On professional and non-professional interpreting in healthcare services: the case of intercultural mediators

A debate that has revolved around the organisation of Italian healthcare interpreting services concerns the choice adopted by most institutions to employ intercultural mediators rather than professional interpreters. Intercultural mediators do not necessarily have a professional training in interpreting, they are, however, preferred to professional interpreters in that they are considered more competent in mediating the possibly different perspectives of healthcare providers and migrant patients. This preference provides food for thought for reflections on professionalism in interpreter-mediated interaction in healthcare. Drawing form a 10-year research on mediator-interpreted interactions in healthcare and a set of data comprising around 250 consultations, our contribution sets out as an attempt to clarify what is involved in this mediating work. Our analysis shows that mediators' agency is relevant both in providing renditions of participants' utterances and in promoting their active participation in the interaction. We describe the different ways in which mediators' agency is displayed in interactions and the interactional constraints on mediators' choices of action. Suggestions derived from our analysis may have an impact on the improvement of both mediators' and interpreters' professionalism with particular reference to facilitating communication with migrant patients, an aspect that has been recognized as highly problematic in the literature.