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ses were coherently interpreted within the framework of the two areas of focus:
the influence of the interpreter on the structure and content of the consultation
and the influence of the context on understanding between doctor and patient.
The influence of the interpreter was discussed in relation to the translating and
mediating tasks of the interpreters. The position of the interpreter as an
employee of the health service implies a loyalty towards the doctors and therefore
the interpreters give priority to mediation towards the need of the doctors
and actively try to keep the consultation within the predictable course and content
of the medical interview. As a result of this, the medical dominance in the
communication is increased and the possibilities of the patient to include his
own agendas are reduced.
Understanding was discussed in relation to the different linguistic and sociocultural
backgrounds of the doctor and the patient and this was related to differences
in the participants' expectations towards the consultation and differences
in language usage. Both of these circumstances were further viewed in relation
to the structure and content of the medical interview in the institutionalised setting.
Also included in the discussion was the significance of the role of the interpreter
as the doctor's assistant. The study concluded that the conditions
described constrain the patient's active participation in the conversation, which
ultimately results in a lack of shared understanding.
The analytical conclusions suggest the need for an increased attention to initiatives
that will strengthen the public debate concerning the population's expectations
to the health service and the doctor. The functions of the interpreters in
the communication will inevitably involve both translation and mediation. A
legitimisation of this will help remedy problems caused by the interpretation;
the extra need for clarification and problems related to the contact between the
doctor and the patient. It must be discussed whether the role of the interpreter
as the doctor's assistant, if possible, should be changed in the direction of a role
with more active mediation and support to the patient.
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