translation. In addition, a relative might not want to translate something clearly if the diagnosis is difficult, such as cancer, for example.

Informed Consent Interpreter Not Provided

In one case, a Vietnamese woman was admitted to the hospital and underwent a medical procedure. She spoke no English. The woman was given medication to take after the procedure and released. A 9-year-old girl and a 16-year-old boy both served as interpreters in the case. The discharging document, which was in English, said to seek medical help if diarrhea occurred, as that was a common side effect of the medication. None of the documents were translated prior to the woman being discharged, so the woman was not aware of the potential problem. She had an adverse reaction to the medication and died.

The same is true of informed consent forms, which are not always translated. Many times, a relative or child interprets an informed consent form, but that is most likely not legal. A recent report states, “Under well-established common law, a patient must be given sufficient information about the treatment, benefits, risks and alternatives to make the consent meaningful. Further, medical treatment without any patient consent may constitute battery.”

In one case, 4-year-old boy broke his arm and an artery became blocked. Doctors recommended amputating the arm. In the case, the parents only spoke Spanish. The parents signed an informed consent form which was only available in English prior to the procedure. A family member provided the translation. When the parents realized what they had agreed to, they were shocked. The hospital paid the family $900,000 in the lawsuit.

Medical Interpreting Best Practice

In recent years, medical facilities have begun to invest more money in full-time foreign language interpreters, or they are hiring medical interpreting services. A study by the American College of Emergency Physicians found a low error rate among professional translators. The error rate was 2% for professional translators with over 100 hours of training. The number increased to as much as 22 percent for ad hoc interpreters.

According to the study, “Federal policy requires that hospitals provide adequate language assistance to these patients. Our findings add to the growing body of evidence that paid, professional interpreters are essential for delivering high-quality healthcare to our patients.”

Up Next: Medical Translation of Clinical Trials