The Linguist

@CIOL_Linguists AUTUMN 2024 The Linguist 33 OPINION & COMMENT From fatal miscommunications to a lack of accountability, Eleanor Taylor-Stilgoe, Félix do Carmo and Sabine Braun look at the risks of using automated translation in healthcare Would you feel comfortable going into hospital knowing that the person providing treatment doesn't speak your language and may use a free, unregulated translation app to communicate with you? Would you feel confident that you had received the right medication and were on the road to recovery? Situations like this arise more often in the UK than you might think, afflicting patients and health professionals alike. Reports emerged in 2018 of doctors in the NHS turning to online machine translation (MT) tools to communicate with Romanian and Polish people when delivering vaccines, rather than using remote or face-to-face interpreting services. 1 The reasons given included the perceived cost and appointment time pressures, as well as difficulties in finding professional interpreters for the required languages. One of the doctors claimed to use Google Translate very often, commenting "It's better than me struggling… and the person not having a clue what I'm talking about." A 2020 study found that public health providers in England were using Google Translate for consultations with Romanian and Roma communities, raising concerns that "messages would be lost in translation". 2 The Royal College of Midwives has identified language as both a risk factor and a barrier to effectively delivering care to people with little to no English. 3 While remote interpreting services can be procured from LanguageLine, one midwife reported: "we are discouraged from using LanguageLine for things that aren't urgent due to cost implications." NHS England cautions staff against using online translation services on the grounds that "there is no assurance of the quality of the translations". 4 The same guidance states: "Patients should be able to access primary care services in a way that ensures their language and communication requirements do not prevent them receiving the same quality of healthcare as others." In practice, however, health professionals are turning to these tools as a 'better than nothing' solution to provide this care. A lack of accountability Where does legal liability lie when turning to such apps? The licence agreements we accept when installing them transfer all responsibility for the consequences of their use to the user, fully protecting the tech company against any liabilities. Where does this leave well-meaning healthcare staff in the event of errors in communicating important, even vital, information to patients? A notable case is that of two-year-old Awaab Ishak, who died in 2020 as a result of prolonged exposure to mould in his flat. During a hospital visit in the days prior to his death, he was accompanied only by his mother, whose English was very limited. Google Translate was used to communicate important yet insufficiently precise discharge instructions. By contrast, an Arabic-speaking GP was asked to explain the medical team's decision to the family when nothing further could be done to save Awaab. The coroner's verdict stated that "an appropriate translator should have been A medical emergency © SHUTTERSTOCK

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