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NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
WWW.NCIHC.ORG
Guest Speaker: Cynthia E. Roat, MPH
Webinar Workgroup Hosts:
Erin Rosales & Rachel Herring
Teaching
Ethical Decision-Making
to Healthcare Interpreters
www.ncihc.org/home-for-trainers
March 22, 2013
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
You can access the recording of
the live webinar presentation at
www.ncihc.org/trainerswebinars
Home for Trainers Interpreter Trainers Webinars Workgroup is an initiative of the Standards and Training Committee
http://www.ncihc.org/trainerswebinars
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
Home for Trainers Interpreter Trainers Webinars Workgroup
An initiative of the Standards and Training Committee
www.ncihc.org/home-for-trainers
Home for Trainers
an initiative of the
NCIHC Standards and Training Committee
National
Standards for
Healthcare
Interpreter
Training
Programs
• Mentoring Program
• Support for Trainers of
Interpreters in Languages
of Limited Diffusion
• Webinar Series
Home for Trainers
an initiative of the
NCIHC Standards and Training Committee
Home for Trainers Interpreter Trainers Webinars Workgroup
An initiative of the Standards and Training Committee
www.ncihc.org/home-for-trainers
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
Welcome!
Guest Speaker:
Cynthia E. Roat, MPH
“… one of the nation’s premier authorities
on language access in health care.”
Teaching Ethical
Decision-Making
to Healthcare
Interpreters
Cynthia E. Roat, MPH
for the NCIHC
Home for Trainers
March 2013
Goals for this workshop
 Clarify what ethics are and why they are
important to interpreters.
 Review the National Code of Ethics for
Healthcare Interpreters
 Share some techniques for teaching
ethical decision-making in short, medium,
or longer courses.
3/22/2013
Cynthia E. Roat, MPH
7
What are “ethics?”
A principle of right or good conduct.
- The American Heritage Dictionary of the English Language
The principles of conduct governing an
individual or a group.
- Merriam-Webster.com
3/22/2013
Cynthia E. Roat, MPH
8
Ethics reflect values
 Beneficence
 Fidelity
 Respect for the importance of culture and
cultural differences
3/22/2013
Cynthia E. Roat, MPH
9
How to use ethics:
an evolution
 To begin, a list of rules to be followed
 As we grow, a guide to decision-making
3/22/2013
Cynthia E. Roat, MPH
10
Rules vs. guidelines
Ethics as rules
 Reflects a view of
interpreting as a
technical profession.
 Focuses on learning
the rules.
 Less useful to
practicing interpreters,
but a necessary
starting point?
Ethics as guidelines
 Reflects a view of
interpreting as a
practice profession.
 Focuses on learning
the principles behind
the rules and how to
apply them.
 More useful to
practicing interpreters,
but takes time to
develop professional
judgment.
3/22/2013
Cynthia E. Roat, MPH
11
Example: Confidentiality
 What is the rule?
“Interpreters treats as confidential, within the treating
team, all information learned in the performance of
their professional duties, while observing relevant
requirements regarding disclosure.”
 What is the purpose of the rule?
 How can the rule be applied?
3/22/2013
Cynthia E. Roat, MPH
12
Ethical Dilemmas
 These occur when two canons of the Code
of Ethics seem to guide the interpreter to
two mutually exclusive courses of action.
Example: Provider speaks and asks the interpreter
not to interpret. Accuracy or respect?
 Or when following a canon of the Code
seems to violate one of the values behind
the Code.
Example: Interpreter knows critical health
information not shared with the provider.
3/22/2013
Cynthia E. Roat, MPH
13
Resolving ethical dilemmas
 Requires an understanding of the principle
behind the canon.
 There are often multiple possible
resolutions.
3/22/2013
Cynthia E. Roat, MPH
14
Teaching
ethical decision-making
How you teach depends on:
 Your group: how
experienced are they?
 Your agenda: how much
time do you have?
3/22/2013
Cynthia E. Roat, MPH
15
Teaching ethical
decision-making, one hour
1. Introduce the concept of ethics.
2. Read the canons of the National Code
of Ethics.
3. Apply to straightforward sample
situations.
3/22/2013
Cynthia E. Roat, MPH
16
Teaching ethical
decision-making, four hours
1. Introduce the concept of ethics.
2. Break into small groups and have each group
a) read a canon of the National Code of Ethics,
b) explain the canon in their own words, and
c) provide an example of how the canon could be
applied.
3. Debrief in a large group.
4. Provide escalating ethical dilemmas. Which
canon(s) apply? Provide clear answers.
3/22/2013
Cynthia E. Roat, MPH
17
Teaching ethical
decision-making, eight hours
1. Introduce the concept of ethics.
2. Break into small groups and have each group:
a) read a canon of the National Code of Ethics,
b) decide what the principle is underlying this
canon; what it is trying to accomplish; what its
purpose is, and
c) provide an example of how the canon could be
applied.
3. Debrief in a large group.
4. Provide escalating ethical dilemmas. Which
canon(s) apply? Brainstorm options. Analyze
consequences.
3/22/2013
Cynthia E. Roat, MPH
18
Brainstorm options.
Analyze consequences.
3/22/2013
Cynthia E. Roat, MPH
19
From Robyn Dean, M.A., C.I./C.T., University of
Rochester, Beyond “It Depends…”: The Practice
Profession Shift in Interpreting, 2010.
Intervened appropriately
Did not intervene,
but should have
Intervened, but
should not have
Brainstorm and analysis
 What could you do?
 What ELSE could you do? And what else?
 What are reasonable positive outcomes
of each option? How likely are they?
 What are the reasonable negative
outcomes of each option? How likely are
they?
3/22/2013
Cynthia E. Roat, MPH
20
Let’s look at an example
3/22/2013
Cynthia E. Roat, MPH
21
Boundaries
1. The canon:
The interpreter maintains the boundaries of
the professional role, refraining from personal
involvement.
2. What is the principle underlying
this canon? What is it trying to
accomplish?
3. Example
3/22/2013
Cynthia E. Roat, MPH
22
Boundaries, cont’d
4. Dilemmas
Provide escalating ethical dilemmas.
Which canon(s) apply?
Brainstorm options.
Analyze consequences.
3/22/2013
Cynthia E. Roat, MPH
23
Summary
 Ethics guide professional behavior.
 A study of the Code of Ethics is most
useful if understanding of the canons is
followed by:
1. discussion of underlying principles,
2. concrete examples
3. consideration of dilemmas focusing on
options and analysis of likely outcomes.
3/22/2013
Cynthia E. Roat, MPH
24
Discussion
and Questions
Cynthia E. Roat, MPH
cindy.roat@alumni.williams.edu
206-546-1194
3/22/2013
Cynthia E. Roat, MPH
25
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
- Future events
- Session Evaluation
- Follow up via email
TrainersWebinars@ncihc.org
Home for Trainers Interpreter Trainers Webinars Workgroup
An initiative of the Standards and Training Committee
www.ncihc.org/home-for-trainers
Announcements
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
WWW.NCIHC.ORG
Guest Speaker: Cynthia E. Roat, MPH
Teaching Ethical Decision-Making to Healthcare Interpreters
www.ncihc.org/home-for-trainers
Thank you!
Home for Trainers Interpreter Trainers Webinars Workgroup
An initiative of the Standards and Training Committee
March 22, 2013
NATIONALCOUNCILONINTERPRETINGINHEALTHCARE
You can access the recording of
the live webinar presentation at
www.ncihc.org/trainerswebinars
Home for Trainers Interpreter Trainers Webinars Workgroup is an initiative of the Standards and Training Committee
http://www.ncihc.org/trainerswebinars

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Teaching Ethical Decision-Making to Healthcare Interpreters

  • 1. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE WWW.NCIHC.ORG Guest Speaker: Cynthia E. Roat, MPH Webinar Workgroup Hosts: Erin Rosales & Rachel Herring Teaching Ethical Decision-Making to Healthcare Interpreters www.ncihc.org/home-for-trainers March 22, 2013
  • 2. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE You can access the recording of the live webinar presentation at www.ncihc.org/trainerswebinars Home for Trainers Interpreter Trainers Webinars Workgroup is an initiative of the Standards and Training Committee http://www.ncihc.org/trainerswebinars
  • 3. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE Home for Trainers Interpreter Trainers Webinars Workgroup An initiative of the Standards and Training Committee www.ncihc.org/home-for-trainers Home for Trainers an initiative of the NCIHC Standards and Training Committee National Standards for Healthcare Interpreter Training Programs
  • 4. • Mentoring Program • Support for Trainers of Interpreters in Languages of Limited Diffusion • Webinar Series Home for Trainers an initiative of the NCIHC Standards and Training Committee Home for Trainers Interpreter Trainers Webinars Workgroup An initiative of the Standards and Training Committee www.ncihc.org/home-for-trainers
  • 5. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE Welcome! Guest Speaker: Cynthia E. Roat, MPH “… one of the nation’s premier authorities on language access in health care.”
  • 6. Teaching Ethical Decision-Making to Healthcare Interpreters Cynthia E. Roat, MPH for the NCIHC Home for Trainers March 2013
  • 7. Goals for this workshop  Clarify what ethics are and why they are important to interpreters.  Review the National Code of Ethics for Healthcare Interpreters  Share some techniques for teaching ethical decision-making in short, medium, or longer courses. 3/22/2013 Cynthia E. Roat, MPH 7
  • 8. What are “ethics?” A principle of right or good conduct. - The American Heritage Dictionary of the English Language The principles of conduct governing an individual or a group. - Merriam-Webster.com 3/22/2013 Cynthia E. Roat, MPH 8
  • 9. Ethics reflect values  Beneficence  Fidelity  Respect for the importance of culture and cultural differences 3/22/2013 Cynthia E. Roat, MPH 9
  • 10. How to use ethics: an evolution  To begin, a list of rules to be followed  As we grow, a guide to decision-making 3/22/2013 Cynthia E. Roat, MPH 10
  • 11. Rules vs. guidelines Ethics as rules  Reflects a view of interpreting as a technical profession.  Focuses on learning the rules.  Less useful to practicing interpreters, but a necessary starting point? Ethics as guidelines  Reflects a view of interpreting as a practice profession.  Focuses on learning the principles behind the rules and how to apply them.  More useful to practicing interpreters, but takes time to develop professional judgment. 3/22/2013 Cynthia E. Roat, MPH 11
  • 12. Example: Confidentiality  What is the rule? “Interpreters treats as confidential, within the treating team, all information learned in the performance of their professional duties, while observing relevant requirements regarding disclosure.”  What is the purpose of the rule?  How can the rule be applied? 3/22/2013 Cynthia E. Roat, MPH 12
  • 13. Ethical Dilemmas  These occur when two canons of the Code of Ethics seem to guide the interpreter to two mutually exclusive courses of action. Example: Provider speaks and asks the interpreter not to interpret. Accuracy or respect?  Or when following a canon of the Code seems to violate one of the values behind the Code. Example: Interpreter knows critical health information not shared with the provider. 3/22/2013 Cynthia E. Roat, MPH 13
  • 14. Resolving ethical dilemmas  Requires an understanding of the principle behind the canon.  There are often multiple possible resolutions. 3/22/2013 Cynthia E. Roat, MPH 14
  • 15. Teaching ethical decision-making How you teach depends on:  Your group: how experienced are they?  Your agenda: how much time do you have? 3/22/2013 Cynthia E. Roat, MPH 15
  • 16. Teaching ethical decision-making, one hour 1. Introduce the concept of ethics. 2. Read the canons of the National Code of Ethics. 3. Apply to straightforward sample situations. 3/22/2013 Cynthia E. Roat, MPH 16
  • 17. Teaching ethical decision-making, four hours 1. Introduce the concept of ethics. 2. Break into small groups and have each group a) read a canon of the National Code of Ethics, b) explain the canon in their own words, and c) provide an example of how the canon could be applied. 3. Debrief in a large group. 4. Provide escalating ethical dilemmas. Which canon(s) apply? Provide clear answers. 3/22/2013 Cynthia E. Roat, MPH 17
  • 18. Teaching ethical decision-making, eight hours 1. Introduce the concept of ethics. 2. Break into small groups and have each group: a) read a canon of the National Code of Ethics, b) decide what the principle is underlying this canon; what it is trying to accomplish; what its purpose is, and c) provide an example of how the canon could be applied. 3. Debrief in a large group. 4. Provide escalating ethical dilemmas. Which canon(s) apply? Brainstorm options. Analyze consequences. 3/22/2013 Cynthia E. Roat, MPH 18
  • 19. Brainstorm options. Analyze consequences. 3/22/2013 Cynthia E. Roat, MPH 19 From Robyn Dean, M.A., C.I./C.T., University of Rochester, Beyond “It Depends…”: The Practice Profession Shift in Interpreting, 2010. Intervened appropriately Did not intervene, but should have Intervened, but should not have
  • 20. Brainstorm and analysis  What could you do?  What ELSE could you do? And what else?  What are reasonable positive outcomes of each option? How likely are they?  What are the reasonable negative outcomes of each option? How likely are they? 3/22/2013 Cynthia E. Roat, MPH 20
  • 21. Let’s look at an example 3/22/2013 Cynthia E. Roat, MPH 21
  • 22. Boundaries 1. The canon: The interpreter maintains the boundaries of the professional role, refraining from personal involvement. 2. What is the principle underlying this canon? What is it trying to accomplish? 3. Example 3/22/2013 Cynthia E. Roat, MPH 22
  • 23. Boundaries, cont’d 4. Dilemmas Provide escalating ethical dilemmas. Which canon(s) apply? Brainstorm options. Analyze consequences. 3/22/2013 Cynthia E. Roat, MPH 23
  • 24. Summary  Ethics guide professional behavior.  A study of the Code of Ethics is most useful if understanding of the canons is followed by: 1. discussion of underlying principles, 2. concrete examples 3. consideration of dilemmas focusing on options and analysis of likely outcomes. 3/22/2013 Cynthia E. Roat, MPH 24
  • 25. Discussion and Questions Cynthia E. Roat, MPH cindy.roat@alumni.williams.edu 206-546-1194 3/22/2013 Cynthia E. Roat, MPH 25
  • 26. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE - Future events - Session Evaluation - Follow up via email TrainersWebinars@ncihc.org Home for Trainers Interpreter Trainers Webinars Workgroup An initiative of the Standards and Training Committee www.ncihc.org/home-for-trainers Announcements
  • 27. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE WWW.NCIHC.ORG Guest Speaker: Cynthia E. Roat, MPH Teaching Ethical Decision-Making to Healthcare Interpreters www.ncihc.org/home-for-trainers Thank you! Home for Trainers Interpreter Trainers Webinars Workgroup An initiative of the Standards and Training Committee March 22, 2013
  • 28. NATIONALCOUNCILONINTERPRETINGINHEALTHCARE You can access the recording of the live webinar presentation at www.ncihc.org/trainerswebinars Home for Trainers Interpreter Trainers Webinars Workgroup is an initiative of the Standards and Training Committee http://www.ncihc.org/trainerswebinars