Prologue Theend of the twentieth century and the beginning of the twenty-first witnessed important changes affecting healthcare delivery to limited-English-speaking patients in the United States. As a result, a gradual emergence of academic questions regarding the nature of communication between healthcare providers and patients across gulfs of language and culture, especially when brokered by interpreters, began to trigger debate as to what roles the interpreters should play. This concern was echoed in practical pleas of interpreters themselves who asked: “What can I do to help, what is my role?” The field of medical interpreting, in particular, has been undergoing an extraordinary evolution. First, Title VI of the Civil Rights Act of 1964 estab lished the need for professional interpreters, in order to ensure meaningful access to healthcare for patients with limited English proficiency. As a result, government-funded programs for healthcare institutions have been mandated to provide interpreting services to limited-English-speaking patients(Allen2000). At the same time, medical interpreter organizations are writing and publish ing codes of ethics and pursuing certification efforts (California Healthcare Interpreters Association 2002; Massachusetts Medical Interpreters Association 1995). Funding agencies are increasingly paying attention to issues of cross cultural and linguistic communication. In 2001, the Robert Wood Johnson Foundation funded Hablamos Juntos,an18-million-dollar national initiative to improve healthcare communication for the Latino population in the United States. At the time this book was written, Latinos were the largest and fastest growing racial/ethnic group in the United States with 35.33 million, 12.5 per cent of the total population, counted in the 2000 census (US Bureau of Census, May 2000). Finally, legislation banning the use of children as interpreters in healthcare institutions (Yee, Diaz, and Spitzer 2003) and publications denouncing the use of bilingual janitors and untrained interpreters (Allen 2000; Cambridge 1999; Marcus2003)havebeenfuelingthedebateonthequalityofaccesstohealthcare available to speakers of non-societal languages in a multilingual society.
