A growing number of health institutions are employing medical interpreters, bilingual individuals who facilitate communication between health care providers and patients. Organizations working to establish the professional status of medical interpreting have articulated codes of ethics that prescribe a number of different roles for interpreters in their clinical work. Interviews obtained from 17 medical interpreters support the observation that the code of ethics, based primarily on a conduit model of interpreter communication, does not provide consistent guidance in clinical practice. I discuss the role of communication theory in developing improved models for interpreter practice.

The literature reveals that exclusion, isolation, and fear remain realities for Canadian LGBTIQ adolescents. The Canadian experience suggests that negative social attitudes toward LGBTIQ persist despite progressive legislation. The value of social justice positions nurses to constructively intervene in promoting the health and well-being of LGBTIQ youth in the face of social homophobia.

Medical interpreters provide a bridge across the language gap for patients and practitioners. Research suggests that practitioners and interpreters experience numerous difficulties in their collaboration that can negatively affect service to patients with limited English proficiency, many of whom are immigrants. Using qualitative evidence from interviews with medical interpreters, I argue that many of these difficulties result from the fact that interpreter practice is based on a theoretical understanding of communication that does not adequately describe the problems faced by interpreters in negotiating between immigrant and practitioner groups. Suggestions for a more theoretically complete practice are offered.

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Evidence-based medicine's (EBM) quantitative methodologies reflect medical science's long-standing mistrust of the imprecision and subjectivity of ordinary descriptive language. However, EBM's attempts to replace subjectivity with precise empirical methods are problematic when clinicians must negotiate between scientific medicine and patients' experience. This problem is evident in the case of bibliotherapy (patient reading as treatment modality), a practice widespread despite its reliance on anecdotal evidence. While EBM purports to replace such flawed practice with reliable evidence-based methods, this essay argues that its aversion to subjective language prevents EBM from effectively evaluating bibliotherapy or making it amenable to clinical and research governance.

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