Six Layers of Complexity in Interpreter-Mediated Healthcare Encounters

Srikant Sarangi

University of Cardiff, UK

WS166: Language Use, Interaction and Representations of Health in Urban Contexts of Immigrant Health Provision

Healthcare delivery, especially in the primary care sector in urban settings, is increasingly becoming multicultural and multilingual in character. One response to this scenario is the provision of professional interpreting services, although this is not always available or taken up by patients and their families. Instead, it is common practice for a family member to accompany the patient and `mediate’ the consultation. In this presentation, I first offer a broad contextualisation of primary health care delivery in the urban multicultural setting in the UK by drawing attention to patients from different linguistic, cultural backgrounds. From an activity analysis framework, I then characterise interpreter-mediated healthcare encounters along the following six trajectories which influence the process and the outcome of the consultation: (i) the linguistic barrier which occasions the mediated nature of the consultation; (ii) the intercultural dimension which encodes cultural differences in explanatory models of health and illness, relational preferences and racism/perceptual biases; (iii) the expert-lay knowledge asymmetry that underpins professional-client encounters with tacit levels of interpretive procedures; (iv) the multi-party nature of healthcare encounters whereby the participatory status of the interpreter – as mouthpiece, as spokesperson, as advocate, as gatekeeper etc – conflates with information-exchange systems; (v) the institutional practices based on a patient-centered ideology, which calls for shared decision making, patient autonomy and responsibility; and finally, (vi) the positioning of the analyst vis-à-vis the healthcare sphere and the lifeworlds of the participants. In conclusion, against the above six trajectories, I situate the relevant studies in the field of interpreter mediated consultations involving professional interpreters, allied healthcare professionals taking on the role of interpreter, and family members stepping in as `ad hoc’ interpreters.

Session: Workshop (part 1)
Language Use, Interaction and Representations of Health in Urban Contexts of Immigrant Health Provision
Thursday, April 3, 2008, 13:45-15:15
room: 07