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Translating Health

Translating Health. Enhanced English for Interpreters Fujian Normal University. 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

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Translating Health

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  1. Translating Health Enhanced English for Interpreters Fujian Normal University FNU Language Enhancement 2012-2013

  2. 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. FNU Language Enhancement 2012-2013

  3. 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

  4. The Leader (the Doctor) Handling Problems

  5. Medical Ethics and Values Beneficence a practitioner should act in the best interest of the patient. Autonomy the patient has the right to refuse or choose their treatment. FNU Language Enhancement 2012-2013

  6. 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 “non-communicable” FNU Language Enhancement 2012-2013

  7. 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? FNU Language Enhancement 2012-2013

  8. Contacts Way of Life FNU Language Enhancement 2012-2013

  9. Luxi Community Center, Evergreen Family Friendship Services Shanxi, China FNU Language Enhancement 2012-2013

  10. 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 FNU Language Enhancement 2012-2013

  11. Medical Ethics and Values Beneficence a practitioner should act in the best interest of the patient. Autonomy the patient has the right to refuse or choose their treatment. FNU Language Enhancement 2012-2013

  12. Case 1: Hong Kong • 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. Case 2: USA • 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-not-resuscitate” (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

  13. 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. FNU Language Enhancement 2012-2013

  14. FNU Language Enhancement 2012-2013

  15. 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. FNU Language Enhancement 2012-2013

  16. Culture and Ethics • Which medical ethical value does Chinese culture esteem more? Why? • Which medical ethical value does Western culture esteem more? Why? FNU Language Enhancement 2012-2013

  17. Ping Pong Debate All terminally ill patients should know their diagnosis and prognosis FNU Language Enhancement 2012-2013

  18. 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. • Describe the process of drawing blood samples in China. Where do you go? How and where do you pay? • What routine immunizations are given in China? Where can you get the injection? What information is given about the injections? • How are medications prescribed and dispensed in China? • If you are ill, how do you make an appointment to see a doctor? • Who takes care of food, clothing for the patient at the hospital? • How much money should you bring money to visit to the doctor? The hospital? How and who do you pay? • Describe an appointment with the doctor. What kind of tests might they run? What type of questions might be asked?

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