Let's talk about critical consciousness

doi:10.1136/bmj.39143.032801.1F

BMJ 2007;334:490 (10 March), doi:10.1136/bmj.39143.032801.1F

Letters

Translation services

Let's talk about critical consciousness

The first 150 words of the full text of this article appear below.

Jones is correct that many people with limited English who seekNHS care are vulnerable, sick, and disempowered and have goodreasons why they cannot immediately or easily learn English.¹Adams is also correct that providing a free translation servicecreates a perverse incentive for people to resist the socialintegration that could improve their health and wellbeing.²But translating what is said is often the least problematictask faced by the professional interpreter, whose multiple (andinherently conflicting) roles also include those of advocate,cultural adviser, negotiator, broker of trust, professionalfriend, teacher, taxi service, and citizens advice bureau.³⁴⁵Translation without careful attention to the patient's healthliteracy, receptiveness, and personal priorities (for rightof residence, housing, and so on) may erode rather than enhancedoctor-patient communication.⁴⁵

Before we all lock horns over "paying for translation," letus shift the debate to more fruitful territory. I propose westart . . . [Full text of this article]

Trisha Greenhalgh, professor of primary health care

University College London, London N19 5LW

p.greenhalgh@pcps.ucl.ac.uk