Ethical Obligations if Patients Have Limited English Proficiency
June 1, 2024 2 minutes read
As a nurse and clinical bioethicist, Melissa Kurtz Uveges, PhD, MA, RN, had a strong desire to facilitate communication with patients with Limited English Proficiency (LEP) and to provide information in their preferred language.
“Ethical issues related to cases involving LEP patients who are likely to initiate an ethics consult include insufficient informed consent and breach of confidentiality,” reports Uveges. Uveges and colleagues authored a paper exploring nurses’ ethical obligations for patients with LEP.1
“Routine assessment of patients’ language preferences is imperative to optimize healthcare outcomes,” underscores Uveges, an assistant professor at Boston College’s Connell School of Nursing. Clinicians need an adequate understanding of the professional role obligations of the interpreter, who facilitates communication between the patient and healthcare team. “Accessing professional interpreters to facilitate communication with patients, while sometimes time-intensive, is imperative,” says Uveges.
This can prevent errors in healthcare interpretation, medical errors, and hospital readmissions. “It can also promote patient comprehension, maximize care utilization and clinical outcomes, increase patient satisfaction, and ensure the patient’s perspective is appropriately communicated,” adds Uveges.
Clinical ethicists can help to resolve issues arising in cases where care has been suboptimal. This can happen with the use of untrained interpreters. “Clinicians’ use of family or ad hoc interpreters occurs often, especially in the context of private practice healthcare visits,” notes Uveges.2
Ethics consultants can contribute to organizational efforts aimed at ensuring access to professional interpretive services for all patients. Ethicists also can educate healthcare providers as to why the use of family or ad hoc interpreters is not ideal. “Clinical ethicists can help guide how best to navigate ethical quandaries arising in such cases,” says Uveges.
REFERENCES
- Uveges MK, Milliken A. Nurses’ ethical obligations when caring for patients with limited English proficiency. AACN Adv Crit Care 2024;35:66-74.
- Centers for Medicare and Medicaid Services. How healthcare providers meet patient language needs: Highlights of a Medscape provider survey. September 2017. https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Issue-Brief-How-Healthcare-Providers-Meet-Patient-Language-Needs.pdf
As a nurse and clinical bioethicist, Melissa Kurtz Uveges, PhD, MA, RN, had a strong desire to facilitate communication with patients with Limited English Proficiency and to provide information in their preferred language.
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