A guide to identifying and responding to cross-cultural issues in health care delivery. Doctors should clearly explain the procedure and post-operative care to the patient and close family members, using an interpreter, and diagrams or models, where appropriate. People need to be given the opportunity to express their fears. For example, one mother refused to let her child have surgery for a cleft palate because of fear of brain damage, but did not have the opportunity to discuss these fears with the doctor. It may be necessary to have a professional interpreter in theatre for procedures that do not require a general anaesthetic.
Informed consent is a major issue.
It is very difficult to be sure that even patients who speak English as their first language fully appreciate the nature of a condition, the procedures that might be involved and the risks entailed, and are therefore in a position to give true informed consent. For those who do not speak English as their first language, the difficulties are magnified, and fear may also inhibit language facility at this time. If the person is not competent in English, make sure you get an interpreter who can explain the procedure, the risks and the benefits, in the person's own language. It may be helpful to ask if patients would like you to talk to someone in their family to help with the decision about the procedure. People may not ask questions and may say they have understood, even if they have no or only partial understanding.