Ꮫ఩ㄽᩥせ᪨䠘༤ኈᏛ఩ㄽᩥせ᪨䠚㻌 㻌 㻌㻌㻌㻌㻌㻌 㻌 㻌 㻌 㻌 㻌 㻌 JAITS㻌ㄽᩥ㢟┠㸸  Development of Medical Interpreting in the UnitedStates 1ᥦฟ⪅䠖㻌 ➉㏕࿴⨾㻌ᤵ୚ᶵ㛵䠖㻌 ኱㜰኱Ꮫ㻌ྲྀᚓᏛ఩䛾ྡ⛠䠖㻌 ༤ኈ䠄ே㛫⛉Ꮫ䠅㻌Ꮫ఩ྲྀᚓ䛾᪉ἲ䠖㻌 ㄢ⛬㻌ྲྀᚓᖺ᭶᪥䠖㻌 2014 ᖺ 3 ᭶ 25 ᪥㻌
Abstract
With globalization proceeding apace, medical institutions find it necessary to ensure
accurate and speedy communication between patients and medical professionals, but only alimited number of countries have professionally trained medical interpreters. This study willattempt to clarify the process of development of medical interpreting .
Chapter One outlines the situation in Japan and other countries. In Japan, the number offoreign residents has been increasing steadily since the immigration control law wa s amended
in 1990. Recently, however, the number of foreign visitors has grown dramatically, but thedevelopment of medical interpreting has just started. Some local governments have taken theinitiative to train medical interpreters and to build their own systems to employ them, butthere has yet to be a national blueprint for doing so. With medical interpreting becoming aninternational issue, this study has chosen the United States, an advanced country in this area,
as the place for field research. This study aims to analyze oral histories of medicalinterpreters in order to identify stakeholders who subjectively contributed to developing theprofession and to figure out what roles they have played in the process.
Chapter Two reviews papers on medical interpreting studies. Most of them shed lighton issues through the viewpoints of physicians. Only a few research studies conducted by
medical interpreters themselves. Development of medical interpreting as a profession has
been treated as a secondary issue. With these findings in mind, I decided to clarify the entire
development process by identifying how stakeholders, including medical interpreters, wereinvolved in the process.
Chapter Three describes my methods: Oral histories to analyze subjective narratives on
private issues such as how people became medical interpreters and what challenging
experiences they can recall. Due to a lack of written materials regarding the beginning ofTAKESAKO Kazumi, “Development of Medical Interpreting in the United States,” Interpreting andTranslation Studies, No.14, 2014. Pages 313-316. © by the Japan Association for Interpreting andTranslation Studies

1313ࠗ㏻ヂ⩻ヂ◊✲࠘ྕ  

medical interpreting, I searched for the initial members of medical interpreters associations toobtain materials they have preserved. I tried my best to recruit targets with different countriesof origin and ethnicity. Since oral histories have been criticized due to the unreliability ofpeoples’ memories and misinterpretation of their meanings, I confirmed with several targets
about incidents they experienced together and have meticulously checked their narratives
with written materials.
Chapter Four provides general information about a total of twenty-nine targets whoworked between 1979 and 2013, outlines of each oral history and four themes: (a) advocacy;(b) stakeholders; (c) perspectives on the profession; and (d) motivations. The targets comefrom twenty countries and speak twenty-five languages including less common languages
such as Khmer, Hmong, Tibetan, Nepali, and Navajo. Fourteen of them were immigrants, fivewere refugees, and one was a resettler. Seven married U.S.-born citizens. Six studied abroad,in the United States, or another foreign country. A total of eight were the first staff
interpreters at their institutions, and ten assumed management positions. A total of seventeen
have worked as professional trainers, while six were the initial group members of the
Massachusetts Medical Interpreters Association, the world’s oldest NPO for professional
medical interpreters, founded in Boston, Massachusetts, in 1986.

They recounted how asmall group of staff interpreters gathered to share difficult cases at work, before developing
their circle into a professional association. Professiona l associations published their own
technical standards in order to establish minimum requirements to be professionals . They
took the initiative in advocacy activities to secure professional sta tus by collaborating with awide variety of stakeholders.

Individual motivation to become a medical interpreter varied

depending on each person’s ethnic roots, family environment, language and cultural barriers
they experienced, however, their primary role as practitioners has been to work as a bridge tofacilitate communication.
Chapter Five focuses on the civil rights movements of the 1960s, which broadly
changed social values in the United States. They remembered how Asians, Hispanics andNative Americans carefully observed the civil rights movement of African -Americans, which
motivated them to demand equal rights to public services . Medical interpreting services
gradually came to be considered an important tool for securing equal access to health care forpeople with limited English proficiency (LEP). Under such circumstances, many stakeholders
became involved in the process of developing medical interpreting. This study highlights thecoincidence of the influx of immigrants in the 1970s and the introduction of informed consent
as a standard practice due to a series of malpractice cases across the country. Together, these
two factors caused medical professionals in general to give importance to medicalinterpreting.
I examined stakeholders’ roles. The federal government enacted laws and encouraged2314Ꮫ఩ㄽᩥせ᪨state governments to comply with them, establishing two main agencies for this purpose: TheOffice of Minority Health and the Office for Civil Rights under the Department of Health andHuman Services. State governments have varied in their language policies, and they all
implemented measures at their discretion. They recounted that the enactment of laws createdjobs for them and led society to recognize their professional status to a considerable extent.
However, the legal status of professional medical interpreters has not been secure enough inthat the laws stipulate that LEP patients must be able to secure meaningful access to healthcare. These laws don’t state LEP persons should be provided with professional interpreters.
The United States’ policy has been consistent in trying to ensure equal access to health carefor the entire population, but it allows bilingual staff, volunteers or an yone competent tointerpret. Physicians played an important role in conducting studies that encouraged policy
makers, government agencies, and foundations to promote medic al interpreting. They
referred to specific physicians who worked closely with professional medical associations to
help enact state laws regarding medical interpreting. The positive stance of physicians helped
medical interpreters secure status as members of the health care team.

Some foundations

which questioned ethnic disparities in health care outcomes played an important role infunding demonstration projects of medical interpreting and large-scale surveys or research.
The development of medical interpreting in the United States is characterized by the positive
involvement of foundations as financial supporters.
Professional medical interpreters associations played an important role as advocates
for the profession. Their bottom-up approach to building their certification testing systems
deserves particular attention. They have taken the initiative in overcoming technical issues bygathering hands-on knowledge from practitioners. They have served as clearinghouses todisseminate crucial information for newcomers to the profession. They have developed
standards such as the code of ethics and standards of practice to ensure good practice. All thetechnical groundwork was established by them.
The initial stage of medical interpreting was characterized by the presence ofnative-English-speaking leaders. But upon obtaining English fluency, members with refugee
and immigrant origins joined the leadership. Such diversity has enabled these associations todevelop culturally- and linguistically-appropriate interpreting. They made decisions tobecome medical interpreters because they knew the profession would enable them to take fulladvantage of their language and cultural backgrounds and to work as a cultural bridge. Acommon contribution by medical interpreters has been as educators at work by showing
physicians and other medical professionals how to work efficiently with them. Many havebeen professional trainers of fledgling interpreters.
This study discusses several factors behind the development of medical interpreting
services: Legislative framework, civil empowerment, professional medical interpreters3315

ࠗ㏻ヂ⩻ヂ◊✲࠘ྕ  

associations’ initiative in publishing standards, advocacy movements, and collaboration withmultiple stakeholders. This multiplicity of factors has produced the synergy needed topromote the social status of medical interpreters in the United States.

Most of thepractitioners at the initial stage of medical interpreting have retired, and their whereabouts
are unknown, and most of the resources from that time have been lost, so many of theinterviewees and stakeholders I contacted have strongly requested that I preserve theiraccounts for future generations. Their narratives mirror their dedication, their rationale forchoosing the profession, and their strategies to overcome challenges. I have dared to write inEnglish, rather than my native Japanese and my second language Spanish, believing that itwill fulfill their expectations and enable me to share heretofore untold stories of pioneers inthis field, complete with their practical knowledge, with potential stakeholders and aspiring
interpreters around the world.
This study provides a new perspective by analyzing chronologically the oral historiesof twenty-nine medical interpreters, covering the time from the inception of the profession to
the present day. Their subjective accounts identify not only stakeholders who promoted thedevelopment process, but also the challenges that medical interpreters have faced at work.
This study expects to serve as a lesson for many countries searching for ways to establish asystem of medical interpreting as well as for Japan, where people are just starting to call forbuilding a system that takes into account the many and diverse issues that interpreters face.
......................................................
࠙ ⴭ ⪅ ⤂ ௓ ࠚ ➉ ㏕ ࿴ ⨾ (TAKESAKO Kazumi)  ⚄ ᡞ ᕷ እ ᅜ ㄒ ኱ Ꮫ 㠀 ᖖ ໅ ㅮ ᖌ ࠋ IMIA
(International Medical Interpreters Association) ᪥ᮏᨭ㒊௦⾲ࠋ་⒪㏻ヂኈ༠㆟఍ึ௦஦ົᒁ㛗࣭⌧⌮஦ࠋ᪥ᮏ㐲㝸་⒪Ꮫ఍࣭㐲㝸་⒪㏻ヂศ⛉఍㛗ࠋ㐲㝸་⒪㏻ヂࢆྵࡴ་⒪㏻ヂ◊✲࠾ࡼࡧ་⒪㏻ヂ⪅㣴ᡂ࣒࢝ࣜ࢟ࣗࣛᵓ⠏࡜ᑓ㛛ᩍ⫱άື࡟ᚑ஦ࠋ

4316