The Medical Interpreter Blog

This article introduces medical interpreters to the amazing work of healthcare spiritual care providers, argues that medical interpreters have a responsibility to prepare for interpreting for spiritual encounters as they would for any other healthcare encounter, and provides some resources to do that.

Spiritual care, which may also be called Chaplaincy, is “a type of care that addresses and seeks to meet existential and spiritual needs and challenges in connection with illness and crisis” (Hvidt, 2020). It plays a unique yet essential role in caring for patients, whether the patient practices a particular religion or needs an additional layer of support in the face of a life-changing health event. 

At the time of my first encounter with Spiritual Care, it was not something I had a lot of experience with. I was about a year into working as a freelance medical interpreter, spending my days shuttling between local hospitals and clinics in the Greater Seattle Area, interpreting for patients and their family members during a variety of medical appointments – from annual check-ups and blood sugar checks, to cataract surgeries and baby deliveries. 

That day, as I was waiting for my assigned patient to arrive in the waiting room of a busy cancer care center, my phone buzzed with a call from an interpreting agency. “Yuliya, the patient is going to have an add-on appointment and we were hoping you’d be able to stay. It’s with Spiritual Care.” Spiritual Care?! I, who only minutes ago was undaunted by having to interpret complex oncology terms, was suddenly apprehensive. After all, I don’t go to church. I don’t know any prayers by heart. Am I even qualified to interpret for Spiritual Care?

Turns out, I am not alone in feeling this way. In several comments under a social media group discussion around interpreting prayers, interpreters  mentioned withdrawing as soon as they hear they have to interpret for Spiritual Care, citing best intentions – not wanting to let a patient down, and worry over their inability to stay impartial. Due to the specific terminology associated with sacred texts and religious rites, even seasoned interpreters may find themselves challenged in this setting. 

However, since that initial encounter, and after having worked with many spiritual care providers – not least the folks from our own amazing Spiritual Care Department at Harborview Medical Center in Seattle, Washington, who were very generous with their knowledge and contributed to my own and my colleagues’ understanding of the outstanding work they do – I have come to realize several important things about interpreting for Spiritual Care encounters that I would like to share below. 

• Spiritual Care can support patients and their families in a variety of ways. Prayer is often the first thing that comes to mind – and indeed, Spiritual Care providers can pray with patients, as well as provide sacraments or rituals such as baptism, communion, and anointing. They can also connect patients and their families with the local clergy and spiritual practitioners of various faiths. A spiritual care provider may help the patient find a source of strength during a difficult time, or help someone come to terms with their regrets at the end of life. They may also offer support during a time of crisis, loss or illness by simply listening and talking, perhaps by discussing spirituality in general terms, not rooted in any particular religion.  
• One of the core values for healthcare interpreters is beneficence – which means they “have as their essential obligation and duty to support the health and well-being of the patient and her/his family system of support” (NCIHC, 2004). Spiritual Care is an integral part of healthcare and addresses a patient’s overall well-being, considering not just their physical health but also the emotional, psychological, and spiritual needs of patients and their loved ones. This comprehensive approach supports a patient’s overall quality of life and healing process.  It is therefore interpreters’ duty to provide accurate and unbiased interpretation during spiritual care encounters – just as we would during other encounters, be it a physical therapy session, a surgery or an office visit. This also means that medical interpreters should familiarize themselves with different sacred texts and religious practices to enhance their ability to effectively interpret for spiritual care conversations – just like they would read up on a medical specialty or a procedure they are not familiar with. 
• Interpreters do not have to share the patient’s faith or beliefs  in order to be able to interpret in Spiritual Care encounters. After all, the NCIHC Standards of Practice states that an interpreter “does not allow personal judgments or cultural values to influence objectivity.” Interpreters should remember that our interpretation doesn’t reflect our personal endorsement; it’s a conduit for communication. 
• If appropriate, having a thorough pre-session can help interpreters learn about the goals of an encounter and to discuss strategies. Will a spiritual care provider be reading from a Bible or offering up a prayer from the heart? Could the interpreter take some time to look up an appropriate passage on a website like Bible Hub in the patient’s language? Would the provider and the patient prefer to pray each in their own language while the interpreter steps back just for that portion of the encounter? 

To sum up, while Spiritual Care encounters may be challenging for interpreters for a variety of reasons, being frank about interpreters’ limitations and actively participating in problem-solving will enhance communication between the parties during a potentially sensitive encounter and may be far less disruptive than immediately withdrawing from interpreting. Being prepared for spiritual care encounters is essential for interpreters to ensure effective, respectful, and culturally sensitive communication that enhances patient care and well-being. The references and resources below can serve as a first step towards that preparation – and feel free to reach out if you have some helpful resources of your own!

This article was first published in the Ocober 2023 issue of Intercambios, the nesletter of the Spanish Division of the American Translators Association (ATA).

Resources for medical interpreters – learn more about spiritual care:

1. Glossary of Spirituality Terms https://en.wikipedia.org/wiki/Glossary_of_spirituality_terms
2. Glossary of Buddhism (available in 16 languages) https://en.wikipedia.org/wiki/Glossary_of_Buddhism
3. A Glossary of Christianity (available in 6 languages) https://en.wikipedia.org/wiki/Glossary_of_Christianity
4. Glossary of Islam (36 languages available) https://en.wikipedia.org/wiki/Glossary_of_Islam
5. Glossary of Catholic Terms https://www.usccb.org/offices/public-affairs/catholic-terms
6. Meditations in multiple languages – MOM Meditations https://www.mommworld.org/meditations
7. Translating The 2500-Year-Old Loving-Kindness Meditation Into The 6800 Languages http://www.ashtangamaui.com/loving-kindness
8. Bible in many languages: https://biblehub.com/ and https://biblehub.com/
9. Bahá’í Prayers in Multiple Languages . (2016, January 2). Retrieved  from http://www.bahaiprayers.org/languages.htm 
10. Prayers. Catholic Online. Retrieved from https://www.catholic.org/prayers/ 
11. Spiritual Resources and prayers. (In English and Spanish) Archdiocese of Galveston-Houston. (n.d.). Retrieved  from https://www.archgh.org/resources/health-updates/spiritual-resources/ 
12. YouTube. (n.d.). Videos About World Religions. YouTube. Retrieved from https://www.youtube.com/playlist?list=PLPXQWpXEHYlcBYxBUfD98ixQh7iKJuHEs.
13. American Translators Association podcast E75: Inside Specialization—Interpreting for Spiritual Care in Health Care Settings https://youtu.be/pDq8eOuUh20?feature=shared
14. Interpreting for Hospital Chaplains. Connecting Cultures. http://www.interpreterdevelopment.com/blog/interpreting-for-hospital-chaplains-xmy2d

Several of the resources above were contributed by my colleague Alex Báez – thank you!

References:

1. Cultural relevance in end-of-life care. EthnoMed. (2021, June 17). Retrieved from https://ethnomed.org/resource/cultural-relevance-in-end-of-life-care/ 
2. Sasson, H. (n.d.). The medical interpreter’s role in spiritual care and end of life situations. Caduceus. Retrieved from https://sites.google.com/site/caduceusnewsletter/miscellaneous/the-medical-interpreter-s-role-in-spiritual-care-and-end-of-life-situations—by-harry-sasson 
3. Association of Professional Chaplains, Association for Clinical Pastoral Education, Canadian Association for Pastoral Practice and Education, National Association of Catholic Chaplains, & National Association of Jewish Chaplains (2001). A White Paper. Professional chaplaincy: its role and importance in healthcare. Journal of pastoral care, 55(1), 81–97.
4. Cultural religious competence in Clinical Practice – NCBI Bookshelf. National Library of Medicine. (n.d.). Retrieved  from https://www.ncbi.nlm.nih.gov/books/NBK493216/ 
5. Hospital Chaplains Contribute to Patient Satisfaction and Well-being. Part 1. Body, Mind, Spirit. (2018). The Source for Joint Commission Compliance Strategies, 16(1), 6–12. Retrieved from https://store.jcrinc.com/assets/1/14/ts_16_2018_01.pdf. 
6. Hsieh, E., & Kramer, E. M. (2012). Medical interpreters as tools: dangers and challenges in the utilitarian approach to interpreters’ roles and functions. Patient education and counseling, 89(1), 158–162. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462307/
7. Interpreting for spiritual care: Importance, controversy and solutions. Martti by UpHealth. (2021, November 17). Retrieved from https://www.martti.us/2020/02/19/interpreting-for-spiritual-care-importance-controversy-and-solutions/ 
8. Roat, C. E. (2010). Interpreting Prayer. In Healthcare interpreting in small bites: 50 Nourshing Selections from the “Pacific Interpreters Newsletter,” 2002-2010. Trafford Publishing. 
9. Robb, N. and Greenhalgh, T. (2006), ““You have to cover up the words of the doctor”: The mediation of trust in interpreted consultations in primary care“, Journal of Health Organization and Management, Vol. 20 No. 5, pp. 434-455. Retrieved from https://www.emerald.com/insight/content/doi/10.1108/14777260610701803/full/html. 

Featured image: image by pch.vektor on Freepik

Extra reading ideas:

Spiritual Care: The Everyday Work of Chaplains by Wendy Cadge

Chaplaincy and Spiritual Care in the Twenty-First Century: An Introduction by Wendy Cadge, Shelly Rambo

Memoirs of a Hospital Chaplain: I Stand Near the Door by Chaplain Geralyn Cappabianca

World Religions: A Beginner’s Guide: Questions and Answers for Humanity’s 7 Oldest and Largest Faiths by Jill Carroll

12 Major World Religions: The Beliefs, Rituals, and Traditions of Humanity’s Most Influential Faiths by Jason Boyett

Faith Under Fire: An Army Chaplain’s Memoir by Roger Benimoff , Eve Conant

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