When patients and doctors don't speak the same language-- concepts of interpretation practice]

In the Swiss Health Care System, working with an interpreter while medically treating migrants speaking a foreign language has become a common practice. However, the theoretical and conceptional framework of this practice has not yet been sufficiently elaborated. Specifically, the presence of an interpreter leads to a triadic interviewing situation that has implications for the medical treatment. Though an interpreter can improve and deepen the understanding between patient and physician, the communication can also become more complex and difficult with his or her presence. The article sheds light on the perspectives that arise from this situation by defining different role models for medical interpreters and discussing their advantages and disadvantages. The discussion focuses on the four following ideal types: word-for-word translation, cultural mediation, patient advocacy and co-therapy. The choice of interpreter's role in influenced by the institutional setting, the kind of treatment chosen as well as by the concrete interaction. To illustrate the different roles as they manifest in the therapeutic situation, examples from taped and retranslated interviews are presented. Doctor-patient interviews will illustrate the different roles interpreters take over while interpreting medical interviews with migrant patients speaking a foreign language.