Linguistic Diversity: A Global Threat to Informed Consent

Bettye G. Wilson, MEd, RT(R)(CT), ARRT, RDMS, FASRT

     *Associate Professor of Medical Imaging and Therapy, Radiologic Sciences Division, The University of Alabama at Birmingham, Alabama.
     Address correspondence to: Bettye G. Wilson, MEd, RT(R)(CT), ARRT, RDMS, FASRT, Associate Professor of Medical Imaging and Therapy, Radiologic Sciences Division, The University of Alabama at Birmingham, Scrushy Building, RMSB 443, 1530 3rd Avenue S, Birmingham, AL 35294. E-mail:


Cultural diversity is on the rise globally. As individuals from different countries continue to travel and relocate to other countries, it becomes apparent that cultural diversity, especially involving linguistic differences, presents certain challenges. One of those challenges is providing quality healthcare to those whose native dialect is different from that of the majority of healthcare providers called upon to treat them. A major aspect of patient care is communication between patients and their providers. As a leader in healthcare delivery, the United States prides itself in the quality of healthcare received by patients. Delivering quality healthcare and achieving positive outcomes can only be actualized through clear and unimpeded communication.

One of the most essential elements of communication in healthcare is providing patients with the information necessary to make decisions regarding their care, including the decision to provide informed consent for treatment. Informed consent provides patients with all of the information concerning a procedure or treatment, especially if the procedure or treatment has the potential to cause adverse reactions or is potentially harmful or fatal. Linguistic differences between patients and healthcare providers are a growing challenge to informed consent. Not only do these differences create a barrier to patient-provider communication, but they also place providers at increased liability for medical malpractice.

Healthcare providers, including medical imaging technologists and radiation therapists, are ethically and legally bound to ensure that patients are informed about their treatments. Many institutions have undertaken initiatives aimed at lessening the impact of linguistic diversity on patient care. The use of interpreters has increased, bilingual healthcare providers continue to be recruited, courses in different languages are being taught to current employees, and documents (including consent forms) have been translated and printed in different languages. All of these initiatives are steps in the right direction, but questions remain as to how effective they are and if there is a need for more. These are just a couple of the questions that need to be answered to ensure that quality patient care is provided globally while protecting patient rights and lessening the legal liability of healthcare providers.

This continuing education article is designed to provide medical imaging technologists and radiation therapists with information on linguistic diversity and its effect on patient care, particularly informed consent. Terminology associated with diversity is defined, and statistics on linguistic variation and global populations are presented. Different types of patient consent are discussed, with special interest in, and exploration of the elements of informed consent. The ethical and legal implications of failure to obtain informed consent are also introduced. Finally, current initiatives designed to lessen the impact of linguistic diversity on quality patient care will be discussed.

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