The ethics of medical translation
The ethics of medical translation turn on where a translator's professional obligations come from, what a code of ethics written for medical translators might contain, and what the codes that exist leave out. The obligations a writer carries in any area of practice are in ethics. What the work demands in skill is in what medical translation demands and who does it, the ethical and legal exposure of leaving a patient without a professional interpreter or translator is in providing language access in healthcare, and data protection in an independent practice is in data protection in a freelance practice.
Know where a translator's obligations come from
The account of a medical translator's obligations comes from a 2024 article in EMWA's journal by a freelance translator of French medical documents into English who teaches medical translation and is a Qualified Member and former board member of the UK's Institute of Translation and Interpreting; its opinions are her own and not necessarily shared by her employer, the institute or EMWA. The March 2024 issue of Medical Writing that carries it (volume 33, number 1, on translation) was admitted from an existing Markdown conversion without content repair; its known limitations are broken ligatures, mangled multi-column tables, interleaved page headers and footers, and figure text represented as marked text.
Much has been written about the ethics of medical interpreting and not so much about purely written translation. Definitions of ethics are disputed, but they include "how one should live" and "a set of concepts and principles that guide us in determining what behaviour helps or harms sentient creatures"; the Greek root relates to character and moral nature, so in the broadest view ethics is how best to develop and use one's own character, and the behaviour a person of good character shows. The question for a medical translator is narrower: professional ethics, the behaviour expected of people in a particular field. Personal ethics will show in the work, but it may not be safe to assume that individuals will always do the right thing, and there needs to be a collective agreement on what ethical behaviour is. For that reason professional ethics are imposed from elsewhere, as codes of professional conduct, compulsory in regulated professions and voluntary in others. To her knowledge no specific code exists for medical translators, so she outlines one, drawing on the institute's code of conduct and her own experience.
Build a code around five obligations
Her proposed code covers five areas.
The main pillar is the ability to do the work: the right language knowledge, with degrees and certification as required — mandatory in some countries and not in others — the right subject expertise and research skills, and a willingness to invest in keeping them current. Linguistic skills are necessary but not sufficient; the skills of carrying meaning between languages should also be part of the ethical armoury, and together they help produce accurate translations that convey meaning without loss and without misleading the reader.
Client care comes next. Whether the client is a private individual — much of her own work — a company or an agency, the duty is a translation fit for purpose, but that is not the whole job. A private individual may be going through a very difficult time, as the patient or as a relative organising the translation for them, and this has to be handled with sensitivity. They may be dealing with doctors in two or more countries, and the translator can offer support by staying available to answer queries that arise when the translation is used. Even with a company or agency, where contact may be no more than brief emails, the interlocutors are human, and the basics still apply: meet deadlines, ask the right questions, and do not subcontract without the client's knowledge.
Data protection and confidentiality follow. Translators often handle personal data, and they should know their obligations under the General Data Protection Regulation and tell clients which policies they follow; data should be kept no longer than needed, and individuals must be able to have it deleted. Companies and agencies often anonymise documents before translation, but reports sent directly by patients must be handled with care. Thought should be given to possible solutions and their implications: whether the cloud-based provider is trustworthy and secure, where the data will be stored, and whether the translator can guarantee that it will be handled so that their obligations under the regulation are met.
Relationships within the profession are the fourth area. The institute's code requires members to share knowledge and experience, and the institute facilitates this with subject and language networks in which members can discuss professional matters, whether tricky terminology queries or questions about client relations. Its long-standing medical and pharmaceutical network is an invaluable source of help and support for many, herself included. In-person workshops with high-profile speakers are a good way to keep subject knowledge current and let colleagues work on texts together, and knowing colleagues' skill levels and ways of working is invaluable when finding people to work with.
Honesty and integrity is the fifth. It is the first category in the institute's code and the last she takes, and it encompasses all the others. It covers everything from advertising services accurately and fairly to colleagues, as a matter of honour and correct behaviour — not unfairly denigrating others' services, for instance — to formal prohibitions of bribery and corruption backed by law.
Know what current codes leave out
Artificial intelligence is the first gap. The institute's code is silent on AI and on the tools of the trade, implying that a good product is all that matters however it was made. But a translator who enters a patient's confidential information into an online machine translation tool or into ChatGPT no longer controls what happens to that data and cannot assure the client it is protected. The use of AI can therefore be a matter of ethics, and professional codes may need updating to say so, though the landscape was changing so rapidly that the issues were hard to pin down. What confidential material may go into a third-party AI tool at all is in deciding what confidential material may go into an AI tool, and the controls that stay in place when machine translation enters the work are in machine translation and AI in the language chain.
The environment is the second, an aspect that to her knowledge current codes of conduct do not tackle. Translators may not travel for work as much as interpreters, but their decisions still have an impact — data stored online needs energy just to be stored — and an organisation may encourage its members or employees to travel more greenly when they do travel, by train rather than plane.
The institute itself had acknowledged that its code of professional conduct may not meet the criteria for a code of ethics, and at the time of writing was reviewing whether a separate code of ethics was needed and what it should contain. She expected the process to examine what ethical behaviour in the profession is, how it can be promoted, and what a professional association can do. Current codes of conduct, which she treats as codes of ethics, are fit for purpose in some ways but could benefit from revision in areas such as environmental awareness and new developments in technology. Above all, she urges codes that reflect the best of what translators can do, in their professional skills, in how they treat others, and in how they face the future.