Confidentiality vs COVID-19
By: Kathleen Lanker
During one of the many COVID-19 webinars I have been taking, there was a discussion of ethics.
(CCHI Webinar on Conversation about the COVID-19 pandemic impact on healthcare interpreters, March 21, 2020.)
The panelists strongly felt that a non-disclosure of this kind is not only affecting one person, it is affecting many. One example they gave was drinking a lot of alcohol. The Deaf individual not disclosing this information is only affecting him/herself, whereas the spreading of an infectious disease involves more than just the Deaf patient.
(As Spock from Star Trek said, “the needs of the many outweigh the needs of the few”.)
I feel this is something that needs to be discussed in our interpreting community and to be aware that we do have an obligation to tell the healthcare provider what we know.
I am not discussing here how should the interpreter work with the d/Deaf consumer and/or healthcare provider in the method or approach to disclosing the d/Deaf consumers whereabouts.
I am discussing here how according to the RID Code of Professional Conduct might come into question for an interpreter, i.e., Tenets 1 to adhere to standards of confidential communication. This pandemic outranks HIPAA, PHI and confidentiality; this pandemic is an exception to the law.
Confidentiality is very important in our profession and it does have its exceptions.
Does the Deaf community know that this is one of those times confidentiality has an exception?
Does the Deaf community know that we may be mandated by law to tell healthcare officials?
Have you had a discussion with a Deaf consumer about confidentiality is out trumped by the pandemic and any laws associated with it?
Another webinar discussed the two types of vectors or ways that infections are spread – a mechanical vector or a biological vector. (MasterWord Webinar Infection Control and Industrial Safety for Medical Interpreters, by Linda Golley).
An example of a mechanical vector is the following:
You are on a bus heading to work. A person comes on and coughs or sneezes causing an infectious mist. The particles from their nose and/or mouth are strayed onto your jacket and backpack. You don’t see this or where the particles go. You leave the bus and walk into the facility where you work. You gel your hands, place your backpack away and then go see a patient. You gel in before entering the patient’s room. You shake the patient’s hand. You have mechanically transferred that germ to the patient. You are a carrier, but you do not become infected.
An example of a biological vector is the following:
You are on a bus heading to work. A person comes on and coughs or sneezes causing an infectious mist. The particles from their nose and/or mouth are strayed onto your jacket and backpack. You don’t see this or where the particles go. These particles enter into your body and start the incubation process. You are not sick yet during this incubation period. You leave the bus and walk into the facility where you work. You gel your hands, place your backpack away and then go see a patient. You gel in before entering the patient’s room. You shake that patient’s hand. You have biologically transferred that germ to the patient. You will become sick.
We, interpreters, are the most dangerous vector in the medical community. We travel across so many different sites (e.g., communities, hallways, rooms, floors, patients, staff, etc.) in a day. We go to a labor and delivery, NICU, ENT appt, ER, surgery, and then … Each department within the healthcare system has their own protocol for safety and infection control. But we come in, leave and then travel to another department which has a very different protocol for safety and infection control. We cross barriers whether we are the mechanical or biological vector, causing an infectious wake while passing through.
An interpreter has contracted COVID-19. Healthcare providers will ask the questions, who have you been in contact with and where have you been? This circles right back to RID CPC Tenet 1, who we interpret for and the locations are considered confidential information.
I thought about this and how I have travelled throughout the Central Ohio area and then some. What a list it would be for me to compose, especially 14-days worth of information???
Does the Deaf community know that we may be mandated by law to tell healthcare officials where we have been and who we have been in contact with?
I don’t keep that kind of information around. Due to HIPAA, when I have been paid for my services, that assignment is removed from my calendar and all associated data.
It gives me cause for pause.
Have you thought about how you would answer those questions if you get infected?
Just wanted to share with you my thoughts
- Kathleen Lanker