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Kliche, Ortrun; Agbih, Sylvia; Altanis-Protzer, Ute; Eulerich, Sabine; Klingler, Corinna; Neitzke, Gerald; Peters, Tim; Coors, Michael (2018): Ethische Aspekte des Dolmetschens im mehrsprachig-interkulturellen Arzt-Patienten-Verhältnis. In: Ethik in der Medizin, Vol. 30, No. 3: pp. 205-220
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Definition of the problem It is well-known that good physician-patient communication is decisive for proper treatment of a patient and the patient's self-determination. In intercultural-multilingual situations, intense discussions are even more important when possible discrepancies on both sides regarding presuppositions and actual facts have to be bridged. Hence, in case of language barriers, the use of qualified interpreters is ethically required. In interpreter-mediated consultations, both physicians and interpreters face specific ethical challenges. When qualified interpreters are not available, physicians, in difficult ethical reflections, have to weigh options regarding alternative solutions. To date, these two issues have received little attention in medical ethics. Arguments Based on research about community interpreting and interpreter-mediated discourse, this paper, first, identifies central ethical challenges and the corresponding spheres of responsibility of physicians and interpreters. It discusses the need of language support, the risk of excluding patients from interpreter-mediated consultations, the observation of the interpreters' ethical principles, the problem of ensuring confidentiality as well as the implications of cultural brokering. Second, the article approaches the physician's options under nonideal conditions when no sufficiently qualified interpreter is available. Calling in a nonprofessional person for spontaneous interpreting, e.g., a relative or a multilingual colleague requires ethical reflection. For this purpose, this article presents for the first time a framework based on nine criteria which can help physicians assess the ability of a specific person to interpret in a given physician-patient encounter and balance competing interests. Conclusion The ethical challenges in interpreter-mediated physician-patient interaction require qualified interpreting. Under nonideal conditions, the framework presented above supports physicians to select alternative solutions. However, it does not substitute long-term solutions on the macro level, e.g., the funding of professional interpreting.