Translating Health

Translating Health

Enhanced English for Interpreters

Fujian Normal University

FNU Language Enhancement 2012-2013

Tongue Twister Review

Betty Botter bought a bit of bitter butter

Which made her batter bitter

But a bit of better butter

Makes better batter

So Betty Botter bought a bit of better butter

Making her bitter batter better.


Why Medical Translators?Case Study: Logan

Location: Fuzhou, Fujian

Purpose of visit: abnormal chest X-ray follow up on routine examination for student visa

Background: foreign student from America, studying Chinese at a university in China.

Medical Tasks

1st visit: investigate abnormal chest X-ray findings to rule out tuberculosis by bronchoscopy (支气管检查 ). Fluid is taken from the air ways to test for tuberculosis (TB).

2nd visit: positive test on bronchoscopy requires start of drug cocktail. TB is not active (latent – 蕴蓄 ). Foreign Affairs health certificate will not be issued until TB test is negative.

3rd visit: Change drug cocktail due to abnormal liver tests

The Leader

(the Doctor)

Handling Problems

Medical Ethics and Values

Beneficence

a practitioner should act in the best interest of

the patient.

Autonomy

the patient has the right to refuse or choose their

treatment.


Discussion

• Identify the cultural barriers that prevent Logan from receiving effective healthcare in China.

• Interpret to the American student, potential reasons the doctors would say the tuberculosis is active when the positive bronchoscopy test report say that the disease is “non-communicable”


Homework Review

• Read the article “A Year in Community Health Work” regarding the Taiyuan Community Health Center in Shanxi province.

Considerations:• Briefly summarize the barriers the team faced

delivering health care to the community. • How did they overcome the barriers?



Contacts

Way of Life


Luxi Community Center,Evergreen Family Friendship ServicesShanxi, China

Medical Ethics: 2 CasesProtective truthfulness: the Chinese way of safeguarding

patients in informed treatment decision

Mei-che Samantha Pang

The Hong Kong Polytechnic University, Hong Kong, China

Journal of Medical Ethics 1999; 24:247-253

Cross-cultural Medicine. Ethical Dilemmas in a Cross cultural Context. A Chinese Example

Jessica H. Muller and Brian Desmond

San Francisco Hospital Medical Centre

West Journal of Medicine 1992; 157: 323-327


Medical Ethics and Values

Beneficence

a practitioner should act in the best interest of

the patient.

Autonomy

the patient has the right to refuse or choose their

treatment.


Case 1: Hong Kong•Mrs Chan, aged 29•carcinoma of the lung, poor prognosis.•husband and sister did not want her to know about her critical condition. Staff told not to tell patient and request is upheld.•Patient is noted by nurse to be perceptive, optimistic and curious. •Nurse avoids talking to patient or responding to her directly but feels patient should have psychological support.•The patient eventually died, still ignorant of her disease.

Case 2: USA•Mrs Lee, aged 49, recent immigrant from China to USA•Terminal lung cancer with metastases to brain and spine•Son is key translator. Will not allow physicians to inform patient of condition.•Physicians try to discuss a “do-not-resuscitate” (DNR) order with patient without success •Patient condition worsens, son begs doctors for intubation. Doctors consult intensive care specialists which agree no grounds for ICU admission•Son threatens litigation due to perceived racism•Patient suffers a code blue during a family meeting and dies

Medical Terminology Notes• Carcinoma- cancer, usually a solid tumor(s) (not blood)

Lung carcinoma, renal carcinoma, hepatic carcinoma

• Metastases or “mets”- cancer spread to other body parts

Breast carcinoma with lung metastases/mets

• “do-not-resuscitate” (DNR) – an order in a hospital setting to not revive someone who is dying. Does not include treatments to provide comfort.

The patient’s cancer has a 3 month prognosis so we need to discuss a DNR order with the patient and the patient’s husband.

• Intubation- placing a tube in the throat to breath

He was declared brain dead even though he was intubated. The question now is whether to remove the vent.



• No grounds- no basis, no justification, no good reason

They fired him even though there was no grounds for his dismissal.

• Litigation- lawsuit

They threatened with litigation when the doctors did not listen to the family’s wishes.

• Code blue – a code for medical staff indicating someone requires emergency help; often cardiac or respiratory arrest.

There’s a code blue in the cafeteria! Quick! Call switchboard!

• Call a family meeting- a meeting which medical staff, a patient’s family +/-patient discuss and make medical decisions about a patient’s care. Common cultural practice in Western hospitals when there are communication problems.


Culture and Ethics

• Which medical ethical value does Chinese culture esteem more? Why?

• Which medical ethical value does Western culture esteem more? Why?


Ping Pong Debate

All terminally ill patients should know their diagnosis and prognosis


HomeworkAnswer ONE question assigned to you. Prepare a clear, informative instruction addressing the question which may help a foreigner navigating the healthcare system in Fuzhou.

1.Describe the process of drawing blood samples in China. Where do you go? How and where do you pay?

2.What routine immunizations are given in China? Where can you get the injection? What information is given about the injections?

3.How are medications prescribed and dispensed in China?

4.If you are ill, how do you make an appointment to see a doctor?

5.Who takes care of food, clothing for the patient at the hospital?

6.How much money should you bring money to visit to the doctor? The hospital? How and who do you pay?

7.Describe an appointment with the doctor. What kind of tests might they run? What type of questions might be asked?

Documents

Translating Health