The Family Member's Request to Withhold Information
At a 45-minute prenatal visit (28 weeks), you are the solo ASL interpreter. The Deaf patient has brought her hearing mother. With about 20 minutes left, the mother turns to you and says quietly, not signed, "Don't tell her about the family history of Down syndrome. It'll just scare her. Just sign that everything's fine." The physician is typing and has not heard this. The patient is watching you and the mother. The mother adds, "You're the professional-handle it." You have no team and no supervisor on site.
1. What do you do in the immediate moment, before the physician resumes?
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Do not agree, and do not silently comply. The interpreter's role is to relay the messages of the participants, not to decide what the patient should know. At the same time, the mother's remark was directed to you, not to the patient, so it is not automatically a message to interpret.
A workable response is brief and neutral: "I interpret everything that's said in the room. I can't agree to leave something out. If you want, I can interpret your concern to her and she can decide what to do with it." Then pause and let the mother choose.
Reasoning: agreeing would make you a co-decision-maker in the patient's care and would compromise the provider's ability to obtain informed consent. Announcing your practice boundary up front also protects the therapeutic alliance-the mother hears a rule, not a judgment about her motives.
2. The mother refuses to have her comment interpreted and says, "Then don't say anything. It's family business." What are your options, and how do you choose among them?
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The request now creates a conflict between the mother's wish and the patient's right to information that bears on her care. Options:
- Decline and inform the provider. Tell the mother you cannot keep a care-relevant request from the provider, then flag it: "I want to let you know a family member has asked me to withhold medical information. I can't do that, so I'd like your help addressing it." This keeps you out of the decision while putting it where it belongs.
- Ask the mother to raise it herself to the provider or the patient.
- Step out only if the situation becomes unmanageable, after telling the provider why.
Choose option 1 in most cases. It preserves transparency, avoids collusion, and does not require you to disclose the mother's exact words to the patient without context. Do not privately tell the patient "your mother asked me to hide something" in a way that puts you in the middle of a family conflict; route it through the provider.
3. What do you document and to whom do you report afterward?
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Document factually and minimally: date, setting, that a family member asked you to omit information, that you declined, and what action you took (provider notified). Avoid clinical detail and avoid characterizing the mother's motives.
Report to your agency or supervising interpreter per policy; many agencies require an incident note when a communication-access conflict occurs. Do not post about it, and do not discuss it with colleagues in identifying terms.
Follow-up reasoning: this is also a signal about the assignment. A solo interpreter in a high-conflict prenatal visit may need teaming or a pre-brief with the provider next time. Note that in your own records as a pattern to watch, not as a complaint about the family.