Transcript MEEng Lesson 10 Translating Health II

Translating Health
Enhanced English for Interpreters
Fujian Normal University
FNU Language Enhancement 2012-2013
Tongue Twister Review
Betty Botter bought a bit of bitter butter
Which made her batter bitter
But a bit of better butter
Makes better batter
So Betty Botter bought a bit of better butter
Making her bitter batter better.
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Why Medical Translators?
Case Study: Logan
Location: Fuzhou, Fujian
Purpose of visit: abnormal chest X-ray follow up on routine
examination for student visa
Background: foreign student from America, studying Chinese
at a university in China.
Medical Tasks
1st visit: investigate abnormal chest X-ray findings to rule out
tuberculosis by bronchoscopy (支气管检查). Fluid is taken
from the air ways to test for tuberculosis (TB).
2nd visit: positive test on bronchoscopy requires start of drug
cocktail. TB is not active (latent – 蕴蓄). Foreign Affairs health
certificate will not be issued until TB test is negative.
3rd visit: Change drug cocktail due to abnormal liver tests
The Leader
(the Doctor)
Handling
Problems
Medical Ethics and Values
Beneficence
Autonomy
a practitioner should act
in the best interest of
the patient.
the patient has the right
to refuse or choose their
treatment.
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Discussion
• Identify the cultural barriers that prevent Logan
from receiving effective healthcare in China.
• Interpret to the American student, potential
reasons the doctors would say the tuberculosis is
active when the positive bronchoscopy test
report say that the disease is “noncommunicable”
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Homework Review
• Read the article “A Year in Community Health
Work” regarding the Taiyuan Community Health
Center in Shanxi province.
Considerations:
• Briefly summarize the barriers the team faced
delivering health care to the community.
• How did they overcome the barriers?
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Contacts
Way of
Life
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Luxi Community Center,
Evergreen Family
Friendship Services
Shanxi, China
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Medical Ethics: 2 Cases
Protective truthfulness: the Chinese way of safeguarding
patients in informed treatment decision
Mei-che Samantha Pang
The Hong Kong Polytechnic University, Hong Kong, China
Journal of Medical Ethics 1999; 24:247-253
Cross-cultural Medicine. Ethical Dilemmas in a Cross
cultural Context. A Chinese Example
Jessica H. Muller and Brian Desmond
San Francisco Hospital Medical Centre
West Journal of Medicine 1992; 157: 323-327
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Medical Ethics and Values
Beneficence
Autonomy
a practitioner should act
in the best interest of
the patient.
the patient has the right
to refuse or choose their
treatment.
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Case 1: Hong Kong
Case 2: USA
• Mrs Chan, aged 29
•
• carcinoma of the lung, poor
prognosis.
•
• husband and sister did not want
her to know about her critical
•
condition. Staff told not to tell
patient and request is upheld.
• Patient is noted by nurse to be
•
perceptive, optimistic and curious.
• Nurse avoids talking to patient or
responding to her directly but feels •
patient should have psychological
support.
• The patient eventually died, still
ignorant of her disease.
•
Mrs Lee, aged 49, recent immigrant
from China to USA
Terminal lung cancer with
metastases to brain and spine
Son is key translator. Will not allow
physicians to inform patient of
condition.
Physicians try to discuss a “do-notresuscitate” (DNR) order with patient
without success
Patient condition worsens, son begs
doctors for intubation. Doctors
consult intensive care specialists
which agree no grounds for ICU
admission
Son threatens litigation due to
perceived racism
• Patient suffers a code blue during a
family meeting and dies
Medical Terminology Notes
• Carcinoma- cancer, usually a solid tumor(s) (not blood)
Lung carcinoma, renal carcinoma, hepatic carcinoma
• Metastases or “mets”- cancer spread to other body parts
Breast carcinoma with lung metastases/mets
• “do-not-resuscitate” (DNR) – an order in a hospital setting to
not revive someone who is dying. Does not include
treatments to provide comfort.
The patient’s cancer has a 3 month prognosis so we need to
discuss a DNR order with the patient and the patient’s husband.
• Intubation- placing a tube in the throat to breath
He was declared brain dead even though he was intubated. The
question now is whether to remove the vent.
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• No grounds- no basis, no justification, no good reason
They fired him even though there was no grounds for his
dismissal.
• Litigation- lawsuit
They threatened with litigation when the doctors did not listen to
the family’s wishes.
• Code blue – a code for medical staff indicating someone
requires emergency help; often cardiac or respiratory arrest.
There’s a code blue in the cafeteria! Quick! Call switchboard!
• Call a family meeting- a meeting which medical staff, a
patient’s family +/-patient discuss and make medical
decisions about a patient’s care. Common cultural practice in
Western hospitals when there are communication problems.
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Culture and Ethics
• Which medical ethical value does Chinese
culture esteem more? Why?
• Which medical ethical value does Western
culture esteem more? Why?
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Ping Pong Debate
All terminally ill patients should know their
diagnosis and prognosis
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Homework
Answer ONE question assigned to you. Prepare a clear,
informative instruction addressing the question which may help
a foreigner navigating the healthcare system in Fuzhou.
1.Describe the process of drawing blood samples in China. Where
do you go? How and where do you pay?
2.What routine immunizations are given in China? Where can you
get the injection? What information is given about the injections?
3.How are medications prescribed and dispensed in China?
4.If you are ill, how do you make an appointment to see a doctor?
5.Who takes care of food, clothing for the patient at the hospital?
6.How much money should you bring money to visit to the doctor?
The hospital? How and who do you pay?
7.Describe an appointment with the doctor. What kind of tests might
they run? What type of questions might be asked?