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Next Great Immigration Hurdle -- The Right to a Medical Interpreter
Today, millions of U.S. citizens and non-citizens who speak limited English have the legal right to free medical interpreting. But tomorrow could tell a different story. The Senate immigration bill sent to the congressional conference committee last week included one amendment that would uphold the right and another that could kill the right by making English the official language of the land. The conference committee -- expected to act by the end of the summer -- can only choose one version or delete both. At a time when health policy experts around the country are trying to make the law more effective, the health of as many as 50 million people, whose primary language is not English, may be at stake. Hilary Abramson, a contributing editor of New America Media, has been researching language access in U.S. health care with a grant from the Fund for Investigative Journalism.
SAN FRANCISCO--The two out of five Los Angeles residents who speak Spanish at home would find it easier to buy a can of paint at Lowe's than explain to a public hospital emergency room doctor where it hurts.
The home improvement store offers foreign language interpreting in less than a minute over a special telephone line at the customer service desk. But there is only one fulltime, trained, Spanish-speaking medical interpreter in L.A.'s five public hospitals and clinics; and the health department is investigating why a desk clerk at the USC Medical Center emergency room recently failed to know the access code to its Spanish language line.
Thousands of miles away, the regional trauma center in Savannah, Ga., boasts of having improved its medical interpreting for a burgeoning limited-English-speaking community. But that was only after a young, Spanish-speaking woman, whose boyfriend acted as her interpreter, died during her second visit to its emergency room.
Across urban and rural America, policymakers are grappling with the reality that more than 20 million U.S. residents -- 1 in 12 -- speak one or more of hundreds of languages, but may not speak English well or at all. By law, they are entitled to free interpreting when they seek medical attention.
The issue of medical interpreting for immigrants is poised as the next challenge to every polarized bone in America's body politic. Buried in the text of the Senate immigration bill -- to be considered by the congressional conference committee during the summer -- is an amendment by Sen. Jim Inhofe (R-Okla.) that could kill the federal law protecting interpreting as a right by making English the language of the land. To counter it, Sen. Ken Salazar (D-Colo.), included in the same bill an amendment that supports language access. The conference committee will have to choose one or the other, or delete both.
The senatorial mixed message comes just when the issue of medical interpreting is showing up on the national radar. Debate begins with the lack of consensus over what a medical interpreter is, how many are working in the country and what constitutes professional training. It dead-ends at how much professional medical interpreting costs and who should pay for it. Language access researchers, lawyers, policy specialists and advocates estimate it will take at least five more years to agree on solutions. Even with current law on their side, many health care experts wonder if they can beat a brewing health crisis within a health care system they consider dysfunctional.
The issue is fraught with danger. The total number of patients dying annually in the United States due to medical error is roughly equivalent to a full 747 jetliner crashing and killing all passengers every other day. According to the Institute of Medicine, which recently studied medical error, language plays a part in many preventable deaths.
Read More
http://news.newamericamedia.org/news/view_article.html?article_id=a2ccf312598b4820d1d0ac25265fc91e
The home improvement store offers foreign language interpreting in less than a minute over a special telephone line at the customer service desk. But there is only one fulltime, trained, Spanish-speaking medical interpreter in L.A.'s five public hospitals and clinics; and the health department is investigating why a desk clerk at the USC Medical Center emergency room recently failed to know the access code to its Spanish language line.
Thousands of miles away, the regional trauma center in Savannah, Ga., boasts of having improved its medical interpreting for a burgeoning limited-English-speaking community. But that was only after a young, Spanish-speaking woman, whose boyfriend acted as her interpreter, died during her second visit to its emergency room.
Across urban and rural America, policymakers are grappling with the reality that more than 20 million U.S. residents -- 1 in 12 -- speak one or more of hundreds of languages, but may not speak English well or at all. By law, they are entitled to free interpreting when they seek medical attention.
The issue of medical interpreting for immigrants is poised as the next challenge to every polarized bone in America's body politic. Buried in the text of the Senate immigration bill -- to be considered by the congressional conference committee during the summer -- is an amendment by Sen. Jim Inhofe (R-Okla.) that could kill the federal law protecting interpreting as a right by making English the language of the land. To counter it, Sen. Ken Salazar (D-Colo.), included in the same bill an amendment that supports language access. The conference committee will have to choose one or the other, or delete both.
The senatorial mixed message comes just when the issue of medical interpreting is showing up on the national radar. Debate begins with the lack of consensus over what a medical interpreter is, how many are working in the country and what constitutes professional training. It dead-ends at how much professional medical interpreting costs and who should pay for it. Language access researchers, lawyers, policy specialists and advocates estimate it will take at least five more years to agree on solutions. Even with current law on their side, many health care experts wonder if they can beat a brewing health crisis within a health care system they consider dysfunctional.
The issue is fraught with danger. The total number of patients dying annually in the United States due to medical error is roughly equivalent to a full 747 jetliner crashing and killing all passengers every other day. According to the Institute of Medicine, which recently studied medical error, language plays a part in many preventable deaths.
Read More
http://news.newamericamedia.org/news/view_article.html?article_id=a2ccf312598b4820d1d0ac25265fc91e
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This is an interesting problem, one related to a certain extent by the separation of Philosophy (in this case Ethics) from Mathematics which took place over the last hundred or os years. What I mean by this is that 200-300 years ago Philosophers would have been conversant with Math and Logic of their times and that this is no longer the case. Thus I do not fault Kant for "logical laxity" because his arguments were OK according to the standards of Math/Logic of his day (technicaly he was on the Math faculty) but I do fault modern Ethicists who are not.
Let me try to explain the problem. We are agreed "A has a right to X". But how do we get from that statement to "B has the duty to supply X to A". In other words, WHAT precisely are we using to be able to make the ASSIGNMENT of the duty to B, as opposed to saying that C or D or .... has that duty.
There are several principles of Ethics to consider.
1) We do not USUALLY consider anybody at fault for "ethical failure" is they are UNABLE (lack the means) to do whatever would otherwise be required. There are of course thousands of human languages in the world and at any moment a person could be broguht into that hospital who was a native speaker of any of them. Are you makign the calim that the hospital is "at fault" for not having an interpreter for Navaho present on duty? How about Finnish? Mongolian? One of the native Australian languages?
Do you understand the problem? You could make the SAME argument on behalf of any patient brought in and an intgerpreter lacking -- so the duty you propose is that the hospital needs to have available at all times an interpreter for every human language. Does that not violate the "possible" rule?
2) Why do you so glibly assign to the hospital the duty. The glib "arbitrary" assignment of duties (without an explicit "axiom of arbitrary assignement") is one of the places Ethics, particularly Neo-Kantism fails according to the standards of 20th Century Logic. Surely the duty, if one exists, devolves equally among all those capable of fullfilling it. So why are you not blaming all the speakers of the language in question from not appearing at the hospital to fullfill their duty to the striken that an interpreter be present.
PLEASE --- I am NOT denying that patients have a right to explanation in a language that they understand. Just suggesting that more thought is needed before casting blame when this right is not provided for. If you disagree, try to explain WHY (among all the humans on the planet) it is the people of the hospital establishment which has the duty). In other words, try to explain why you blame THEM for the fact no intgerpreter was available.
Let me try to explain the problem. We are agreed "A has a right to X". But how do we get from that statement to "B has the duty to supply X to A". In other words, WHAT precisely are we using to be able to make the ASSIGNMENT of the duty to B, as opposed to saying that C or D or .... has that duty.
There are several principles of Ethics to consider.
1) We do not USUALLY consider anybody at fault for "ethical failure" is they are UNABLE (lack the means) to do whatever would otherwise be required. There are of course thousands of human languages in the world and at any moment a person could be broguht into that hospital who was a native speaker of any of them. Are you makign the calim that the hospital is "at fault" for not having an interpreter for Navaho present on duty? How about Finnish? Mongolian? One of the native Australian languages?
Do you understand the problem? You could make the SAME argument on behalf of any patient brought in and an intgerpreter lacking -- so the duty you propose is that the hospital needs to have available at all times an interpreter for every human language. Does that not violate the "possible" rule?
2) Why do you so glibly assign to the hospital the duty. The glib "arbitrary" assignment of duties (without an explicit "axiom of arbitrary assignement") is one of the places Ethics, particularly Neo-Kantism fails according to the standards of 20th Century Logic. Surely the duty, if one exists, devolves equally among all those capable of fullfilling it. So why are you not blaming all the speakers of the language in question from not appearing at the hospital to fullfill their duty to the striken that an interpreter be present.
PLEASE --- I am NOT denying that patients have a right to explanation in a language that they understand. Just suggesting that more thought is needed before casting blame when this right is not provided for. If you disagree, try to explain WHY (among all the humans on the planet) it is the people of the hospital establishment which has the duty). In other words, try to explain why you blame THEM for the fact no intgerpreter was available.
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