GESTIÓN EN SALUD PÚBLICA: Overcoming language barriers and linguistic prejudice in medicine

domingo, 13 de mayo de 2018

Overcoming language barriers and linguistic prejudice in medicine

Overcoming language barriers and linguistic prejudice in medicine

Bioedge

Overcoming language barriers and linguistic prejudice in medicine

by Xavier Symons | 12 May 2018 | 2 comments

The journal Bioethics will shortly release a special issue focusing on the theme of “migration, health and ethics”. One of the papers in the issue addresses the underexplored topic of language barriers in clinical practice.

In her paper “Language barriers and epistemic injustice in healthcare settings”, McGill University linguist Yael Pelad explores how both barriers within languages and barriers between languages can impede everything from diagnosis and treatment to consultation and termination of treatment.

Pelad suggests that communicative factors such as a patient’s accent can introduce subtle bias into a clinician's mind, particularly if the accent is often associated with less educated populations. Alternatively, patients from linguistically diverse backgrounds may struggle to translate illness-related concepts from their native language into a lingua franca such as English. The English language concepts of “pain” and “ache”, Pelad observes, are indistinguishable in Russian, while “depression” is variously conceptualised in different cultures.

Pelad advocates a series of steps to remedy what philosophers call “epistemic injustice”, or unfairness and bias that arises due to aspects of knowledge or communication.

Specifically, doctors should be sensitive to the limits introduced by culture and language, and be more willing to tolerate and work with the cultural ambiguities inherent in our conceptions of disease and illness.

Pelad writes:

“...Even when patients do not expect to be treated in their own language, there are nevertheless certain linguistic actions that can contribute to a more positive rapport and therefore better care delivery, such as a bilingual greeting, the recognition of one’s linguistic identity, the acknowledgement of language needs, and the effort of pronouncing a patient’s name correctly”.

Sunday, May 13, 2018

“Death with dignity” or “aid in dying” is gathering pace in the United States, now that Hawaii has joined the list of states which permit it. Some of the most important input in the debate comes from medical associations. The American  Academy of Hospice and Palliative Medicine  has adopted a position of “studied neutrality”. But how does the American Medical Association stand?

According to a recent decision by its Council on Ethical and Judicial Affairs, squarely against it. Below we report that in a little-noticed report, it endorses many of the arguments raised against assisted suicide: "dying with dignity" is a misnomer; it is probably not safe; and it could lead to a slippery slope. It's a very interesting read -- along with all of our other articles. Check them out.