You don’t hire the professional services of a medical translator just for their language and cultural communication skills. You must also consider their professional duty of care to the healthcare companies, healthcare professionals, and patients that their translations are intended for.
In this blog post, Sophie and Sandrine give us their take on ethics in medical translation, the ethical guidelines they follow in their translations, and the ethical challenges they face in the translation of medical documents.
What role do ethics play in the process of translation for healthcare clients?
Sophie: Our healthcare clients are mainly concerned about confidentiality. Especially when it comes to launching a new product. If they engage our language services for a press release or a brochure, for example, they usually have a very specific launch date in mind. If any information leaks out before that date, it could be disastrous from a legal and communication standpoint. When confidentiality is this critical, we usually delete all project files right after we finish our translation.Sandrine: We sign non-disclosure agreements when we translate health documents that contain patient health information (PHI). Examples would be a patient file or lab results. So we sign an agreement that specifies how all the data will be processed. Sometimes, part of the health document is redacted. As medical translators, we must be careful how we manage ethics in our medical translations.
In your career as medical translators, have you ever been confronted with an ethical challenge?
Sophie: A few years ago, I was asked to deliver an urgent translation of marketing materials for medical sales representatives to promote a drug to healthcare professionals. As I worked through my translation, I began to realize that the entire sales pitch was based on 2 small studies and that both had been funded by the manufacturer of the drug being marketed. And as I was researching my translation, I came across a different study in a well-respected medical journal clearly showing that the drug in question did not have a good risk/benefit ratio.
That situation made me feel very uncomfortable. I felt torn between my professional duty of care to my client and my ethical misgivings about translating a medical document that I did not agree with.
How did you reconcile your client’s needs with your ethics in medical translation?
Sophie: I completed the translation, because I wanted to fulfill my professional duty to my client. But since then, I’ve been more careful. I would raise concerns with a client before accepting a project. That said, the vast majority of our clients are aware of ethical issues. So this was really a once-off problem.
Sandrine: Obviously these are tricky issues we’re talking about. They’re tricky from an ethical and professional perspective. Personally, I can say I have never had a problem like that. We work for big companies. They do their research and the documents are well prepared. I’ve never had to deal with this problem.Sophie: The institutional review boards and the peer review process are also there to prevent this kind of problem from happening. So there are healthcare experts upstream and downstream of our translations who check the scientific and medical information that we are translating. So fortunately for us, these ethical challenges are quite rare.
Can you think of other ethical challenges that medical translators encounter?
Sophie: On a broader level, you can run into problems with marketing claims. For example, you can’t say that a product is a miracle cure. You’ve got to be careful how you word it.
Once, I was asked not to translate a whole list of lab results. The client wanted me to summarize the list into a single sentence saying that the results were normal. As a medical translator, I could not do that. The results were there on the page, the medical information was there. So I had to translate it. It’s not my place to start interpreting and summarizing whole sections of a document.
Do you ever have to slightly change the meaning of a translation to ensure it aligns with healthcare regulations?
Sophie: Generally speaking, you don’t need to deviate too much from the text to solve this. You can write that a product “can” or “may” have a certain effect instead of writing that it “will” have that effect.
Our clients usually offer us guidance in this regard. We had a client recently who told us not to translate “should” as “doit” [must] in our translations. It wasn’t always easy to find the right wording, but we get guidance like this quite a lot.Sandrine: When I get requests like this from clients, I supply a “back translation” to show the client that I have adhered to the original meaning as closely as possible. Not that it’s a literal translation, but that it follows the original. Again, the documents we translate are professional. You can see they’ve already anticipated problems with marketing claims. So we don’t have to deal with them. And with the back translation, the client can check how we’ve translated their document and ask questions if necessary.
How do you protect confidentiality and ensure good ethics in your medical translations?
Sandrine: Sophie and I have been working on a medical translation for a few months. Everything goes through a secure portal. We never discuss the project by email, never share parts of the document in messages or anywhere. On top of that, I of course use passwords and a VPN, and my data are encrypted.
As well as that, I am a member of the SFT [the French translators’ union]. I adhere to their professional code of ethics. I also adhere to ISO 17100, the international translation standard. And of course, we work with the client to meet their own requirements.
Lastly, what risks does AI pose regarding confidentiality and ethics in healthcare translations?
Sophie: You have to be careful with AI translation tools and the way they use the data you provide them. It depends on what is agreed with the client. Some don’t want us to use AI at all. Others never mention it. If you can produce a good-quality medical translation using these tools, I have no problem with that.
Sandrine: Yes, some clients stipulate that we must never use AI. Others use machine translation engines trained with their proprietary data.
That said, I obviously don’t use any tools when translating confidential documents that contain sensitive patient data. I do use my translation software, because the data is mine and it’s only stored on my computer.
Get the balance right with pro re nata
It is tricky reconciling our duty of care to both clients and the end reader of a medical translation. As medical translators, we must be aware of the pitfalls of handling sensitive patient data and confidential product information.
Sophie and Sandrine are a duo of professional medical translators. Together, they form pro re nata, a tag team of language and cultural experts specializing in medical translations for the healthcare industry.