Healthcare interpreters who watch this movie trailer will INSTANTLY be reminded of the ethical decision-making that they must face in their profession.
The Farewell – The Movie
In this movie, the protagonist, Lulu Wang, is confused by her family’s decision to hide her grandmother’s cancer diagnosis from her. In the trailer, we hear the difference of opinions between Lulu, who asks, “What if she wants to say goodbye?” and her extended family, who say that knowing the diagnosis will only make her feel sad. Even the doctor says “It’s a good lie. Most families in China would choose not to tell her.”
Indeed, I am used to an emphasis on being informed, having grown up in the United States. But that is not necessarily the case in other countries. “Approximately 80–90% of patients are given the truth about their diagnosis [in western countries], whereas in other cultures, figures can range from 0 to 50%,” Zahedi states in his article titled The challenge of truth telling across cultures: a case study. He argues that there is a basis for keeping a diagnosis undisclosed, if a patient does not wish to know it. Moreover, this is a practice which takes place widely throughout the world today.
If encountered in real life, this situation would difficult to navigate for everyone–the patient, the family, and their healthcare interpreters. In order to do the right thing, healthcare interpreters must consider their different roles to make the best decision possible.
Roles of the Healthcare Interpreter
The first role of healthcare interpreters is that of a Message Conveyer. A Message Conveyer interprets everything that is said by each person in the room into the other language without adding, omitting, or changing anything that was originally said.
If I was in this situation as The Farewell, and solely based my actions off of the Message Conveyer role, then it would be my first instinct to just interpret the diagnosis to the patient. But what happens when we consider another important role of the healthcare interpreter: Patient Advocate?
If a patient is unable to advocate for their own rights due to a linguistic or cultural barrier, healthcare interpreters may take steps on their behalf to intervene. This is called the Patient Advocate role. This role would definitely become crucial in a situation where a doctor was about to reveal a critical diagnosis.
Given that many older Chinese adults might prefer that a critical diagnosis is not disclosed to them directly, I would need to take steps to make sure that the doctor does not do so against the patient’s wishes. The solution I have come up with is to intervene in the session to ask the patient whether they wish to be informed of critical or terminal diagnoses, and then inform the doctor of their preference. This way, I can maintain a good balance of transparency, while also respecting the patient’s wishes.
In Theaters July 12th in LA and NYC
In the case of The Farewell, I can’t make a determination on whether the actions of the family and the doctors were ethical, because there are so many things that I don’t know about their situation. Guess I will just have to go watch the movie and find out! Make sure to check it out in theaters on July 12th, 2019–unfortunately only out for limited release in LA and NYC!
What is your opinion on the movie? Have you even been faced with a situation like this in your work? Let me know in the comments below.