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“In the absence of any validated online translating tool it is perhaps best to avoid relying on them”


there is a significant risk of error in using it to facilitate medical consultations. Online translating tools often use a literal approach and direct translation of words can fail to take into account the broader context and may alter meaning. Similarly the English translation of a patient’s response may not accurately reflect their intention. In the absence of any validated online


ATION


in securing a trained professional, clinicians are increasingly turning to online translating tools. Perhaps the most recognised is Google Translate, which has been gaining in popularity over recent years. Although it can be useful in social settings, Google Translate has not been validated for use in the medical setting and is not endorsed by the NHS. As a result,


translating tool it is perhaps best to avoid relying on them. Not only is there a significant risk of a potentially serious error, but there’s a good chance using such online tools will breach your hospital’s interpreter/translation policy. Instead, focus on liaising proactively with your hospital’s interpreter service to find out about their availability and any practical help they may be able to offer in more urgent cases. Your hospital may have a list of multi-lingual staff members who are able to assist in urgent situations. Finally, if you find yourself in difficulty don’t forget the immense skills and experience of your colleagues – seek guidance from other doctors, nurses and ancillary staff.


Capacity At the beginning of any patient interaction it is essential to establish whether they have capacity to engage in their medical care and provide consent if required. If a patient lacks capacity for the specific decision required, you should establish whether they have made a valid advance decision or appointed a power of attorney for healthcare decisions. Also check whether the court has appointed an individual to make decisions on their behalf. If in doubt, seek assistance from senior colleagues, your hospital legal department or medical defence


organisation, being sure to carefully document any decision making. If there is no advance decision, power of


attorney or court-appointed decision-maker, you should act in the best interests of your patient. The relevant legislation is the Mental Capacity Act 2005 (England and Wales), the Adults with Incapacity Act 2000 (Scotland) and the Mental Capacity Act (Northern Ireland) 2016. You should be familiar with GMC guidance, Consent: patients and doctors making decisions together, and their website features a very helpful interactive online tool for when you are unsure if a patient has capacity.


Motor speech disorders A patient’s ability to communicate may be affected by a motor speech disorder. A common one is dysarthria which can be caused by factors such as stroke, head injury and facial nerve damage. In isolation, dysarthria does not affect a


patient’s ability to understand. If the level of dysarthria affects your ability to communicate with your patient, consider any means by which you could overcome the difficulties. This may include seeking assistance from the speech and language team, trying to remove background noise, deferring non-urgent decisions if the dysarthria is likely to resolve shortly, or using additional means of communication such as writing. For more specific guidance, contact the MDDUS advice line on 0333 043 4444.


Dr Naeem Nazem is a medical adviser at MDDUS and editor of FYi


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