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Behind the Screens: The Ethics of Medical VRI & Sign Language Interpreters

Behind the Screens: The Ethics of Medical VRI & Sign Language Interpreters

Shelly Hansen explores the ethical implications of VRI in medical settings, especially the impacts of dropped connections during sensitive consultations and loss of consumer choice regarding live, on-site sign language interpretation.

It’s all the rage. Those smooth little carts with satisfying clicks and keys. Sweet control, right here at my fingertips for your eyes. No more waiting for a live interpreter to arrive. No more scheduling…it is on demand 24/7/365. No more incorporating another breathing human being into the interaction; we’ve gone high-tech and modern, happy to share our space with a “machine interpreter”, the term used locally by health care provider staff for Video Remote Interpreting/VRI. The medical facility loves this kind of sterile control.

[View post in ASL]

The patient, on the other hand, may have a mixed response to the cyber–signer. Like cafeteria food and military MRE’s, this is a one-size-fits-all solution. If a person has vision issues, is not a strong signer and/or struggles with the style, speed or information from the “machine interpreter”, if they are dizzy, lying down awkwardly, giving birth, going into a radiology department, are from a foreign country and need a specialized sign language, are elderly and prefer a familiar interpreter, are an active child with attention issues or a CODA utilizing the interpreter, would benefit from techniques used by CDIs such as physical movement, drawings or references to visual aids in the immediate environment (including the current meds list on the computer charting screen), or struggle with paperwork and literacy challenges, they are out of luck. Not only are these individuals out of luck, they now need to self-advocate against a large medical institution or physician who has already invested in a “solution” to this communication barrier, and who feels that due diligence has been satisfied.

Communication in Context

When I step back and consider these experiences as a whole, the impact of VRI appears to be greatest on vulnerable adults. We can all find ourselves vulnerable at times, and some individuals may consistently interact as vulnerable adults. I have noticed that communication is most effective in the context of relationship when interpreting for these encounters. The negotiated meaning within a tangible human relationship provides a context for effective communication that mitigates barriers for vulnerable adults and provides a level of comfort needed to genuinely engage with others. While it may seem an overstatement, trust in the interpreter allows for depth of conversation that is not possible for some clients via technology which has an “outside, looking-glass” quality. I consistently hear feedback about “not remembering what they said”, “not understanding but agreeing anyway” and being told there “weren’t any live interpreters available” when those facilities aren’t calling live interpreters any longer as a standard procedure.

“Do No Harm”

RID Certified sign language interpreters historically have been vigilant to “do no harm”, maintaining high professional standards of ethical conduct, creating ethical codes of conduct, establishing ethical review boards and making every effort to provide quality service to the Deaf, Hard of Hearing, DeafBlind, Late-Deafened, and Hearing communities as allies and professionals. This commitment to the profession has enabled increased access to places of public accommodation throughout society and is a source of quiet pride and job satisfaction for many sign language interpreters who are committed to increased equality, autonomy, and self-actualization.

As a freelance community sign language interpreter, I have seen a dramatic shift in medical interpreting assignments from live interpreting to VRI supported interactions. As I sit on the cyber-fence, wanting to continue the work I love and provide services to people who need, want, and are requesting live interpreters, I am faced with an ethical dilemma. Do I participate in a flawed and “do some harm” medical VRI system because my livelihood is being affected by marketplace shifts?

Sample Scenario of a Botched VRI Appointment

A patient goes to a medical appointment in a facility to discuss the results from a recent scan with a specialist. The office uses a VRI system. The patient is optimistic about VRI, despite prior frustrations with freezing screens and dropped connections resulting in re-scheduled appointments with a local, familiar, RID certified “live” sign language interpreter. The doctor begins to review the results of the scan along with the possible issues that may be causing symptoms of concern. The “worst case scenario” is discussed and then the VRI starts to cut out, freezing. The tech issues cannot be resolved, again. The doctor, exasperated says, “This is not a service, it’s a DIS-service.” The appointment is abruptly curtailed and a follow-up appointment is scheduled for next week with an onsite, “live” interpreter.

When the appointment begins the following week, the “live” interpreter is unaware of the previous snafu. The doctor begins again to explain the medical condition, and informs the patient that s/he does NOT have the fatal condition. The patient breaks down. For an entire week, the last message about the fatal flaw and partially explained scan image had left the person believing that they had the dreaded malformation and the condition was terminal. The visible relief on the face of the patient is combined with frustration and anger. Both the patient and doctor commit to no further VRI appointments, expressing relief to have an in-person sign language interpreter on site. They agree that using VRI just isn’t worth the frustration, miscommunication and emotional duress.

If the “live” sign language interpreter left the room at the moment of diagnosis, s/he could lose her/his certification for ethical malpractice. The patient could file an ethical complaint with RID stating that the interpreter violated NAD-RID Code of Professional Conduct tenets 6.2 and 6.4 (see below).

Unintended Consequences

In my area, an older gentleman took his own life after receiving a terminal diagnosis. His family found him alone in the backyard. To my knowledge, this was not an interpreted interaction. However, it is possible that someone could react with serious consequences to a misunderstood partial-diagnosis. A scenario like this happened January 2017 at the Limerick Hospital in Ireland. A man received a terminal cancer diagnosis and took his own life in the hospital chapel.

Codes of Professional Conduct

Let’s look at some pertinent codes of conduct for medical sign language interpreters.

IMIA (International Medical Interpreters Association)

“Responsibility Toward Ensuring Adequate Working Conditions” The interpreter shall strive to ensure effective and productive communication in any professional situation and make every effort to have working conditions in place that will allow him or her to provide quality interpretation services.

“Right to equal treatment” Patients have a right to receive treatment in a language they understand; these rights are governed by federal anti-discrimination laws and the ADA.

“Informed consent” Patients should be aware of treatment options and consent to treatment only after understanding these options. Communicating information accurately is essential to informed consent.

“Beneficence” The health and wellbeing of patients is a core value in all health care professions, as well as in medical interpreting.

The NAD/RID Code of Professional Conduct

4.0 Respect for Consumers

4.1 Consider consumer requests or needs regarding language preferences, and render the message accordingly (interpreted or transliterated).

4.4 Facilitate communication access and equality, and support the full interaction and independence of consumers.

6.0 Business Practices

6.2 Honor professional commitments and terminate assignments only when fair and justifiable grounds exist.

6.4 Inform appropriate parties in a timely manner when delayed or unable to fulfill assignments.

6.5 Reserve the option to decline or discontinue assignments if working conditions are not safe, healthy or conducive to interpreting.

Similarly, the National Code of Ethics for Interpreters in Health Care includes “beneficence” and “do no harm,” along with “fidelity”:

“The essence of the interpreter role is encapsulated in the value of fidelity. The American Heritage Dictionary of the English Language describes fidelity as involving the unfailing fulfillment of one’s duties and obligations and the keeping of one’s word or vows.”

More Questions than Answers

How can a career medical interpreter agree to work as a VRI medical interpreter with the knowledge that predictable and unresolved VRI technical issues, including consistently disrupted and poor quality connections and communications, are occurring throughout the healthcare system and political practice issues in which “one size fits all” approaches that dictate language use without options for live on-site sign language interpreters are creating barriers for consumers that violate medical and RID certified interpreter ethical standards? Does the interpreter ignore these issues and shift that duty to the health care system and VRI employer, and ignore the systemic impact of complicit participation in a flawed approach to health care interpreting?

At the moment, I am working triage. Those failed VRI encounters, re-scheduled appointments, miscommunicated partial diagnoses are creating a clean-up tier of work for live interpreters. I’m holding out for “live” interpreting, despite the economic uncertainty of increased VRI use and the lower hourly wages those positions offer. Do I want to be part of the machine interpreter phenomenon? How can I ethically participate in quality healthcare interpretation in 2017 and beyond?

Questions to Consider:

  1. What protections are in place for consumers of medical VRI? Are there rating or feedback mechanisms available to track customer and provider satisfaction post-appointment?
  2. What alternatives are available or recourse do consumers have in the event a VRI appointment fails and are there systems in place to allow patients to pre-select live or VRI preferences especially for sensitive or technical appointments?
  3. What duty does an RID certified interpreter have in medical VRI settings and is that duty usurped by VRI companies and medical facilities choosing to eliminate live on-site interpreting in favor of machine interpreting?

References:

The National Council On Interpreting In Health Care, and Working Papers Series. A NATIONAL CODE OF ETHICS FOR INTERPRETERS IN HEALTH CARE (July 2004.): 8. Web. 21 Mar. 2017.

Registry of Interpreters for the Deaf, Inc. “NAD_RID Code of Professional Conduct.pdf.” Www.rid.org. N.p., 2005. Web. 21 Mar. 2017.

“International Medical Interpreters Association Code of Ethics.” IMIA – International Medical Interpreters Association. International Medical Interpreters Association, n.d. Web. 21 Mar. 2017.

Collins, Pamela. “Bringing Scheduling Into View: A Look at the Business of Sign Language Interpreting.” Street Leverage. N.p., 17 Aug. 2016. Web. 21 Mar. 2017.

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Building Trust: Accepting the Mantle of Sign Language Interpreter

Building Trust - Accepting the Mantle of Sign Language Interpreter

Trustworthiness is a trait all sign language interpreters must embody. Wing Butler posits that it is our duty to display our commitment and trustworthiness at all times, on-the-job and off.

Trust is a huge part of the sign language interpreting profession. As ASL interpreters, we are representatives of our clients, our profession, and at times the entire Deaf community. At the end of the day, our job is a commitment to honor those we represent and the mantle they’ve entrusted to us.

[View post in ASL.]

The Epitome of Honor

That much responsibility can feel daunting, but sign language interpreting isn’t the only occupation with such a high level of trust. One of my favorite examples of taking on a mantle for a job—and one that comes with high expectations of conduct—is the elite Tomb Guard of Arlington Cemetery.

These sentinels guard the famous Tomb of the Unknown Soldier. According to their official website, those who train for this rigorous assignment must meet the highest standards, “including following strict rules, training guidelines, and the need for complete dedication and commitment to the Tomb.” The Tomb Guard have been watching this tomb 24 hours a day, 7 days a week since 1937! No matter what the weather is like, there is always a Tomb Guard present.

After 9 months of service at the tomb, these soldiers receive the Tomb Guard Identification Badge (TGIB). This award is symbolic of their dedication to the tomb, a dedication they are expected to honor for the rest of their days. Even when the guards become civilians, the TGIB can be revoked for committing a serious offense that discredits the Tomb of the Unknowns.

In many ways, I feel that sign language interpreters should honor our position just like the Tomb Guard. Ours is a job that can be called on at any time, in any condition. Beyond that, sign language interpreters protect the communities we serve. We’re defenders, helping people navigate tricky situations that could end disastrously if we aren’t doing our job right. And often, no one will ever know if we’re doing our jobs correctly or not. This high level of trust is precisely why our actions and words matter, even when we’re off the clock. Recently I’ve noticed that many in our community are not living up to our professional standards the way we should.

An Awkward Situation

Just this year, I was in a group of interpreters at a regional event, waiting for our next assignment. I was an interpreter from out of state, and the downtime gave me a chance to meet the local interpreter professionals. As many conversations do, it turned into a discussion about our profession: ethics, organizational decisions, and the injustices some find in our craft. Then the discussion turned to the ever-common topic of the national professional organization’s financial decisions—and how much my peers disagreed with them, to the point of emotional vitriol.

As the criticism became harsher and harsher, I found myself slipping to the back of the group. These interpreters had no idea I had left the treasurer position just a couple of months prior. I tried to diffuse the situation by asking if anyone in the group had watched the treasurer’s latest report. The video addressed many of the issues they were complaining about. But they didn’t follow my lead. Instead, the blaming and ill-will finding marched on until I finally told them the truth: that I had recently left the treasurer position. All the interpreters stared at me in shock—and quickly moved the entire conversation to a more supportive, civil place.

Consider The Shadows We Cast

Loud complaining always has the potential to embarrass the complainer, but that isn’t why I’m sharing this story. I’m more concerned about the deeper consequences of being publicly hostile toward viewpoints we disagree with. And how simple venting and unproductive negativity is harming our professionalism as interpreters. Whether we like it or not, our behavior directly impacts our integrity and our trustworthiness as representatives and guests of the Deaf community. We must pay special attention to our actions at all times so we can be worthy of greater trust through greater professionalism.

The Path to Greater Professionalism

How do we become more trustworthy? Our Code of Professional Conduct is a great place to start, but here are some other suggestions to help us stay professional as sign language interpreters.

1.  Show Respect through Restraint

No matter how you shake it, our public behavior off the clock—whether that’s in person or over social media—has consequences for our reputations as interpreters. This is exactly why we need to honor our profession through thoughtful consideration of our actions.

Too many of us are taking our role lightly by posting anything and everything online. Even when we’re expressing disagreement or sharing ideas, the key to showing professional restraint is keeping our expression civil even when it’s tempting not to. In the spirit of keeping things civil, there are certainly opinions that shouldn’t be expressed in public at all. To know which ones, try out the elevator test outlined in my StreetLeverage article “Does Social Networking Impair Sign Language Interpreter Ethics?”

2.  Watch Out for Intergroup Bias

Humans naturally identify with other humans that are like them, whether it’s a sports team, a family, hearing people, deaf people, or people who share a common profession—like sign language interpreting. We all naturally favor the “us” that’s like you and disfavor the “them” that’s unlike you. Psychologists call this concept intergroup bias. According to Professor Mina Cikara, research suggests that an “us versus them” mentality is one of the key factors that drives groups to collective violence. This violence can be as small as hostile discussion or as widespread as genocide.

Intergroup bias is running rampant in our society, but I would suggest that our interpreting community has much more to lose by engaging in intergroup bias. As we’re striving to be trustworthy in our profession, we must all make a concerted effort to stop vilifying others around us. Let’s stop looking for a “them” to blame for our problems and start listening as we try to understand perspectives different from our own.

3.  Share Opinions in a Spirit of Empathy

This one is always a good idea. Are we expressing opinions to share of ourselves and build up the world around us? Are we open to thoughtful, understanding discussions? Even with people who disagree with our beliefs?

In my StreetLeverage Live presentation “Status Transactions: The ‘It’ Factor in Sign Language Interpreting,” I talked all about the power of humility in an interpreter. It is truly an act of humility to slow down, listen to others, and consider both sides. It takes time and it certainly requires effort, but giving other people the benefit of the doubt can improve both our professional and personal lives. Empathetic listening and seeking the truth is the fastest way to come up with creative solutions to our problems. Which brings me to my final point . . .

4.  Focus on Positive Action

Going back to my experience with my fellow interpreters, that entire situation could have gone very differently. All of us could have participated in a thoughtful, civil discussion about our organization’s finances. Maybe we could have watched their annual report together for context. If everyone still felt unsatisfied with the status quo, we could have drafted a letter to the Board proposing a solution in a respectful yet assertive fashion. This whole experience could have turned into positive action to make our sign language interpreter community better.

In a world that’s already filled with harsh critique, we’re going to make a much bigger difference by turning our opinions into meaningful actions. After all, having opinions isn’t nearly as important as how you live by them; that is what makes you a trustworthy interpreter.

Greater Trust is One Decision Away

To me, being worthy of trust boils down to one simple choice: committing to a higher standard of professionalism. If we all strive for a spirit of civility and positive restraint, we’ll already be changing ourselves and interpreting for the better. That is how all of us will truly become guardians of our profession and those we serve.

Questions to Consider:

  1. Think of the most trusted interpreter in your community. What traits do they display which set them apart from other sign language interpreters? Do you share these traits? If not, how can you develop them?
  2. In what ways are you actively seeking to decrease intergroup bias in your professional circles? What is one step you can take to dismantle an “us versus them” paradigm?
  3. Would you be willing to invite an interpreting colleague to join you in committing to a higher professional standard? What would that accountability relationship look like for you?

 

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Accept or Decline? Questions Sign Language Interpreters Should Ponder

Accept or Decline? Questions Sign Language Interpreters Should Ponder

Michael Ballard suggests that sign language interpreters must begin making decisions before an assignment ever begins. Utilizing pre-assignment questions can bring practitioners more clarity when determining readiness for a job.

 

Hello, everyone. I’m Michael Ballard and I’m thrilled to be with you today for Street Leverage. It’s an exciting time. A little about myself: I grew up learning speech and lip-reading in California and I learned to sign at age 15, and I sign still today. My identity underwent a significant change when I started to learn ASL as I began to interact with a variety of Deaf peers at my high school. Through their instruction, my signing ability greatly improved, and I’m still always learning. I also have to thank the friends of mine who are interpreters. Without your hard work, I wouldn’t be where I am today.

[Click to view post in ASL.]

I had been giving thought to this when Brandon Arthur approached me at the Registry of Interpreters for the Deaf conference in New Orleans and asked if I was interested in filming an article. I agreed, and after some thought decided to speak on an issue close to my heart and mind: an interpreter’s thought process when accepting or declining a job.

 

Defining the Lens

This article’s lens uses as a foundation Dean and Pollard’s 2001 research on Demand Control Schema, or DCS[1]. An interpreter needs to fully grasp both concepts of what constitutes the various demands and controls before accepting an assignment.

Demands and Controls

The category of “demands” can be broken into four parts:

  • environmental demands: terminology, technology, roles, physical environment
  • interpersonal demands: that which is specific to the interpreter and clients involved
  • paralinguistic demands: That which is specific to the expressive skills of the client (deaf or hearing)
  • intrapersonal demands: That which is specific to the interpreter (inner thoughts, feelings, bias, physical/emotional state)

The concept of “controls” describe what a person can exert influence over in the situation, such as:

  • actions or behavior,
  • Particular translation/interpretation decisions
  • Internal/attitudinal acknowledgments

Accurately Assessing Readiness

Before I go on, I would like to note the word “anosognosia,” a term coined in 1999 by Dunning-Kruger in an article at Cornell University[2]. The phenomenon of anosognosia arose to describe research participants’ excessive overestimation of their skills and abilities, and the tendency of we as humans to inflate reality so it reflects positively on ourselves. However, it is only through recognition of error that we can reflect and grow. It then follows that interpreters could be prone to the overconfidence that comes with anosognosia, and should make every effort not to overlook that tendency.

Pre-Assignment Analysis

I’d like to pose some overarching questions for interpreter analysis. As an interpreter, one should ask: Do I possess enough controls to satisfy the demands of this assignment? Each of the following sub-questions should be considered through self-analysis and review using a Likert scale approach (1=weakest ability to 5= strongest ability).  

  1. Do I have sufficient linguistic skill and content knowledge in the necessary languages to meet the needs of this assignment, and to interpret or translate with accuracy and cultural equivalency?

It is incumbent on the interpreter to communicate with the managing entity to get all relevant details and demands of the assignment to make that determination. That process takes experience.

At my first staff-faculty meeting at the start of the semester- I am an ASL instructor and moved recently for the job- it so happened that several colleagues wanted to learn some signs, so I invited them to join my class. After two weeks, we attended a meeting to which an agency interpreter had been assigned. The interpreter was not certified or licensed and was clearly incompetent. I was consequently unable to participate in the meeting because I couldn’t understand the content. During the meeting, a colleague texted me and asked about the interpreter because they were noticeably confused and fumbling. I gave feedback about the interpreter to the agency after the meeting on the need to improve the quality of services, and it is my hope that in the two years since that meeting that they have improved. That is an example of the necessity of an interpreter possessing the linguistic skills and knowledge required in an assignment in order to interpret effectively and accurately.

  1.  Am I psychologically and emotionally stable enough to perform the job requisites? Can I interpret without having a negative influence on the parties involved?

Due to the unpredictability of assignments, an interpreter must be mentally and emotionally capable of handling unexpected events.

For example, at the birth of my oldest daughter- we have four children- the interpreter at the hospital was respectful, competent and professional and made the experience as seamless as possible, even given the 3:00 A.M. delivery. I’m grateful to have had that positive of an experience. We specifically requested the same interpreter for our second child’s birth because the first experience had been so wonderful, and it made the day that much more fun. However, at the birth of our third child my wife and I were terribly disappointed at the assigned interpreter’s lack of professionalism in their behavior- they were flirting, making jokes and in general being inappropriate. It was upsetting for my wife to be actively in labor with an interpreter interjecting in the midst of everything. Unfortunately, it’s an example of an interpreter not possessing the mental and emotional clarity to navigate that type of situation, and that lack of self-regulation has a serious impact. 

  1. Am I taking this assignment because I’m qualified, or because I want the experience?

As I mentioned, our first two childbirth experiences were exceptional because the interpreter was qualified, but I wonder if the interpreter in the third birth accepted the job solely to gain more medical interpreting experience. I didn’t think to inquire at the time because I was focused on my wife, but the question for me remains. I suggest in those situations that an interpreter looking to gain experience instead ask to observe or mentor with a qualified interpreter and select appropriate assignments rather than cause a situation where communication access in high stakes settings is in jeopardy due to ill qualifications.

  1.  Does my preparation vary based on my views of what kind of Deaf client or position is seen to be “high profile” or not?

My belief is that there is no hierarchy of clients or professions- a Ph.D. should be approached with the same respect and care as a welder, teacher, nurse, carpenter, stay at home parent or any other occupation or station in life. All have value, but are interpreters investing the same amount of time and energy in preparation to reflect that? Interpreters should take the time to examine assumptions of what merits varying levels of preparation and not unfairly weight some assignments or clients above others. Providing interpreting services in a kindergarten or first grade is just as critically important as interpreting doctorate courses, and we need to examine bias, appreciate the human element and rethink how to approach “high profile” vs “low profile” assignments. 

  1. Am I able to keep my bias in check?

A common phrase among interpreters is one on neutrality in assignments: “I’m neutral, not getting involved,” etc. Metzger (2011)[3] states that the idealistic “neutral conduit” does not exist. Your biases affect and effect how exchanges take place. Will my presence lead to further oppression of a marginalized group or build bridges that bring groups together? An interpreter should be aware of biases and look for ways to mitigate any negative impact on the interpreted product. For example, if an interpreter finds themselves in a situation where they feel strongly about communication modes being discussed for cultural or educational reasons, or perhaps are interpreting political views that may contrast their own, it is important that the interpreter recognize biases and thoughtfully consider their ability to provide quality service. If it’s not possible, they need to excuse themselves from the assignment or allow a team interpreter to interpret. An interpreter not possessing adequate controls will ultimately deliver a flawed product. Ideally, an interpreter should be mentally and emotionally aware enough to recognize biases and determine qualifications and fit prior to the assignment.

Post-Assignment Considerations

I’d like to shift focus from pre-assignment self-analysis questions for considering to post-assignment questions. In my estimation, it’s rare that in-depth analysis post-assignment happens as often as it should, but it is worthy of thought. Similarly to the initial set of questions, these would be helpful to answer using the Likert scale method:

  1. Am I confident that my interpretation was linguistically and culturally accurate in both English and ASL?
  2. What would I do differently if and when I am in a similar context, linguistically, interpersonally, etc?
  3. Finally, did I approach the client after the assignment to provide clarifying comments or check in about comprehension?

Considering these questions both before and after each assignment will help develop a stronger awareness of self and decision-making process.

In the End: Gratitude

Again, I want to reiterate that without interpreters, I wouldn’t be where I am in my life today. My life journey would look completely different. For all of your hard work, the hours of training, your minds and hearts, blood, sweat, and tears- many, many, thanks. I look forward to seeing you around in the community and will gladly accept any questions on this article. Enjoy your day.

Questions to Consider:

  1. How might I better solicit meaningful advice and feedback from my clients as a resource to maintain a healthy self-appraisal?
  2. What do I do to gauge emotional readiness to interpret in any given environment?
  3. What mechanisms do I employ to keep my bias in check while interpreting?
  4. What does “high profile” mean and how does that definition play a part in my preparations?

References:

[1] Dean, R.K., & Pollard, R.Q. (2001).  Application of demand-control theory to sign language interpreting: Implications for stress and interpreter training.  Journal of Deaf Studies and Deaf Education, 6, 1-14.

[2] Kruger, J., & Dunning, D. (1999). Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology. 77, 1121–1134.

[3] Metzger, M. (2011).  Sign language interpreting: Deconstructing the myth of neutrality.  Washington, D.C.: Gallaudet University Press.

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What Are We Really Saying? Perceptions of Sign Language Interpreting

Sign Language Interpreter Framing Their Work

Kelly Decker examines common ways sign language interpreters frame the task of interpreting and peels back some of the implications and impact on the field and the larger communities served.

 

Sign language interpreters are taught that meaning is conveyed through accurate word choice. Do we give the same considerations to word choice when we label and describe interpreting itself? How do our words and actions frame our work?

As a professional sign language interpreter, I would like to address some of the language used when conversing with colleagues, training new interpreters, and depicting the profession to the mainstream media. The frames we use, as a profession, have the power to devalue the work we do, and by extension, the communities we serve. Continued reinforcement of these frames impacts public perception of sign language interpreting.

[Click to view post in ASL.]

It takes years of intentional practice, reflection, and dedication to develop competence as a sign language interpreter. Platforms such as Street Leverage allow us to continually highlight and examine the ways we have yet to grow. MJ Bienvenu’s Bilingualism: Are Sign Language Interpreters Bilingual and Carol Padden’s Do Sign Language Interpreter Accents Compromise Comprehension? illustrate two fundamental problems we face in the field.

While we have begun to address the language we use to talk about our work, there is more work to do. I have selected four examples which demonstrate various ways interpreters contribute to current understandings of our work. There are many other examples that could be analyzed. I encourage you to contribute to this conversation online and with your colleagues to further examine how our use of language can contribute to a misperception of our profession and the disenfranchisement of the Deaf community. These types of conversations lead to greater awareness, which can be a catalyst for change.

The Labels We Use: “Terp”

It is not clear to me where this abbreviation came from. A cursory search on the internet found that it is cited as slang for “interpreter” and paired with the word ‘deaf’. We work with marginalized communities who are continuously disenfranchised regardless of the abundance of evidence and research regarding language, intelligence, and Deaf Gain [1]. We deflate our profession and the work we do for the sake of a few saved keystrokes.

This word “terp” (and I call it a word since it has become commonplace nomenclature and somewhat of a phenomenon within our field [i.e. TERPexpo],) is used primarily in written English when interpreters communicate with and refer to each other, and when interpreting agencies make requests for “terps”. The use of the term “Terp” does not stop within sign language interpreting circles. Since it has become somewhat the norm internally, it has spilled out into the larger community as the preferred label for what many interpreters want to be called. I feel this does a disservice to the field. I am an interpreter.

Misleading Terminology

“Hands-up”

As I understand it, in most instances, this phrase refers to actual interpreting. I come across it when dialoguing with ASL/English interpreting students. This term is used in practicum to indicate a requirement that is different from observation hours – the need for “hands-up” hours.

When sign language interpreters in the field and educators in interpreter education programs use this term to talk about the work we do, it implies that interpreters only interpret in one direction, into American Sign Language. It implies that Deaf people have nothing to say nor contribute. In reality, our work is working between – at least – two languages. This misguided idea is further bolstered by how our national organization frames the act of interpreting. The interpreter certification exam tests interpreting capabilities and decision-making. Yet ASL vlogs, created by RID, refer to the performance portion of the interpreting exam using a gloss that gives the literal impression that the exam is a “signing test”[2].

As explained above, “hands-up” addresses only half of the work we do. Or does it? When colleagues say “I prefer to work into ASL, it’s easier” or “I don’t do any ASL to spoken English work,” is it because interpreters, too, believe that interpreting is only done in one direction?

Additionally, the term “hands-up” perpetuates the erroneous notion that sign language interpreters, most of whom are second language learners of ASL, prefer to work into ASL because they are “comfortable”, “have more experience working into ASL,” or “feel they are clear”.  Substantial evidence is to the contrary [3].

Interpreting, and more broadly, signed languages, have little to do with the hands. While sign language is expressed in a visual modality, the hands are but one element of that mode. Language is rich and complex. It conveys thoughts, emotions, and abstract ideas and it results in human connections. Language is influenced by and interwoven with culture. It is impacted by generational, intersectional and regional influences. Reducing an entire language to its modality is a prime example of how the dominant language and culture exerts power over and diminishes a linguistic and cultural minority.

“Voicing”

This term “voicing” has become commonplace within our field as a descriptor for the spoken language work we do as interpreters. It is a descriptor that oversimplifies the nature of the work, as if it requires no cognitive decision-making by the interpreter, nor cultural brokering between the two languages, and that the interpreter functions simply as a sign-by-sign voice over.  In Jessica Bentley-Sassaman’s article, Taking Ownership: Defining Our Work As Sign Language Interpreters, she states “voicing” does not appropriately state what we do, what does is naming what we are actually doing when interpreting.

As the profession continues to use the term “voicing”, I believe that we perpetuate a medical perspective on deafness. It bolsters the idea, that when deaf people use sign language they need to be fixed somehow, given a voice, and that’s what interpreters are doing.

This portrayal of the work reinforces a view held by the majority culture that  the language used by the Deaf community is somehow deficient. This misconception is propagated by the Alexander Graham Bell Association, whose position was made public [4] after the televised accomplishments of Nyle DiMarco, that desirable language development and outcomes for deaf children are only possible when focusing on listening and speaking, both of which are deeply rooted in the deficit-based medical model of what it means to be deaf.

As sign language interpreters, I believe we ought to unpack the implications and impacts of how we frame our work.

Perceptions of Professional Interpreters: Shake It Off [Interpreter Version] [5]

This video was so popular on social media after its release in December 2014, that the video’s participants were a part of the entertainment during RID’s 2015 national conference in New Orleans, LA. I have cited this piece not based on its participants but as an example of how we portray who we are, what our work entails, and how we approach the task of interpreting.

From what I gather, this video was made as a parody, a day-in-the-life of a sign language interpreter. All joking aside, what I cannot shake off while watching this video without audio input, is that it clearly represents misconceptions about the work we do:

(1) we only work into sign language, as the tired arms, hands and fingers portray;

(2) we only do this work for the money, as the interpreter runs off screen following the dollar bills;

(3) we self-medicate, as the abundance of pills clearly shows; and

(4) we can brush off the significance of the task of interpreting, as the title of the song conveys.

This day-in-the-life video makes no mention of the substantial cognitive work we do, which is the foundation of the product we produce. The sole focus is the self-aggrandizement of the interpreter. We must consider how this can contribute to the  mainstream media’s abundance of misleading and demeaning pieces about sign language interpreters while #DeafTalent continues to go unnoticed.

Holding Ourselves Accountable

These examples are both subtle and not so subtle. As these flawed representations proliferate, we, as practitioners, as educators, and as a professional organization, become complacent and immune to the deleterious effect they have on our profession. We may dismiss it, saying, “This is the way we’ve always talked about the work,” “This how my interpreter training program said it,” or “I never really thought about it.”

We need to think about it. We need to talk about it. We need to question and remind each other when we use language that trivializes our work.

Mastery of interpreting is no easy feat. It is a labor of love, a demanding cognitive endeavor, and a dedication to craft. Above all, we are collectively accountable to representing our work with the utmost respect for the Deaf community.

How will you model talking about the work we do?

Questions for Consideration:

  1. The ways in which we, as a profession, talk about the work we do is anchored upon our understanding of what interpreting means. Are the ways we portray the work, the profession, and the communities we serve accurate?
  2. How do you think the ways that we talk about the work impact the profession?
  3. Do you have examples of times when dialoguing with colleagues where how they were talking about the work just did not sit right?
  4. With those examples in mind, how can you further explore what it is that did not sit right?

References:

[1] Bauman, H-Dirksen and Murray, Joseph. Editors. Deaf Gain Raising the Stakes for Human Diversity. University of Minnesota Press. October 2014.

[2] Registry of Interpreters for the Deaf, Inc. RID Announces Moratorium on Credentialing You Tube https://www.youtube.com/watch?v=Y6PM4a1tR7E Posted 9 Aug 2015.

[3] Nicodemus, Brenda and Emmorey, Karen. Directionality in ASL-English interpreting Accuracy and articulation quality in L1 and L2. Interpreting. Vol 17:2. 2015. p. 145-166.

[4] Sugar, Meredith. Dispelling myths about deafness. Online: http://www.agbell.org/inthe-news/response-nyle-dimarco/ Posted 1 April 2016

[5] Ott, Stephanie. Shake It Off [Interpreter Version] You Tube https://www.youtube.com/ watch?v=DS2UdoXS3xA Posted 13 Dec 2014.

 

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Sign Language Interpreters: Team Interpreting and its Ethical Consequences

Sign Language Interpreter Considering the Ethics of Her Team

Accepting team assignments with sign language interpreters who continually violate the CPC is tantamount to approving and participating in ethical breeches. How can we better hold our colleagues – and ourselves – accountable?

For various reasons we, as interpreters, decline assignments. These reasons may include, but are not limited to: one’s level of familiarity with content, a conflict of interest, a lack of availability, gaps in training, and a respect for the interpreter preference of the communities we serve. How many times is it that we decline work based on the ethics and integrity of our team?

We are all accountable for ourselves and for the ethical challenges we are faced with while working. Within this accountability is discretion about teaming – discretion that employs itself when we accept or decline work.

When an interpreter continually violates the NAD-RID Code of Professional Conduct (CPC) (1), that interpreter blatantly oppresses the communities we serve and is harming peoples’ lives; we are all affected. I have often heard “I work with ‘so-and-so’ interpreter, and even though I know and have seen these behaviors that interpreter has done nothing to me.”

These are comments I do not understand.

The rationale behind the comment, “ . . . that interpreter has done nothing to me,” is astounding. When interpreters are destructive on the job and breach the ethics they are bound to uphold, they are directly affecting our profession and, consequently, the communities we serve. These behaviors imply to all parties involved that this is what interpreters do and should be doing.

Doing Nothing is Doing Something

To do nothing is to passively accept unethical actions.

To do nothing is to shirk the responsibility of holding each other accountable.

Unethical behavior takes all shapes and sizes: fraudulent business practices, threats of retaliation, withholding information from the parties involved, stealing information from the parties involved, disregarding professional boundaries while on the job, disclosing confidential information, accepting work continuously in a setting for which one is unqualified… the list goes go on and on.

While the above-mentioned acts all violate the current rules-based (2) CPC, I would like to go one step further, to acts where one asserts their power and privilege while interpreting. This unethical behavior is audism. Examples of audist behavior could include, but are not limited to: using spoken English to co-opt an interpreted interaction for the interpreter’s benefit, making side comments to the hearing participants unbeknownst to the Deaf individual(s), having rudimentary language fluency, ignoring the request for a Deaf interpreter, and possessing minimal Deaf world cultural context, all of which are tactics of disempowerment (3).

As Lewis Merkin points out in his recent vlog (4), audism can be experienced in many forms, some even covert. As we take a deeper look into why and when we turn down work, we also need to consider that accepting assignments with an unethical interpreter as your team is a form covert audism.

While working in a teamed situation we are seen as one. When we choose to work with unethical interpreters we are clearly showing, to all parties involved, that we have consented to work with these individuals and that we support each other. This consent condones past behaviors, supports current ones, and perpetuates the opportunity for further occurrences. When we accept work with unethical teams we are complicit in the infractions; what’s more, we are reinforcing the offers of work available on teamed assignments.

The Current Frame for Ethical Guidance

During the 2012 RID Region I Conference in Atlantic City, NJ, RID Ethical Practices System (EPS) (5) representatives gave an overview of EPS policies and procedures, as well as the occurrences of grievances filed within the past few years. The number of accepted complaints was in the single digits.

These representatives explained that, though they receive dozens of grievances, many grievances are not accepted due to the following: time lapse since the occurrence, complaints against working, but not RID-certified interpreters, and/or complaints against interpreter agencies.

In my mind, the EPS procedure is inordinately lengthy. In order for any person to file a complaint, one must have a comprehensive understanding of the 37 page handbook, and trust the system from which it originated.

Could this be the reason the number of grievances are in the single digits?

Case in Point

A couple of examples.

Example One

(reference at approximately 3:04 and 5:20 into video)

As is indicated in example one (6), RID’s response to the grievance was that the 90-day time limit was up, and that “This case will now be dismissed and she [the interpreter] will not be notified of this.” What is the rationale for not notifying the interpreter that a grievance had been filed against her? Notification would make the interpreter aware that the decisions she is making are causing harm and, albeit past the 90-day limit, a grievance has been filed against her. Instead, by doing nothing, her behavior has been endorsed.

Example Two

As we see in example two (7), the grievance was filed and a request was made for expediency due to the severity of the situation and extenuating circumstances. Even so, the process took two years for a final decision. Within this final decision the interpreter was cited to have violated four of the seven tenets within the CPC. The resolution to the matter – the interpreter is to take an online course.

Unfortunately, this system sends a clear message that the Deaf experience of prolonged encounters with egregious and oppressive interpreter behavior, two years of costly waiting, and four serious violations of the CPC, all amounts to a measly slap on the wrist and an online course.

To me, this is hardly a resolution.

While the number of public grievances may be small, unethical behavior is still running rampant. As it stands, RID is the sole vehicle to certification. Revoking someone’s certification as a sanction for unethical behavior is critical to protecting the value of certification.

What Should be Done?

As interpreters, we have the duty to make decisions based on discretion. This discretion is powerful. We have the ability to choose where, when, and with whom we team and work. If the people with whom we work create discord in our ethical conscience, it is time to reevaluate.

Suppose we were to reframe the ways in which we accept work? What if we all stood on the grounds of doing the most good and upholding the linguistic rights of the communities we serve and ultimately are a part of, (8) each and every time?

We may be faced with discomfort in telling an agency or a requestor: “I am available, but I have an ethical conflict with this interpreter. Therefore I am unable to accept this assignment.” In doing so, we are taking the initiative to create change (9) and shift the paradigm.

We may be met with resistance since we are “that interpreter” who questions teaming decisions made by the gatekeepers in our profession. The beauty of that resistance is the opportunity for dialogue and deeper exploration as to why ethical teams and practices matter.

I invite you to be the catalyst for an ethical support community and delve into this idea of declining work based upon the unethical history of our potential team. In this ethical support community, let’s talk about how this idea and practice affect us as individual practitioners, affect the communities we serve, affect our overall working rapport, and ultimately, reflect our accountability.

What lasting impression will you create?

 

Works Cited

(1) Registry of Interpreters for the Deaf, NAD-RID Code of Professional Conduct, May 2013

(2) Kidder, Rushworth How Good People Make Tough Choices New York: Harper, 2009. Print.

(3) Suggs,Trudy Street Leverage, Deaf Disempowerment and Today’s Interpreter, Posted December 11, 2012 Retrieved May 2013

(4) Lewis Merkin You Tube personal vlog, Posted April 24, 2013 Retrieved May 2013 https://www.youtube.com/watch?feature=player_embedded&v=XIeSlSmOyIg_

(5) Registry of Interpreters for the Deaf, Ethical Practice Systems Policy Manual, May 2013

(6) Dottie Stafford Griffith personal vlog, Posted April 22, 2013 Retrieved May 2013

(7) Paul Shreeman You Tube personal vlog, Posted January 14, 2013 Retrieved May 2013

(8) Cokely, Dennis “Exploring Ethics: A Case for Revisiting the Code of Ethics”, 2000

(9) Street Leverage, Sign Language Interpreters Embody the Change You Want to See, Posted May 8, 2013 Retrieved May 2013

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Case Discussion: Sign Language Interpreters Contain Their Inner “What the…!!!?”

 

Real-life case discussion brings a myriad of benefits to us as sign language interpreters. Kendra Keller highlights how engaging in supervised, structured case discussion can lead to not only enhanced technique but a deeper relationship among us doing the work.

As sign language interpreters, we continue to struggle with the very real human costs, the fallout from the gaps in our professional development and consideration of each other in our work. As we continue to evolve in how we discuss our work with each other, we need to consider a process which will assist us in staying engaged with consumers and all aspects of our work.

Case discussion, in the context of supervision, is an important tool sign language interpreters have available to them for this very purpose. Case discussion is a professional space to hold discussions using our actual experiences, in a shared commitment to uphold ethics, confidentiality and a collective process.

Case Discussion – How it Works

The structured process of case discussion allows for sufficient support without constricting the actual discussion and helps to highlight, tease out and identify the interpreting decisions made in the face of the tasks we are confronted with while on the job.

As a result of this process, case discussions become a mirror of the individual process, reflecting back to the individual the effectiveness and ethicality of their work via the light of many eyes, minds and hearts. This guided self-discovery provides a profound and meaningful learning opportunity.

Redirect Fight or Flight

What is it that keeps us from effectively talking about our work?  As mentioned above, as a profession, we continue to struggle with the very real human costs, the fallout from the gaps in our professional development and consideration of each other in our work. Sign language interpreters, like those in other helping professions, show a trend of being hypercritical of our selves…[and therefore, others]…(Feasey, 2002).  This hypercritical response grows to a tipping point where we are expelled from a process engaged with team and consumers, into some version of a fight/flight defense reaction.  Operating in a state of flight or flight limits our engagement and awareness of others except as the source of potential threat and therefore,  options, thought worlds, culture, and communication dynamics. This stance preempts our awareness of choices, or controls – thus hobbling an effective and ethical decision-making process.  This occurs when we are interpreting as well as in discussion with colleagues.  It could be seen as an inherent ‘system failure.’

Shared Process

When managing the complexity of the task results in a system failure for the working sign language interpreter it can be attributed to two things, if you apply the thinking of Gorovitz and MacIntyre in Atul Gawande’s The Checklist Manifesto: How To Get Things Right:

  1. Ignorance. The partial or incomplete understanding of the task and its complexities.
  2. Ineptitude. A failure to apply what we know correctly.

This ignorance may simply be that we may not be aware of what we don’t yet know.  Research shows that in some settings we may be unaware of controls or do not feel we can use them if we are aware of them. (Dean and Pollard, 2010). Alternately, our concept of role and interpreter presence may be constricted; we may not be aware of a demand to be able to respond with an effective control option.  For example, the interpreter who is trying to be ‘invisible’ fails to consult with the Deaf and hearing consumers before and after an assignment or during breaks, overlooking the consumers’ needs.   We may not realize that the decision to spell out the same word repeatedly for which there is an agreed upon sign creates more visual noise and even a foreignalization or word which looks like a new vocabulary item to the deaf person.  We are not aware of the fact that we are responding to many demands, that we are making decisions; nor are we aware of the consequences of them.

Ineptitude can be described here as overwhelm at the complexity of a task.  A pilot who has 20 years of experience flying a variety of aircraft, and is charged with flying a new aircraft with twice as many tasks to perform results in a crash landing during a test flight.   A sign language interpreter who knows how to keep the processing transparent yet in a high stress situation reacts with an “I missed it, what did they say?!” urgency in the middle of a feed from their team.  Our thinking and processing may also be occluded by our own self-criticism or fear of failure, resulting in an inability to hold our attention on the work, much less to discuss it with colleagues.

The importance of a shared process is that it provides a framework, the creation of a schema, systematizing our decision making process, which is inclusive of more factors than one person may be able to retain and respond to in a given moment, aids in recall, recognition, recourse and supports the elimination of this (unavoidable) human ignorance and ineptitude.

Presenting a Case for Discussion

The concern about confidentiality may lead to an avoidance of talking about our work.  Through effective case presentations, sign language interpreters learn to practice confidentiality, by sorting out the important details and a reason for bringing it into discussion.  It might be the more mundane situation which is the greatest gem for discovery.  Situations we interpret on ‘automatic pilot’ – perhaps therefore using a less considered decision-making process and habituated responses, are the most fertile ground for searching for clues to consumer reactions that we are mystified by; or responses from teams or others which appear to be mirroring the opposite intentions we are working under.  It may serve us equally as well as discussing a profound experience.

Important Aspects of Case Discussion

Commitment:  A commitment is to participation in a reflective process, to brooking both the familiar and unpleasant or unwanted aspects of our work for the gain of insight.  Each participant has to be committed to creating a process individually and as a group, “by each member to the interrogation of one’s own beliefs and assumptions as well as of others” (Kennedy and Kennedy, 2010).

Facilitation:  It is the role of the facilitator to jump in during learning moments; redirect, restate, restructure the interaction or reflect back to the group. It is essential to clarify and establish the role of the facilitator – participants discuss and agree on a dynamic set of ground rules.  Remember, the facilitator is responding to maintain the structure of the interaction acknowledging the potential for perceived interruptions and taking the floor as rude and disrespectful, which needs to be clarified (R. Dean, 2010, personal communication).

It is important to work with a facilitator who is trained to lead case discussions in the supervision context.  One who possesses the skills and experience required for supervision – cultural sensitivity, knowledge of the myriad approaches to an interpreter’s professional development and of group dynamics.

Ground Rules:  Creating the safety needed for a vibrant discussion and protection of confidentiality is supported by setting effective ground rules.  Agreed upon rules encourage a ‘scientific’ type curiosity, supported by a critical thinking consciousness and a sharing of perspectives as equals.  Some examples of ground rules are:

  1. Confidentiality:  for example, discussions outside of the formal meeting should be brought back to the group, all case notes are collected and shredded/deleted.
  2. One conversation at a time.
  3. Recognition of the privilege we have as interpreters: sacred place;  serious ethos.
  4. Agree to disagree: recognition of valid but competing values.
  5. Avoidance of the need to ‘fix’ or provide solutions – referred to by Parker Palmer as the Righting Reflex.
  6. Inquiry and clarification to allow seeing the case elements as the interpreter presenting sees them.

Ground rules should focus on supporting the delivery of valuable feedback to the recipient, not on the value or “release” that it provides the person giving the feedback (Lehner, 1975).

Schema and structure:  for example, the use of the demand control schema, developed for sign language interpreters out of concern and compassion, focuses case discussions on identifying and decreasing contributing factors that cause undue stress and contribute to ethical dissonance.

Preparation:  It is important to make the case available before the group meets so that participants can familiarize themselves with its details. Cases may be both retrospective or prospective, looking back or looking forward in preparation.

 Methods: Case discussion groups can use online discussion boards, live video conferencing, and online classroom environments to do their reviews. Of course, let’s not forget that they can be conducted in small groups or 1:1.

Group process:  This process supports the development of interpreters’ ability to dialogue with one another in a deliberate problem solving, community-building manner. “Emphasis is placed on the capacity to remain sensitive to context and the beliefs of others” and “…a community of interpretation which we understand as a spontaneous human discourse form…” (Corrington in Kennedy & Kennedy 2010).

Benefits of Case Discussion

The practice of Case discussion and the associated preparation and analysis help sign language interpreters remember or recognize details, realize that we are making myriad decisions on the fly by responding to a complex constellation of demands, and expands our response options. We better understand the sheer complexity the work and deepen our appreciation of the human elements of what we do.  Vicarious learning with our peers lessens the ignorance, shedding light on the complexity and developing a systematic approach helps to prevent failures of ineptitude.

In short, case discussion creates a process and setting which helps sign language interpreters contain their inner “What the…!!!?” long enough to engage with the person/task at hand and do the most effective job possible.

What Can You Expect?

Sign language interpreters using case discussion can expect to:

  • Develop or enhance individual schema or collection of schema for use by sign language interpreters when working.
  • Develop a common language for describing one’s process.
  • Experience growth in negotiation skills with colleagues and consumers.
  • Participation in and development of  “double- vision” for monitoring the process simultaneously with the content.  This procedural awareness allows for appropriate authorship of decisions and outcomes with direct application to the individual interpreting process.
  • Reveal the complexities of the work, as well as the discovery of similar complexities others are dealing with and similar or common decision making strategies.

Let’s Return to the Conversation

Let’s converse with each other in a manner which does not diminish us by limiting our discussions solely to technique (Palmer 1998).  The process of case discussion in supervision strengthens our relationship to our communities. Case discussion is ultimately a wellspring of shared experience, building upon the natural processes from within our communities in a manner both considered and reflective (including our Deaf and Coda communities). Case discussion assists sign language interpreters in the development of a common language for describing our process, to gain or hone negotiation skills with colleagues and consumers.

The effective use of Case discussion supports growth in a sign language interpreter’s ethical decision making, learning to trust each other to a greater degree…we begin, and return to, the conversation.