Relay Interpreting Using an Intermediary Person

The term relay interpreting is used when more than one "interpreter" is needed to convey the message. This technique is used whenever the patient does not understand interpreting or the interpreter has difficulty understanding the voice or the signing of the patient. The reasons for using relay interpreting might be:

  • the patient has lost vision recently, can no longer rely on visual sign language and is uncomfortable with tactile sign language but understands a relative or friend

  • the patient has a neurological condition that makes the sign language or speech deviate from normal

  • the patient needs the support or presence of a family member who may be involved in part of the interpreting although some of the interpreting usually goes directly via the interpreter

  • a patient with minimal language skills (MLS) who needs an interpreter who knows his limited vocabulary.

Usually the second person helping in the communication is either a family member, teacher or social worker. However, even if they use sign language they should not function as the only interpreter because it is not humanly possible for such a person to be impartial in the examination process. They usually function as advocates which is a different role than that of an interpreter. Also, we cannot expect that they know how to interpret our medical terminology well enough to cover all of the questions and/or to function properly in the different test situations.

When relay interpreting is used, the time for communication increases as does the possibility of losing some information on the way. Both the interpreter and the physician have to be very alert and sensitive and help the relay person rephrase questions using simple, more common concepts if the patient does not seem to understand. Since we have to use the simplification method, it is important to get practice in simplifying the contents of our different questions without losing the exactness of their meaning.

The use of a relay person is one of the most delicate situations in communication. The person is unlikely to know the ethics of interpreting and, even if these rules are known, cannot apply them in communication when there are close, personal ties. We have to accept the fact that the relay interpreter sometimes talks for and instead of the patient. In this case we have to try to rephrase the question, gently suggesting that the question in its new form might be "easier for the patient to understand and answer". We use the relay person as our communication cable and we do not want to break the communication by disturbing the person who is having a hard time even without any additional critical comments on his performance.

In situations where the relay interpreter is deaf and the answers have to be voiced, it is helpful if the interpreter says who is speaking because the doctor usually has to watch the reactions of the patient and cannot keep track of how much the patient is signing.

Figure 5. Relay interpreting. A. The interpreter voices the signing of a deafperson who can read the signs of the deaf patient.

B. The deaf relay person signs the information signed by the interpreter.