title: Understanding patient needs without understanding the patient: the need for complementary use of professional interpreters in end-of-life care.
abstract: High-quality doctor-patient communication in end-of-life care results in better quality of life for patients. In linguistically and culturally diverse societies, language discordant consultations become daily practice, leading to difficulties in eliciting patient preferences toward end-of-life care. Although family members invariably act as informal interpreters, this may cause some ethical dilemmas. We present a case of a palliative patient whose son acted as an interpreter. This case generated a triple- layered ethical dilemma: (i) how to safeguard patient autonomy against paternalistic interventions by family members, (ii) how to respect the relational context in which patient autonomy can be realized, and (iii) how to respect the ethno-cultural values of the patient and his family. These issues are being discussed and reflected upon within the framework shared decision making involving informal- and professional interpreters. The complementary use of professional interpreters next to family members acting as informal interpreters is recommended.
authors.affiliation: Faculty of Arts, University of Leuven, Sint-Andries Campus Antwerp, Sint-Andriesstraat 2, 2000, Antwerp, Belgium. demi.krystallidou@kuleuven.be.
authors.forename: Demi
authors.identifier: http://orcid.org/0000-0002-4821-6383
authors.initials: D
authors.lastname: Krystallidou
authors.affiliation: Department of Primary Care and Family Medicine, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ - 6K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Ignaas
authors.initials: I
authors.lastname: Devisch
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ- 2B3, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Van de Velde
authors.affiliation: Department of Primary Care and Family Medicine, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ - 6K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Pype
mesh_terms: D000368:Aged; D003219:Confidentiality / Q000941:ethics; D054521:Cultural Competency / Q000941:ethics; D005260:Female; D006801:Humans; D007802:Language; D010358:Patient Participation; D026684:Personal Autonomy; D011788:Quality of Life; D013727:Terminal Care / Q000941:ethics* / Q000458:organization & administration*; D014175:Translating
keywords: Agency; Communication; Interpreters; Patient autonomy; Patient needs; Shared decision making