Narrative inquiry in bioethics最新文献

This commentary examines the experiences of medical interpreters through a collection of narratives exploring the complex interplay of language, culture, and power dynamics within the healthcare setting reported by medical interpreters. By analyzing themes of power differentials, language barriers, and vulnerability, this commentary highlights the critical role of interpreters in bridging communication gaps and advocating for patient needs. In addition, this commentary explores the personal and professional challenges faced by interpreters, emphasizing the impact of working conditions on interpretation quality. This commentary contributes to a deeper understanding of the experiences of medical interpreters and underscores the importance of supporting their work to improve patient care and health outcomes.

This commentary discusses 12 stories about receiving ethics consultation in hospitals. Five stories are by physicians, three by nurses, and four by family members; three of the writers have training in bioethics. Some writers requested the consultation, others experienced the consultation as an imposition forced upon them, and in two cases, the story is about the absence of any consultation service. Three types of narrative are found to structure the stories: the genuine dilemma narrative, the institutional intransigence narrative, and the relational care narrative. Throughout, the question is what makes for a valuable consultation, and the general answer is whether consultation enables the development of mutually supportive relationships.

Every day, medical interpreters encounter the vulnerabilities of patients with limited English proficiency and systemic barriers to doing the right thing for patients. The narratives in this issue of NIB demonstrate a love of the interpretive practice. There are many stories of advocacy that go above and beyond what is expected of them. Yet, even with national standards, tensions exist as to the boundaries of their role-how much advocacy is expected and how much is above and beyond? What are the emotional costs of advocating for patients who are so vulnerable and in a system that is both huge and changing all the time? Overall, the narratives convey a sense of being situated within teams and within healthcare organizations as moral communities. As you read their stories, circle back to this context every now and then to ground the narratives and yourself in what it means to be a member of a team and moral community. I hope this grounding will help us be better at what we do together.

This symposium collection of twelve narratives from individuals who experienced clinical ethics consultations provides perspectives from a group that has not been adequately explored in the bioethics literature. The authors represent a variety of stakeholders who received ethics consultations: healthcare providers and family members. This commentary will focus on three themes addressed in the different narrative accounts: the reasons for requesting an ethics consultation; the expectations of the narrators from the consultation; and the conclusions the authors drew from their experience of the ethics consultation.

This commentary reflects on twelve stories of participants in clinical ethics consultations from the perspective of family members, some of whom are ethics consultants, and healthcare professionals. Together they reveal expectations of ethics consultations and suggest descriptions of the service. Some common themes emerge, including the role of the clinical ethics consultant in navigating complex situations, assuring all stake-holder voices are heard, attending to moral distress, addressing issues that seem beyond medical practice, and being accessible. They are almost uniformly positive about the experience, with criticism primarily about lack of access to the service.

Medical interpreters are indispensable in healthcare, breaking down language barriers to restore autonomy to patients with Limited English Proficiency (LEP). By facilitating clear communication, they enable these patients to understand and make informed choices about their treatment options. However, their role extends beyond translation; medical interpreters also advocate for LEP patients within a healthcare system that can often be unjust. This advocacy can expose interpreters to the very inequities and challenges they strive to overcome on behalf of LEP patients, adversely affecting their own health and well-being. The narratives explored here shed light on these experiences, highlighting the need for systemic changes. By understanding these stories, we can better advocate for reforms that support and value medical interpreters, ultimately improving the health and well-being of both interpreters and the communities they serve.