Medical interpreters as tools: dangers and challenges in the utilitarian approach to interpreters' roles and functions.

OBJECTIVE: This study explores the tensions, challenges, and dangers when a utilitarian view of interpreter is constructed, imposed, and/or reinforced in health care settings.

METHODS: We conducted in-depth interviews and focus groups with 26 medical interpreters from 17 different languages and cultures and 39 providers of five specialties. Grounded theory was used for data analysis.

RESULTS: The utilitarian view to interpreters' roles and functions influences providers in the following areas: (a) hierarchical structure and unidirectional communication, (b) the interpreter seen as information gatekeeper, (c) the interpreter seen as provider proxy, and (d) interpreter's emotional support perceived as tools.

CONCLUSION: When interpreters are viewed as passive instruments, a utilitarian approach may compromise the quality of care by silencing patients' and interpreters' voice, objectifying interpreters' emotional work, and exploiting patients' needs.

PRACTICE IMPLICATIONS: Providers need to recognize that a utilitarian approach to the interpreter's role and functions may create interpersonal and ethical dilemmas that compromise the quality of care. By viewing interpreters as smart technology (rather than passive instruments), both providers and interpreters can learn from and co-evolve with each other, allowing them to maintain control over their expertise and to work as collaborators in providing quality care.