Core Values

The National Code of Ethics for Interpreters in Health Care is grounded in four core values. Three values, beneficence, non-maleficence, and autonomy, are widely recognized in biomedical ethics. These values align the healthcare interpreting profession with the broader field of healthcare ethics. The fourth value, Fidelity is specific to interpreting, especially in terms of fidelity to the meaning of the message. Biomedical ethics takes justice, (fair and equitable distribution of resources and treatment), as their fourth core value. In the National Code of Ethics for Interpreters in Health Care the value of justice is not a named value, but it is embedded throughout the document and is specifically expressed through the interpreter’s responsibility of equitable practice.

Beneficence

Beneficence[1] is the positive obligation[2] to do good and promote the well-being of others. Beneficence means acting in ways that benefit others. It goes beyond simply avoiding harm; it means actively seeking to do good. Beneficence includes kindness and compassion, while respecting everyone’s rights and dignity.

The health and well-being of patients and their support systems (family, friends, and community) is a core value for interpreters. This value is shared with all other healthcare professions[3].

One way healthcare interpreters adhere to the value of beneficence is by ensuring their interpretations are accurate and complete, thus providing both the patient and the provider with the information they each need to make the best decisions in support of the patient’s well-being.

Non-maleficence

Non-maleficence is the negative obligation[2:1] to avoid causing harm or making choices that would negatively affect others. This core value is also shared by all healthcare professions. Non-maleficence includes not treating people dismissively or unkindly.

A core value for health professionals, including healthcare interpreters, is avoiding, preventing, and removing harm to the well-being of patients. Interpreters are responsible for preventing any harm of which they are aware, based on their professional training and practice-based knowledge.

Non-maleficence includes interpreters avoiding acts that, intentionally or unintentionally, lead to ineffective communication, such as leaving uncorrected any mistakes they have made or not addressing misunderstandings of which they become aware.

Autonomy

Autonomy is the right to self-determination and the freedom to act according to your own values and interests, free from constraining and controlling behaviors.[4] Health care providers have increasingly focused on patient autonomy over the past 100 years.[5]

In the medical setting, autonomy means patients have the right to:

In the cross-cultural interactions of an interpreted encounter, patient autonomy needs to be understood and addressed in the context of the patient’s cultural values and beliefs, including family dynamics related to decision making. The goal is that the patient shall have meaningful access to information about their care and to be able to express their thoughts and concerns freely.

Fidelity

Fidelity is “the unfailing fulfillment of one’s duties and obligations and the keeping of one’s word or vows. In a related non-personal sense, it refers to faithfulness to an original…”[7] Fidelity in the healthcare interpreting profession is a commitment to upholding the values and ethical principles found in the National Code of Ethics for Interpreters in Health Care. Fidelity is demonstrated in three areas.

Fidelity to the message means being accurate and true to the original message. This includes preserving the intended meaning, tone, style, and goals of the speaker, with any nuances such as humor, irony, and emotions, so that the perceived message is fully conveyed.

This is not always easy, especially when the substance is difficult, emotionally laden or of a nature that elicits in the interpreter feelings of discomfort or even pain. The value of fidelity requires that interpreters develop the ability to remain objective and to separate their own feelings and thoughts from the content they are interpreting. The value of fidelity reminds the interpreter to guard against consciously or unconsciously omitting or distorting messages because they find the message personally offensive, or because they are uncomfortable with the language, the feelings expressed, or the content of the message.[3:1]

Fidelity to the profession means acting in ways that support the credibility and integrity of the interpreting profession.

Fidelity to those served focuses on the function of interpreters to make possible linguistic and interpersonal connections between providers and patients as if they shared the same language and culture. Accurate and complete interpretation supports shared understanding, dialogue, and joint problem-solving.

  1. Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press. Discusses the role of ethical principles (autonomy, beneficence, nonmaleficence, justice) as normative guides for professional conduct in healthcare. ↩︎

  2. Dean, R. (2021). Healthcare interpreting ethics. In Ş. Susam-Saraeva & E. Spišiaková (Eds.), The Routledge handbook of translation and health (pp. 203–216). Routledge. https://doi.org/10.4324/9781003167983-16 ↩︎ ↩︎

  3. National Council on Interpreting in Health Care. (2004). A National Code of Ethics for Interpreters in Health Care. ↩︎ ↩︎

  4. According to Merriam-Webster (n.d.), autonomy is “the quality or state of being independent, free, and self-directing.” ↩︎

  5. “Over the last 100 years or so, in response to certain changes taking place in both research and clinical practice, the bioethics movement ushered in the autonomy model, and with it, a profoundly different way of approaching decision making in medicine.” “The autonomy model is founded on the assumption that if given adequate information, a patient will be capable of making an informed decision consistent with his or her sense of well-being, that is, an autonomous choice, free from controlling interference that is deserving of respect as such.” (Will, 2011) ↩︎

  6. Garcia-Beyaert, Sofia. (2015). Communicative Autonomy and the Role of the Community Interpreter https://www.researchgate.net/publication/367326583_Communicative_Autonomy_and_the_Role_of_the_Community_Interpreter ↩︎

  7. The American Heritage Dictionary of the English Language. (2022). Fidelity. Faithfulness to obligations, duties, or observances. ↩︎