Language, cultural brokerage and informed consent - will technological terms impede telemedicine use?
AbstractBackground. Telemedicine provides a solution to treatment of economically and geographically compromised patients and enhances the level of care. However, a problem has arisen in safeguarding patients' rights to informed consent.
Objective. To determine the impact of language, translation and interpretation barriers on gaining legally valid informed consent in telemedicine.
Methods. Forty-one key words relevant to computer terminology and concepts required to gain informed consent for a telemedicine encounter were selected and sent for translation into isiZulu, the local indigenous language of KwaZulu-Natal, South Africa. A questionnaire with the list of words was developed with three domains covering information communication technology (ICT) use, ICT terms and ethics terms. This was administered to patients at four outpatient departments in rural KwaZulu-Natal hospitals.
Results. Of the 54 participants, 50 (92.6%) did not know or understand the term 'telemedicine', 49 (90.7%) the term 'video conference' and 49 (90.7%) the term 'electronic records'. Words such as 'consent' and 'autonomy' were understood by less than a third of the participants. Only 19 individuals (35.2%) understood the word 'consent', and only 4 (7.4%) understood both the words 'consent' and 'telemedicine'.
Conclusions. Obtaining informed consent for a telemedicine consultation is problematic. Alternative ways of doing so need to be investigated.