The Nondisclosure Request at Intake
You are the Spanish interpreter for a 34-year-old patient at an outpatient behavioral health clinic. During the pre-session huddle, the patient says in Spanish: "I don't want my husband to know I'm coming here. He thinks I'm at work. If he calls or comes in, please don't tell him anything." The clinic front desk later asks you, in English, whether the patient's spouse has been informed of the appointment because he called asking about her schedule. The provider has not yet been told about the patient's request. The clinic's policy states that staff may confirm whether a patient is 'present in the building' if a family member calls, but not disclose visit details. There are 25 minutes before the appointment.
1. What do you do with the patient's request, and how do you respond to the front desk? Show your reasoning.
Read the worked answer
The patient's request is a communication and privacy issue that belongs to the care team, not to the interpreter alone. My steps:
- Do not answer the front desk myself. Whether the spouse is told anything is a clinical/privacy decision, not an interpreting decision. I do not confirm or deny presence, and I do not relay the patient's statement to the front desk.
- Interpret the patient's request to the provider accurately and completely during the session, including the part about the spouse calling. This is information the provider needs to plan care and to handle the front-desk question.
- Clarify my role to the front desk: 'I'm not able to discuss the patient's information; please route that question to the provider or privacy officer.'
- Flag the policy tension to the provider: the clinic policy permits confirming presence if a family member calls, which may conflict with the patient's stated wish. That is the provider's/privacy officer's call to resolve and to explain to the patient.
Key judgment: I do not act as gatekeeper of the patient's information, and I do not make a privacy determination. I interpret the request faithfully and let the accountable parties decide.
2. The patient asks you privately, before the provider enters, 'You won't tell him, right? You're on my side?' How do you answer?
Read the worked answer
I acknowledge the patient's concern without promising an outcome I don't control, and I clarify my role.
A workable response in Spanish: 'Entiendo que esto es importante para usted. Yo interpreto todo lo que usted dice para que el equipo lo entienda, y no comparto su información con nadie fuera de la consulta. Lo que decida el personal sobre el esposo no depende de mí; se lo voy a decir a la proveedora para que lo hable con usted.'
Reasoning:
- Don't say 'I'm on your side' in a way that implies advocacy or alliance against the care team; that undermines impartiality and can set up a false expectation.
- Do reassure that I won't disclose to the spouse and that I interpret faithfully.
- Redirect the decision to the provider, who is accountable for privacy handling and for explaining options to the patient.
- If the patient's fear involves safety (e.g., intimate partner violence), I ensure that information reaches the provider, since safety planning is a clinical matter.