Ethical Tensions in the Role of the Medical Interpreter.

Medical interpreters play central roles in the care of patients with limited English proficiency, many of whom are vulnerable to challenges in care. Yet ethical tensions arise in the care of these patients, including tensions between translating with fidelity to spoken words versus ensuring understanding; supporting values of beneficence versus autonomy; reacting with passivity versus advocacy; and interacting with patients with neutrality versus compassion. These tensions reflect the commitment of interpreters featured in narratives to providing patient-centered care through challenging circumstances. Yet interpreters are often poorly supported, with low wages, multiple stressors, and vicarious trauma as a result of witnessing difficult medical encounters and interpreting during them in the first person. Interpreters should be recognized as valued, integral care team members who recognize patients as individuals deserving of the best care.