Working with interpreters

Healthcare workers and interpreters need to work together to ensure that communication is facilitated effectively between all parties involved in discussions about voluntary assisted dying.

Interpreters in the voluntary assisted dying process

It is essential for a person accessing voluntary assisted dying to clearly understand what is happening throughout the process. Sometimes family members, friends or a healthcare worker may offer to interpret for the person receiving care. This is not allowed when voluntary assisted dying is being discussed.

A certified interpreter can facilitate communication during all steps in the voluntary assisted dying process when people who speak a language other than English (or require assistance to understand English) or people who use non-spoken language (for example, Auslan) are involved in conversations with healthcare workers. If an interpreter is required:

• the healthcare worker should allocate additional time for the consultation
• the interpreter should be briefed on the content matter prior to the consultation
• the interpreter should be given the opportunity to choose not to be involved.

More information regarding working with interpreters is available from the Queensland Health website:

• Useful tips on how to conduct the interpreting session (PDF 66 kB)
• Working with Interpreters Guidelines (PDF 438 kB)
• Compassionate conversations: a guide to using an interpreter in virtual communication

Interpreter role

An interpreter may facilitate communication between healthcare workers and the person who is accessing voluntary assisted dying during all stages of the voluntary assisted dying process, including:

• a person communicating their first request to a medical practitioner to access voluntary assisted dying
• the assessment process, including assessment of the person’s eligibility to access voluntary assisted dying by two separate medical practitioners (the first and consulting assessments)
• appointment of a contact person
• the provision of information about the administration of the substance
• all aspects of the review of a decision by QCAT.

Interpreter requirements

Eligibility criteria

Under the Voluntary Assisted Dying Act 2021 (the Act), an interpreter for a person who is requesting access to voluntary assisted dying must meet all the following criteria. An interpreter must:

• be certified by a body approved by Queensland Health (in the case of voluntary assisted dying, the body approved by Queensland Health is the National Accreditation Authority for Translators and Interpreters – NAATI) or have been granted an exemption; and
• not be a family member of the person, including their spouse, parent, grandparent, sibling, child or grandchild; and
• not be a person who, under Aboriginal and Torres Strait Islander custom, is regarded as a person mentioned above; and
• not know or believe they are a beneficiary under the will of the person; and
• not know or believe they will benefit financially or in any other material way from the death of the person, excluding reasonable fees for the provision of interpreting services; and
• not be the owner of, or responsible for the management of any health facility at which the person is being treated or resides; and
• not be directly involved in providing a health service or personal care service to the person.

An interpreter may be granted an exemption from the certification requirement in the Act if Queensland Health is satisfied that:

• no certified interpreter is available for a particular case; and
• there are exceptional circumstances for granting the exemption.

Read more information regarding the process for applying for an interpreter exemption.

Additional requirements

An interpreter is required to provide their contact and certification details on approved voluntary assisted dying forms. The authorised voluntary dying practitioner will submit the relevant forms to the Queensland Voluntary Assisted Dying Review Board.

An interpreter may be required to provide sight translation during 2 steps that include written forms for the person to complete:

• making a second request
• appointing a contact person.

If required to provide sight translation, interpreters should be suitably qualified, such as being a certified translator or level 3 certified. If the interpreter is not confident or adequately skilled, they should refuse the request to provide sight translation services.

If sight translation services are provided, the interpreter must sign a statement certifying that they provided a true and correct sight translation of any material translated.

The healthcare worker will manage the session and ensure the required paperwork is completed.

Interpreter participation in voluntary assisted dying

Interpreters do not have to participate in the voluntary assisted dying process. An interpreter can decide not to participate for any reason, including due to a conscientious objection. A conscientious objection is when a person declines to participate in a lawful process or procedure due to their personal beliefs, values or moral concerns. A healthcare worker or interpreter has the right to refuse to participate in voluntary assisted dying if they conscientiously object.

If an interpreter decides not to provide interpreting services in relation to voluntary assisted dying, this should be managed by the entity or person seeking their services, for example, a medical practitioner.

All NAATI certified interpreters must continue to comply with the Australian Institute of Interpreters and Translators (AUSIT) Code of Ethics and Code of Conduct requirements.

Being involved in a process in which someone is choosing to end their life can be challenging. It may be helpful for interpreters to think about their feelings and beliefs about the issue of voluntary assisted dying and decide if they want to provide services related to voluntary assisted dying.

Healthcare workers who seek out the services of an interpreter should be respectful and considerate of any decision made by an interpreter to not be involved in voluntary assisted dying.

Pre-briefings and debriefings with the interpreter

It is recommended that the healthcare worker pre-briefs the interpreter prior to the voluntary assisted dying consultation. This allows for a shared understanding of the process and purpose of the session and to discuss any sensitive matters.

It is also recommended to debrief with the interpreter after the session. This could be with the healthcare worker who is providing voluntary assisted dying services or form part of a broader debrief with the multidisciplinary team.

Interpreters may experience a range of emotions following their involvement in a discussion about voluntary assisted dying. Debriefing can help to manage emotional reactions, support wellbeing, and decrease the risk of vicarious trauma to the interpreter. It can also help to resolve any interpreting issues and improve the interpreting process.

Providing interpreting services during the voluntary assisted dying process may be challenging. It is important for interpreters to reflect on their needs in relation to emotional wellbeing and strategies for self-care and seek assistance from their relevant support networks if required. Employee assistance programmes, community-based services or health providers can also provide support.

Read more about help and support options available.

Restrictions on using telehealth

Interpreting services often occur over the phone. However, this is not allowed in some steps of the voluntary assisted dying process. As part of providing professional services, both the interpreter and healthcare worker should be aware of the Criminal Code Act 1995 (Commonwealth) (Commonwealth Criminal Code) restrictions.

The Commonwealth Criminal Code prohibits discussing suicide via a carriage service, such as telehealth, telephone, fax, email, internet, or videoconference. Although voluntary assisted dying is not considered suicide under the Act, the Queensland legislation cannot override the Commonwealth Criminal Code. There is a risk that aspects of the Queensland voluntary assisted dying process would amount to an offence under the Commonwealth Criminal Code if conducted over a carriage service. This means that some discussions about the voluntary assisted dying process must be face-to-face. If a healthcare worker must conduct part of the voluntary assisted dying process face-to-face and an interpreter is required, the interpreter must also be in the same location.

The risk of committing an offence under the Commonwealth Criminal Code extends to translation services. If a translator translates content that includes any restricted topics, they may need to provide translation services in hard copy via post, courier or hand delivery to avoid committing an offence. Restricted topics include any information given to a person which:

• urges or advises a person to access voluntary assisted dying
• encourages practitioner administration or self-administration of a voluntary assisted dying substance
• provides instructions on practitioner administration or self-administration of a voluntary assisted dying substance.

Pre-brief discussions

The risk of an offence includes any pre-brief between a healthcare worker and an interpreter if it occurs via a carriage service and includes discussion of a restricted topic. If a pre-brief is conducted via a carriage service, the pre-brief must be limited to practical and technical discussions and must not discuss any of the restricted topics outlined above.

More information regarding the Commonwealth Criminal Code restrictions on discussions about voluntary assisting dying over a carriage service is available in the QVAD Handbook.

Consultations that must be face-to-face

The following discussions about voluntary assisted dying must be conducted face-to-face:

• A consultation with the coordinating practitioner to make an administration decision. This is likely to involve detailed discussion about the administration options, the method of administration, instructions on how the substance is administered and the person’s ability and concerns about administration.
• The coordinating practitioner, administering practitioner or the QVAD-Pharmacy pharmacist instructing the person about how to prepare and self-administer the voluntary assisted dying substance. Discussions via a carriage service about administration of the voluntary assisted dying substance must be limited to the method by which the substance is likely to be administered and must not include instructions on the method of administration.

If the services of an interpreter are required for these discussions, the interpreter must be present face-to-face with the healthcare worker and the person who is accessing voluntary assisted dying.

QVAD-Access

QVAD-Access can help people living in regional, rural, and remote areas to access voluntary assisted dying. QVAD-Access may support the travel costs of interpreters who are required to travel to interpret during the voluntary assisted dying process. More information about QVAD-Access.

What to do if restricted information is discussed via a carriage service

The Commonwealth Criminal Code applies to every person, and it is therefore the responsibility of both the healthcare worker and interpreter to be aware of the restrictions on topics which may be discussed over a carriage service when working with people who are accessing voluntary assisted dying.

As part of a pre-brief held via a carriage service or in anticipation of a consultation with a person who is accessing voluntary assisted dying being held over a carriage service, it would be good practice for the healthcare worker and interpreter to discuss how restricted topics may arise and agree how to manage the situation. Strategies which may assist include:

• the healthcare worker clearly explaining the planned content of the consultation to the interpreter, including any restricted topics that might arise and the terminology that may be used in the event that restricted topics are raised
• directing the interpreter to specific information regarding restrictions under the Commonwealth Criminal Code in advance of the pre-brief and consultation, for example, information in the QVAD Handbook (PDF 8073 kB)
• providing an opportunity for the interpreter to ask questions and clarify information regarding restricted topics
• the healthcare worker and interpreter agreeing how the emergence of restricted topics will be managed during the consultation, for example, agreeing that either the healthcare worker or interpreter may stop the conversation if restricted topics are discussed.

Finding an interpreter

• Queensland Health services: professional interpreters should be engaged through the Hospital and Health Services Interpreter Service Coordinators or using local procedures.
• Non-Queensland Health services: follow local procedures.

If an interpreter who meets the requirements to be involved in voluntary assisted dying is not available, the healthcare worker must apply for an exemption.