1. Working practices and ethical challenges of healthcare interpreters as institutional agents embedded in the patients’ community Maria Aguilar-Solano University of Massachusetts Boston

2. How do interpreters negotiate and channel the moral demands of their practice? Moral demands Profession Patients Institution

3. Virtue-Ethics “Virtue ethics focus on the agent; on his or her intentions, dispositions, and motives; and on the kind of person, the moral agent becomes, wishes to become or ought to become as a result of his or her habitual disposition to act in certain ways”. (Pellegrino 1995)

4. Limitations of habitus Bourdieu’s concept of habitus as it stands is problematic: ▸ It’s articulated with a high degree of passivity (McNay 1999) ▸ It doesn’t fully overcome objectivity (King 2000) ▸ It lacks of conscious choices (King 2000) ▸ It downplays the role moral criteria in social judgments (Lamont 1992) ▸ It doesn’t account for change unless there’s conflict ▸ It doesn’t account for interpreters’ sense of moral responsibility.

5. The Ethical Habitus ▸ It’s still a very dynamic concept, which will allow me not to enter into the realm of “role”. ▸ It integrates interpreters’ dispositions to choose the good whenever confronted with a choice. ▸ Is not a habit in the sense of being an unconscious reflex. ▸ It will allow to integrate moral agent to her acts, the nature of the acts, the circumstances and the consequences.

6. Research questions ** Is there such a thing as an “ethical habitus” in** healthcare interpreting? ▸ If so, how has these interpreters’ “ethical habitus” been shaped? ▸ If so, how does interpreters’ “ethical habitus” shape their practice? ▸ To what extend is it possible to apply an “ethical habitus” to other healthcare interpreting contexts?

7. Research Question II How has these interpreters’ “ethical habitus” been shaped? ▸ Looking at interpreters social trajectories ▸ Looking at the field structures

8. Some facts about the setting ▸ 2 Spanish hospitals in the South of Spain ▸ Non-traditional country for immigration until a decade ago ▸ Lack of financial resources for community interpreting ▸ Patients’ foreign population is very diverse ▸ Education available in T&I at many universities ▸ Many healthcare institutions have volunteer interpreters ▸ Volunteer interpreters ≠ Ad hoc or family and friends ▸ Volunteer interpreters = high degree of organization and training for the specific setting ▸ Volunteer interpreters are hosted by the healthcare institution and financed by the regional government

9. The Interpreters

10. Interpreters’ social trajectory-Motivation ▸ Rebecca: “I wanted... To be honest with you, I wanted to give something to the community because the community's been good to me. And... You know one thing, because I have always worked for myself I'm able to organise my time and so I just wanted to do something good for the community, and I thought it was a good idea.” ▸ Hannah: “Well, in my case is to do something for society, and also I think we can do something very significant.” [my translation]

11. Interpreters’ social trajectory-Begginings Dorothy: “He [the director of the Hospital Clínico] said: “They're going to build a hospital in Marbella, why don't you go and speak to the director, the new director, Doctor Pizarro?” So we went out and he [Dr Pizarro] said: “Give me a proposal, what do you want to do?” So I gave him a proposal, and so you know I wrote down the whole thing of what we wanted to do, what I thought should happen, and he said: “Fine”. And that's how it started. So we were here when the doors opened. So I've been here for 16 years, you know?”

12. Interpreters’ social trajectory–Social

13. Interpreters’ social trajectory-Governmental

14. Interpreters’ social trajectory-Institutional

15. Research question III How does interpreters’ “ethical habitus” shape their practice? ▸ Observing what interpreters do ▸ Examining what interpreters say they do

16. General tasks of interpreters ▸ To show compassion and understanding without giving advice on medical procedures, except in psychiatry when asked by the practitioner. ▸ To visit foreign patients on a daily basis in order to assess their communicative requirements and sort out any problems they may be experiencing as a result of not speaking Spanish (Exception: health insurance which will be dealt by social workers). ▸ To accompany patients to consultation rooms (interpreters will not assume the role of the healthcare professional). ▸ To offer moral support to patients’ relatives where necessary and contact religious representatives at the request of the patient. ▸ To take careful notes on the report book on a daily basis and note down any information of relevance for the next shift. (This excerpt from the handbook was translated from the Spanish)

17. Why an “ethical habitus”? The concept of “ethical habitus” could enable interpreters to: ▸ Be reflective practitioners who think critically about their position, its moral demands and limitations. ▸ Negotiate the moral demands of their positioning as institutional members embedded within the patients’ community. ▸ In other words, value compassion and empathy for patients and loyalty for the institution as moral responsibilities. ▸ Construct their normative selves by negotiating the moral demands from a virtue-ethics perspective.

18. To sum up An ethical habitus would enable us to examine how agential dispositions (or habitus) form through the interplay between moral demands – resulting from interpreters’ positioning as institutional agents embedded within the patient’s community – and reflective practice.

19. THANK YOU! Maria.Aguilar-Solano@umb.edu University of Massachusetts Boston