How conflicting loyalties affect children interpreting in healthcare

What happens when children need to interpret healthcare information that puts them in a moral dilemma? This was the focus of a recent study. And what they found has a massive impact on healthcare.

The term “child language brokers” refers to young migrants who translate and interpret for family members and peers.  A recent UK study addresses two strategies that these young brokers use to manage difficult situations in healthcare. 

In the study, 29 child language brokers, aged 13-16, were presented with a hypothetical scenario. In the scenario they translate for a neighbor at the doctor's office, when the neighbor mentions smacking her child.

Strategies to handle a moral dilemma

Participants then discuss the potential consequences of translating this information. Including the involvement of social services and the potential that the neighbor can lose the child to protective care.  Most child language brokers used two strategies in this scenario:

1. Delaying

The language brokers discussed different delaying tactics while figuring out what information to translate. For example, saying that they needed to continue to discuss with the neighbor in their home language to get clarification. Other participants suggested telling the neighbor directly that it is not allowed to smack their children in the UK and that they can lose custody.

2. Withholding or modifying information

In the study, 22 out of 26 participants mentioned that they would withhold or selectively modify the information about the neighbor smacking her child.

Why children should not translate

This study demonstrates the complexity of the role these children have. They not only act as translators but also as decision-makers in high stake situations. It’s also a reminder of the reasons why young language brokers should not be used as translators in healthcare:

The emotional and psychological impact

These young language brokers often find themselves torn between their loyalty to family members and the responsibility to convey sensitive information to healthcare professionals. A dilemma that can have profound emotional and psychological effects on the children involved.

The risk to patient safety

The text reveals that young language brokers may not provide accurate translations due to protecting people close to them. Imagine if a child modified or withheld healthcare information from a doctor (such a patient diagnosis) for the same reason. It could result in inadequate treatment, or delayed interventions. Essentially, pose a significant risk to the health and well-being of patients.

The need for professionalism

Healthcare communication requires professionalism, accuracy, and objectivity. Children may not possess the maturity and training required for such responsibilities.

A call for improved guidelines

The researchers suggest tailored practical guidance for healthcare professionals. For example, for healthcare professionals to have a mandate to ask the child to leave the room if sensitive matters need to be discussed. Simply a recognition that there are some conversations in which children should not be involved.
We encourage all healthcare providers to think about how you manage children translating in your organization. To work out guidelines for how your staff can avoid using children translating, and alternative ways to communicate in these situations.  Care to Translate aims to bridge the language gap in situations when professional interpreters are not available. It is a safe digital medical translation app that does not jeopardize patient integrity and patent safety in the way that a translating relative does. Please contact us if you want to know more.