تفسیر پزشکی: غفلت از حقوق بشر Medical translation: the neglected human right

Introduction: the Right to Health Language barriers between patients and medical professionals are becoming an increasing feature of many healthcare systems around the world (Meeuwesen et al., 2011; Quan and Lynch, 2010). Many communities are facing a growing number of immigrants in hospitals and clinics, and the issue extends to ethnic minorities who speak other languages. Hearing-impaired and visually impaired citizens also commonly face language barriers. Healthcare professionals themselves are ever more likely to practice far from their home communities, which often implies that they have to communicate in another language. Those circumstances may result in a barrier to accessing care, medical error, or an outright denial of care for a patient: as such, the right to a translator in healthcare settings would seem to be given under International Law. Furthermore, the denial of proper translation has proven to lead to denial of preventative care, maiming, and even death (Price-Wise, 1998; Kelly, 2010). Both the 1948 Universal Declaration of Human Rights (UDHR, art. 25)[1] and the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR, art.12 (2)(b,d)[2] specifically mention the Right to Health. The 1946 Constitution of the World Health Organization[3] preamble outlines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The UDHR guarantees “medical care and necessary social services” as a human right, whereas the ICESCR goes further by guaranteeing “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health,” which includes “the creation of conditions which would assure to all medical service and medical attention in the event of sickness.” The United Nations’ Office of the High Commissioner for Human Rights further commented on the issue of access to care in 2000[4], outlining four distinct dimensions of accessibility: non-discrimination, physical accessibility, economic accessibility (affordability), and information accessibility. To quote the attorney Natalie Huls (2004) (US Occupational Safety and Health Review Commission): “Most international human rights law tends to overlook access to health because the right to health indirectly addresses how that right is to be fulfilled. The right to health states that everyone should have access to health, but does not address the specific issues of access, guarantees to access, and does not explain what access entails.” The result is that a wronged patient seeking redress may feel that article 25 of the UDHR or article 12 of the ICESCR may not be the most practical grounds with which to bring suit before an international court, and decide to “forum shop” by appealing to other international bodies (e.g. The European Court of Human Rights), “grounds shop” (by filing using a legal basis other than the Right to Health), or simply file a case nationally.