Yes, Ethics really do matter: Current Events and Long-term implications

It is easy to doge our responsibilities, but we cannot dodge the consequences of dodging our responsibilities.  

~Sir Josiah Charles Stamp

Let me preface this post by saying that since I started leading the VRID Ethics & NIC Interview discussion groups, I have become that much more interested in ethics and the discussion of ethics.  Preparing for this Saturday's discussion group has caused further contemplation and the idea for this post has been marinating for several weeks, before the invalid NIC rater scores came to light.

Before I address this week's events, let's take a step back:

On June 4, Janet Bailey lead a VRID community dialogue on FCC & VRS, highlighting the new FCC mandates and RID's response.  As she discussed the actions that the FCC has taken in response to fraud in VRS settings, I began to see "long-term implications" in a new light.  In an attempt to curb future fraud, the FCC has take reactionary measures.  Among other things, VRS interpreters are no longer allowed to use privacy screens or work from home, because some of the fraudulent activity occurred when privacy screens were used or interpreters were working from home.  While I know much discussion took place and FCC did not make this decision arbitrarily, it is a solemn reminder that the actions of a few can impact the whole.

During the ethical discussion groups, as well as my own preparation for the NIC Interview exam, I have always considered the short-term implications as immediate to the individual and those directly involved in the hypothetical scenario and the long-term implications to be the bigger pictures- the impact on the larger group- the interpreting community, the Deaf community, or hearing community.  As we talk about short-term and long-term implications of imagined scenarios, the long-term implications of real-life bad ethical decisions are sending shock waves through the interpreting community.
 

On Tuesday afternoon, I was heading home from my assignments D.C. and I received this email while waiting for the bus:

"[....] We must regrettably report that a former RID employee committed fraudulent activities that affected the scores of 34 individuals whose National Interpreter Certification (NIC) Interview and Performance Examinations were scored between January and September 2010. These individuals represent less than three (3) percent of those who took the exam in 201.

While RID has determined that the impact on RID and its members is very limited, we take this fraud seriously and are working diligently to resolve the issues this incident has raised.

At this time, RID has sent notification letters to all affected individuals via trackable mail, with delivery scheduled on or before today, Tuesday, June 21, 2011. Therefore, if you have not received an official communication or notification of an official communication from RID regarding this matter, then neither your certification nor your exam results are in question [...]" 

As I read the email from RID Executive Director Clay Nettles (available online in written English and ASL), I was stunned and angry.  I had taken the exam in January 2010 and a small part of me was worried that a letter was waiting at home for me.  Unsettled is probably the best adjective to describe how I have been feeling.  While I was not one of the thirty-four individuals affected, I couldn't help but wonder what this would mean for them and their careers, as well as the interpreting profession as a whole.  As I continually checked RID's Facebook page for reactions, comments, and discussions, I noticed that many members had the same questions and concerns as me.  We want to be supportive of the "Band of 34," while having access to the information that ultimately impacts our profession.

The bad decisions of one individual has jeopardized the livelihood of thirty-four and created a domino effect that impacts the livelihood of others.  The resulting audit and new procedures has slowed down the rating of NIC Performance and Interview Exams.  In the meantime, individuals waiting for results are potentially earning less (especially if an individual is non-certified) and at risk for losing their job, if they are unable to satisfy licensure or employment conditions.  A friend of mine is another category- as a recent graduate of a two-year ITP, she has her Associate's degree and is facing the June 30, 2012 deadline to take and pass the NIC before the Bachelor degree requirement goes into effect.

Beyond income and employment, many individuals have already questioned the validity of the NIC Performance and Interview exam and this event will likely add fuel to the fire.  More importantly, while it seems that most members appreciate the measures that the RID National Office has taken and their attempt at transparency, RID runs the risk of losing its members' trust.  Worse, we, the interpreting profession, run the risk of its consumers- hearing and Deaf- losing their trust in us.  It is my greatest hope that everyone realizes that one man is responsible for this fiasco and it is not a reflection of our profession as a whole.

I am disheartened that our profession has had to face two such scandals in a relatively short period of time.  However, I am pleased to say that on a daily basis, I work with a great group of interpreters that I am proud to consider my colleagues and friends.  Our profession is resilient and will move forward.  There may be more hiccups along the way, but hopefully it will always be the miniscule minority- the 0.1%- and not the majority- the 99.9%- that make these egregious and destructive decisions.  While we are beginning to see the long-term implications, it may be years before we know the final outcome of either situation.

I recently learned about the Gallup Poll's Annual survey of Honesty and Ethics in Professions.  As Gallup evaluated the public perception of professions, service professions dominate the top rankings.  Granted interpreters were not included on the list, but it made me think.  Where would interpreters be? And where do we want to be?

RID Business Meeting Motions

In preparation for the National Conference next month, RID is trying something new.  The National Office has posted the proposed motions for the business meeting on their Facebook page's discussion board.  Below, I have posted my response to the motions.  As you can see, I feel very strongly about Motion E (unfortunately I was unable to attend the Region II conference when they proposed this motion, so I have know about it for the past year).

Motion E.

That a new position on the RID Board of Directors be created as the CODA Member-At-Large.
From: Region II

Rationale: Children of Deaf Adults (CODAs) have exhibited unique skill, cultural understanding, and advocacy for citizens who use American Sign Language. Notwithstanding the countless interpreters who learned the skill through education and exposure later in life, CODAs have been in Deaf culture from birth. Therefore, in honor of the late Lillian Beard, Lou Fant, and so many others who have dedicated their personal and professional lives to this profession and to RID, we move that this new board position be created. Such a voice on the board would insure that tradition and dual cultural perspectives remain in the decision making processes of the board of directors.

Cost per member/fiscal impact: Significant. Increased costs for interpreting for conference calls and costs for travel, per diem and hotel.

Board comments: TBD
National office comments: TBD
Committee position: TBD
Member comments: TBD
Sense of the membership: TBD

My response:

While I do appreciate the experience and perspective of CODAs, I do not support this motion. Unfortunately, the interpreting community continually finds ways to divide itself, rather than present a united front. The "us versus them" mentality is very discouraging, particularly for newer interpreters. As addressed in previous posts, any one of the unique viewpoints can be represented in current board positions. All perspectives are valuable for our profession. Currently, many of these groups and perspectives are being represented by Special Interests Groups. Rather than establishing a new board seat, perhaps RID should be looking for ways to be more inclusive of all special interest groups, rather than singling out a specific group for inclusion on the Board.

Respectfully,

Amanda Kennon, NIC

Motion H.

That the RID national office maintains continuing education transcripts for all certified interpreters for a period not less than 35 years.
From: Jennifer Moyer and Charlene Lavine

Rationale: Currently, the RID national office maintains continuing education transcripts for five years, after which time, records are purged from the system. This period is inadequate, especially for interpreters who must produce documentation for previous training; likewise, maintaining personal paper files is cumbersome and not failsafe. By keeping transcripts on file electronically, RID can provide a centralized means for interpreters to access these records and provide documentation as needed for a period of time of not less than 35 years which is approximately the length of one’s employment career.

Board comments: TBD
National office comments: TBD
Committee position: TBD
Member comments: TBD
Sense of the membership: TBD

 My Response:

I agree with Cat [previous post]. Personally, I was unaware that transcripts were only maintained for 5 years. While I do believe transcripts should be accessible longer (and the current limit should be better publicized), 35 years puts a lot of responsibility when RID members should have personalized accountability as well. I think maintaining records for 2-3 cycles should be sufficient. Granted, I am a fairly new certified interpreter, but how many employers request your entire professional development history (if you're hitting that 35 year mark)?

To offset cost, one option could be for RID to maintain records and charge a minimal fee when an "official" copy is required- similar to requesting your official transcript from a college. This way, individuals using the service would be charged instead of increasing everyone's membership dues.

Motion L.

That RID work, in collaboration with appropriate stakeholders, on the development of a standard practice paper for Trilingual (Spanish-English-ASL) Interpreting.
From: David Quinto-Pozos and Yolanda Chavira

Rationale: Trilingual (Spanish-English-ASL) interpreting occurs regularly throughout the United States. Such services are supported by various VRS providers, and multiple communities throughout the country utilize trilingual interpreters regularly across multiple domains (e.g., community, educational, social service, and legal settings). As one example, trilingual interpreters appear often in Individual Education Plan (IEP) Conference meetings throughout the K-12 educational system (e.g., to interpret amongst the deaf/hard of hearing signing children, the Spanish-speaking parents, and the English-speaking school personnel). Additionally, the Gallaudet Research Institute (GRI) reported that, in 2008, nearly 22% of deaf and hard of hearing children in K-12 programs throughout the country come from households where Spanish is the dominant language. These facts provide evidence that trilingual interpreting is growing, and it will likely continue to increase in demand over the next several years.

Currently, an RID standard practice paper does not exist for Trilingual (Spanish-English-ASL) Interpreting. Yet, we feel that the need for such a document is imminent. We suggest that various aspects of trilingual interpreting should be considered for inclusion in the document (e.g., protocol for team support, need for appropriate remuneration for services rendered, trilingual certification as available, and guidelines for using trilingual interpreters).

Board comments: TBD
National office comments: TBD
Committee position: TBD
Member comments: TBD
Sense of the membership: TBD

 My response: 

I support this motion! This is certainly one of the fastest growing segments of our profession and should be address proactively, rather than re-actively. I am thrilled to see RID cultivate their relationship with Mano a Mano and provide more exposure for their members who currently do not work as trilingual interpreters.

Medical Interpreter Institute: Days 2 & 3

This post has been a work in progress for the past couple of weeks.  Obviously, I learned a lot and had a lot to share. 

"Introduction for Medical Interpreting" was followed by a full weekend of learning:

Saturday, May 21
 
Medical Terminology for Interpreters
Presented by Dr. Rachel St. John

I've been to several "let's learn the sign for that" workshops.  Despite best intentions, I find these workshops rather impractical.  Let's face it...you sit in a room for hours on end, then leave remembering a fraction of what you learned.  Eventually, if you don't use what you've learned, you forget what little you initially retained.

What I loved about Rachel's workshop was that she took a different approach than typical terminology workshops.  Instead of memorization, she provided a foundation and resources for medical terminology.  Rachel provided a handout with root terms by system as well as common abbreviations.  We went through several examples where we had to decipher the meaning of a term, using our "cheat sheet" as a guide.
Examples: hyperglycemia --                                  macrocephaly --
                  hyper = elevated                                   macro = enlarged
                  glycol = sugar                                       cephalic = head               
                  emia = in the blood

Rachel addressed several common issues in medical settings, both from her "doctor hat" and "interpreter hat," including:
-Asking the doctor to speak your language ("Can you explain what that means so I can interpret it accurately?")
-Additional information need to interpret vs. additional information/ explanation that the patient needs (what is too much or too little? does it change the dynamic?)
-When/ how to use expansion or ask for clarification
-Is the physician explaining appropriately? Who s the audience?
-Is knowing too much information a role conflict?
-What cultures come into play? (hearing, Deaf, medical, layperson...)

Rachel also directed us to NAD's  "Questions and Answers for Health Care Providers."  She observed that by referring doctors and patients to resources, it becomes practice, rather than individual.  For our own benefit, she also recommended Stedman's Medical Dictionary as a resource.

Ethics and Law in the Medical Setting
Presented by Jay Moradi-Penuel

The content of this workshop was similar to Jay's"Medical & Legal: The One & the Same" workshop that I attended in December.  However, a new set of participants brought a new set of questions as well as different perspectives.  Jay addressed sticky situations & potential legal impact in addition to pertinent laws, our Code of Professional Conduct, contracts & limitations, boundaries, conflict & perceived conflict, mandatory reporting & duty to warn, what is legally permissible on an invoice, and qualification versus certification.

Critical take-home points:
-"Non-deference...The Deaf person is not the only person in the room" (Jay)  We must evaluate the needs of all of our consumers- hearing and Deaf!
-"Legal necessity of boundaries" (Jay)
-It 's okay to say this situation is "outside my scope of practice" (Jay)
-When in doubt, get a qualified D.I. (Deaf Interpreter).
-"Every medical situation is a legal situation" (Jay)
-Who is responsible for following the law? Everyone!
-Related to neutrality and impartiality- "You are a person & have feelings.  It's what you do with those feelings" (Rachel).
-Freelance interpreters should have a business associate agreement (BAA) with health care providers.  The less specific it is, the less protection there is for you [the interpreter] as well as patient privacy.  BAA is different than Terms & Conditions.
-If you breach HIPAA, you can be fined.  Liability insurance does not protect you if you break the law.
-The law can compel you to answer.  A subpoena can require you to testify unless it is a privileged interaction.  An interaction is privileged if no one else is present (i.e. doctor & patient or lawyer &; client in a private situation), however interpreters are exempted.
*Law beats the CPC.
*You are your own best advocate.

Debriefing and Social Construction of Knowledge
Facilitated by Jay Moradi-Penuel & Rachel St. John

This was a unique "workshop."  Instead of a workshop with a formal presentation, we all went to a local Mexican restaurant to take advantage of a more relaxed atmosphere while engaging in dialogue with our peers.  It was a fantastic opportunity to process and share what we had learned the last two days, as well as discuss our own experiences.  Since I lack medical interpreting experience, I was rather curious how hospitals and medical institutions screen their interpreters, assessing their skills, qualifications, and credentials.  While I did pose this question during Jay's "Ethics and Law," workshop, I was not satisfied with the response.  During his workshop, one participant, who is on staff with a hospital system and has a nursing and interpreting background, shared her procedures, however during the de-briefing, I posed the question to my colleagues once more.  While her experience and expertise is valuable, from my perspective, her policies and procedures seem atypical; arguably, she is more savvy than the average medical institution, if only for the fact she was participating in the Medical Interpreting Institute.  Presenting this question to my colleagues provided me with a broader view of medical interpreting.

One of the big learning points that I shared was that I was surprised to learn (in Jay's workshop) that  IEP (Individualized Education Plan) meetings are indeed legal situations and that the interpreter is required to sign the IEP document.  I shared that I was actually relieved to learn this.  Not too long before this, I interpreted an IEP meeting and was taken aback when asked to sign the IEP as well.  Originally, I was asked to sign my name and "participant;" I was not prepared for this request and was there as an agency interpreter, making it an uncomfortable situation.  I agreed to sign the IEP as "interpreter," but was struggling with my decision.  Having worked as an educational interpreter, I honestly did not think that interpreting for an IEP meeting was a big deal when I accepted the assignment, even though I had not interpreted an IEP meeting previously.  This was certainly an interesting tidbit that I never would have expected to pick up at a medical workshop- but is immediately applicable to my work.


Sunday, May 22

Teaming in the Medical Setting
Presented by Jay Moradi-Penuel &Rachel St. John

This was my favorite workshop of the weekend.  First and foremost, Jay and Rachel's approach to interpreting as a practice profession, rather than a technical profession, really resonates with me.  Secondly, approaching an assignment with a holistic team approach makes a lot of sense to me.  Essentially, by approaching the assignment as a team, an interpreter can do his or her job better.  Unfortunately, a holistic team approach cannot happen overnight and requires mutual respect and willingness to invest the time and energy- both the interpreter and medical professional have to "buy in" and be partners in the endeavor.

With the holistic team model,
- The interpreter is a professional- not a paraprofessional.
-Language match and position can be achieved.
-Interpreters can optimize his/her boundaries by receiving the necessary information to interpret effectively and accurately (this is not carte blanche access to patient records).
-There is pre- and post-conferencing with the medical team as well as environmental pre-assessment.
-There is "inclusivity modeling"- all participants are included in all aspects of the interaction.

Jay and Rachel also addressed concerns about a holistic approach violating the Code of Professional Conduct (CPC) and the perceived requirement of interpreters being invisible or neutral.  They highlighted the following points:

Confidentiality (CPC Tenent 1.0)
1.1- "Share assignemt related information only on a confidential and 'as needed basis'..."

Professionalism (CPC Tenent 2.0)
2.2- "Assess consumer needs and the interpreting situation before and during the assignment and make adjustments as needed."
2.3- "Render the message faithfully by conveying the content and spirit of what is being communicated, using language most readily understood by consumers, and correcting errors discreetly and expeditiously."
2.5- "Refrain from providing counsel, advise, or personal opinions."

Towards the end of the workshop, Jay and Rachel also touched upon the Demand-Control Schema and Critical Friends Model as tools to process ethical decision making.

As with every workshop, participants are required to complete an evaluation form and answer the following question: What is one thing you will remember from today?

My response?  "People first!  Interpreters are people too!"


Sometimes as interpreters, we lose ourselves and identity in the interpreting process.  The interpreting process can become so seamless that those around us forget we're there.  This approach to interpreting in the teaching of interpreting has further compounded the problem.  The holistic teaming approach can help us re-claim our identity and place on the team.  Jay repeated emphasized to always put people first and remove the labels; as Rachel aptly stated "You are people who are interpreters."

In closing, two stellar life lessons from my dear friend, Jay:

"Progress, not perfection."

"If you give yourself permission to be a rock star, you're a rock star."