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加拿大的难民医疗口译服务:实践现状及促进所有人基本人权的考虑因素

Medical Interpreting Services for Refugees in Canada: Current State of Practice and Considerations in Promoting this Essential Human Right for All.

机构信息

Department of Family Medicine, McMaster University, Hamilton, ON L8S 3L8, Canada.

School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada.

出版信息

Int J Environ Res Public Health. 2024 May 2;21(5):588. doi: 10.3390/ijerph21050588.

Abstract

Language barriers, specifically among refugees, pose significant challenges to delivering quality healthcare in Canada. While the COVID-19 pandemic accelerated the emergence and development of innovative alternatives such as telephone-based and video-conferencing medical interpreting services and AI tools, access remains uneven across Canada. This comprehensive analysis highlights the absence of a cohesive national strategy, reflected in diverse funding models employed across provinces and territories, with gaps and disparities in access to medical interpreting services. Advocating for medical interpreting, both as a moral imperative and a prudent investment, this article draws from human rights principles and ethical considerations, justified in national and international guidelines, charters, codes and regulations. Substantiated by a cost-benefit analysis, it emphasizes that medical interpreting enhances healthcare quality and preserves patient autonomy. Additionally, this article illuminates decision-making processes for utilizing interpreting services; recognizing the pivotal roles of clinicians, interpreters, patients and caregivers within the care circle; appreciating intersectional considerations such as gender, culture and age, underscoring the importance of a collaborative approach. Finally, it provides recommendations at provider, organizational and system levels to ensure equitable access to this right and to promote the health and well-being of refugees and other individuals facing language barriers within Canada's healthcare system.

摘要

语言障碍,特别是在难民中,对加拿大提供高质量医疗保健构成了重大挑战。虽然 COVID-19 大流行加速了创新替代方案的出现和发展,例如基于电话和视频会议的医疗口译服务和人工智能工具,但加拿大各地的获取途径仍然不均衡。这项全面分析突出表明,加拿大缺乏协调一致的国家战略,这反映在各省和地区采用的不同资金模式上,在获得医疗口译服务方面存在差距和不平等。本文从人权原则和伦理考虑出发,为医疗口译辩护,认为这既是道德义务,也是谨慎的投资,这些原则在国家和国际准则、宪章、法规中都有规定。通过成本效益分析得到证实,它强调医疗口译可以提高医疗保健质量并维护患者自主权。此外,本文还阐述了利用口译服务的决策过程;认识到临床医生、口译员、患者和护理人员在护理圈中的关键作用;理解性别、文化和年龄等交叉因素的重要性,强调了协作方法的重要性。最后,它在提供者、组织和系统层面提出了建议,以确保公平获得这一权利,并促进加拿大医疗保健系统中面临语言障碍的难民和其他个人的健康和福祉。

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