Requirements to obtain informed consent prior to any significant medical intervention are covered by legislation and, for New Zealand social workers and counsellors, by their codes of ethics. The essential elements of informed consent are effective communication, full information and that it is free from coercion.
The complexity of obtaining informed consent, when working with language barriers and between cultures is the focus of this paper. An immigrant, Muslim couple was referred to a fertility clinic for treatment. the woman was non-English speaking whilst her husband spoke enough English to get into a tangle. They were insistent that they use the husband's brother as an interpreter, an accepted and preferred practice within their culture but one which fell short of the requirements for interpretation of medical, clinical and ethical information. Combined with cultural limitations about what a man can discuss with his sister-in-law, the brother's interpreting was not only inadequate but incorrect and the process silenced the woman's voice.
The paper follows this complex case. It highlights the challenges to obtaining informed consent and identifies steps taken to provide clear boundaries within which the communication could proceed between all parties and thus ensure consent was well in formed.