- Religious Literacy and Medical Interpretation: Giving Meaning to Meaning in the Twenty-First-Century American Hospital
Not many scholars of religion can claim to have ever had their work appear on the New York Times’ “Best Seller List,” but Stephen Prothero, a professor of American religion at Boston University, can, for that is where his 2007 book wound up: Religious Literacy: What Every American Needs to Know—and Doesn’t.1 One of the book’s greatest merits is its demonstration of just how dangerous for humanity religious illiteracy is. The dangers are compounded in the United States, furthermore, by the fact that it is an ethnically and religiously diverse country, as well as being the world’s third largest country and its oldest democracy, which amplifies the possibility for religious misunderstanding and its legal and political ramifications. If we wed to these factors the reality that the U.S. is home to some of the world’s best hospitals, which attract patients and their families from all corners of the globe, the issue at hand becomes even clearer: The consequences of the combination of religious diversity and religious illiteracy for the contemporary health care profession are serious and many. Therefore, we argue that training in religious literacy should be provided to all health care providers ideally, or at a minimum to those professionals [End Page 299] who serve as cultural brokers, such as social workers and medical interpreters (chaplains generally already possess such credentials). We briefly focus here on medical interpretation, though the implications for the former should be clear, and the authors hope that they will be explored in the future by other scholars, as well as by policymakers, legislators, and hospital administrators.
Fluency in languages is obviously essential to effective medical interpretation, but informed awareness of patients’ and their relatives’ religious beliefs and practices is often quite critical as well. The misunderstanding or outright ignorance of such beliefs and practices has created and will continue to create potentially fatal and/or legally detrimental situations in health care settings. In such culturally diverse American cities as Miami and Philadelphia, the need for religious literacy among interpreters and other medical professionals is especially acute. In addition, while there are clearly safety concerns that amount to a priori answers to questions such as “Can Buddhist families burn incense in the operating room?” or “Can Santeros sacrifice chickens in the intensive care unit?”—other questions about religion are open to debate, with patient rights (and even, thus, human lives) in the balance. Religious literacy is vital to soundly informing such debates.
But, just what is religious literacy? Prothero defined it as “the ability to understand and use in one’s day-to-day life the basic building blocks of religious traditions—their key terms, symbols, doctrines, practices, sayings, characters, metaphors, and narratives.”2 These things go far in shaping many people’s lives, including the concerns, restrictions, assumptions, and ambitions that they bring with them to the health care setting. When medical interpreters are required to enable communication between doctors and their patients, over and above their linguistic acumen, they should also have a basic understanding of such “basic building blocks.” The following case studies demonstrate why.
The Case of Jane Doe
One summer day several years ago, a 15-year-old Latina named Jane Doe (pseudonym) was brought to the emergency room at Children’s Hospital [End Page 300] of Philadelphia (CHOP) after enduring a grueling month’s worth of bone pain, lethargy, sweats, and swelling in various parts of her body. Urine and blood analyses were performed and revealed compromised renal function; thus, Jane was admitted, and a renal biopsy was scheduled for the next day. Although Jane was born in the U.S. and is bilingual, neither of her parents, Mexican natives, spoke English well enough to comprehend medical nomenclature, whether complex or commonplace. Thus, throughout their experience at CHOP, they had a certified medical interpreter to assist them and their providers, which is required by law (telephonic interpretation services are also permissible), though there is no stipulation in interpreters’ certification (nor in that of other health care professionals, save chaplains...