title: The Absent Interpreter in Administrative Detention Center Medical Units.
abstract: The particular situation of the French administrative detention center (ADC) medical units appears to be an exemplary case to study the difficulties facing medical practice. Indeed, the starting point of our inquiry was an amazing observation that needed to be addressed and understood: why are professional interpreters so seldom requested in ADC medical units, where one would expect that they would be "naturally" present? Aiming to fully explore the meanings of the "absent interpreter", this article takes into account the possible meanings of this situation: the recourse to professional interpreters in France is far from expected given cumulative evidence of its benefits; perceptions of illegal immigrants and medical habitus itself may both hamper the use of a third party; the ADCs are a very stressful place for healthcare professionals, with conflicting missions, political issues enmeshed with medical goals, and heavy affective burden that may lead to self-protection. Silencing voices of suffering others might be seen as the hidden indecent truth of the "absent interpreter". These reflections open a window to a larger issue with regard to the full range of medicine: what are the place, the role and the function of patient's words and narratives in contemporary medicine? The highly invested somatic perspective and its political corollary giving primacy to bare life harbor potential risks of obscuring speeches and undervaluing narratives.
authors.affiliation: Institut de Recherches Interdisciplinaires sur les Sciences et la Technologie, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg Cedex, France.|Service de médecine interne, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg Cedex, France.|Association Migrations Santé Alsace, 24 rue du 22 Novembre, 67000, Strasbourg, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Rondeau-Lutz
authors.affiliation: Institut de Recherches Interdisciplinaires sur les Sciences et la Technologie, Université de Strasbourg, 4 rue Kirschleger, 67085, Strasbourg Cedex, France. jcweber@unistra.fr.|Service de médecine interne, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg Cedex, France. jcweber@unistra.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Weber
mesh_terms: D003144:Communication Barriers; D004641:Emigration and Immigration; D005602:France; D006301:Health Services Needs and Demand; D006801:Humans; D011057:Politics
keywords: Bio-politics; France; Immigration detention centers; Interpretation; Medical ethics; Medical practice; Migrants