A 2003 study from the American Academy of Pediatrics found that 2 out of 3 mistranslations have clinical consequences. In the U.S. state of California, 40% of the population speaks a language other than English at home. This high percentage translates into a high likelihood that a parent will use a non-medical savvy Anglophone child as an interpreter. In fact, according to the California Department of Managed Health Care, children regularly serve as medical interpreters in the immigrant-rich state. Fearing potentiallly lethal mistranslations by the offspring of patients, California will consider preventing children from interpreting at private hospitals, physicians’ offices, and clinics.

To date no other state has completely prohibited children from interpreting for their relatives, so these hearings have drawn a lot of attention from every point on the socio-politico-linguistic spectrum — including family rights advocates, insurance companies concerned with medical liability, insurance companies worried about the cost of providing language services, the clinics and hospitals facing a US$15 million invoice for interpreting services (we think that’s a low estimate), English-firsters, those who view limited English proficiency (LEP) as a disability, and laissez faire politicians who say that young children should be able to interpret for their parents if that is the will of the family — even if they “lack the vocabulary and the emotional maturity to serve as effective interpreters.”

In a state with budget problems struggling to meet the needs of its multicultural population, it will be hard to replace the child interpreters. Suggested options include professionalizing the role with roaming bands of medical interpreters, using telephone or video interpretation services, or employing in-house bilingual staff. Some larger hospitals have interpreters on staff, and states like New York increasingly mandate in-hospital language services.

Barring comparable legislation, funding, and finding interpreters for all required languages, though, we suspect that most doctors and clinics will choose the ever popular option of doing nothing — zero interpretation — or using the interpreter at hand, which will likely mean a young relative of a patient or victim. But some health care advocates warn that doctors and clinics faced with providing interpreters would rather turn away patients than provide this costly service. Whatever the outcome of the California hearings, it is clear that multiculturalism in the U.S. will not be legislated out of existence. Looking at the issue more optimistically, we see an opportunity for American businesses (and hospitals) that are friendly to non-English speakers — and for language service providers offering speech-to-speech services.