title: Inuit interpreters engaged in end-of-life care in Nunavik, Northern Quebec.
abstract: Inuit interpreters are key players in end-of-life (EOL) care for Nunavik patients and families. This emotionally intensive work requires expertise in French, English and Inuit dialects to negotiate linguistic and cultural challenges. Cultural differences among medical institutions and Inuit communities can lead to value conflicts and moral dilemmas as interpreters navigate how best to transmit messages of care at EOL.
  
  
  
  Our goal was to understand the experience of Inuit interpreters in the context of EOL care in Nunavik in order to identify training needs.
  
  
  
  In the context of a larger ethnographic project on EOL care in Nunavik, we met with 24 current and former interpreters from local health centres and Montreal tertiary care contexts. Data included informal and formal interviews focusing on linguistic resources, experiences concerning EOL care, and suggestions for the development of interpretation training.
  
  
  
  Inuit working as interpreters in Nunavik are hired to provide multiple services of which interpretation plays only a part. Many have no formal training and have few resources (e.g. visual aids, dictionaries) to draw upon during medical consultations. Given the small size of communities, many interpreters personally know their clients and often feel overwhelmed by moral dilemmas when translating EOL information for patients and families. The concept of moral distress is a helpful lens to make sense of their experience, including personal and professional repercussions.
  
  
  
  Inuit interpreters in Nunavik are working with little training yet in context with multiple linguistic and cultural challenges. Linguistic and cultural resources and focused training on moral dilemmas unique to circumpolar contexts could contribute to improved work conditions and ultimately to patient care.​​​​.
authors.affiliation: a Department of Psychoéducation , Université de Montréal , Montreal , Quebec , Canada ​​​​.
authors.forename: Shawn Renee
authors.initials: SR
authors.lastname: Hordyk
authors.affiliation: b Oral Health and Society Research Unit, Faculty of Dentistry , McGill University , Montreal , Quebec , Canada ​​​​.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Macdonald
authors.affiliation: c Department of Medicine and Epidemiology, Biostatistics and Occupational Health , McGill University , Montreal , Canada.|d Centre for Clinical Epidemiology , Jewish General Hospital , Montreal , Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Brassard
mesh_terms: D001110:Arctic Regions; D003142:Communication; D003150:Community Health Workers / Q000941:ethics / Q000458:organization & administration*; D054521:Cultural Competency / Q000523:psychology*; D006801:Humans; D007318:Inservice Training; D004930:Inuit; D009014:Morals; D011792:Quebec; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration*; D014175:Translating
keywords: End of life care; Interpretation; Inuit; Moral distress; Nunavik