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Reporting an unethical/illegal issue found on translation. PLEASE HELP
Thread poster: Lucia Moreno Velo

Lucia Moreno Velo  Identity Verified
Spain
Local time: 03:27
Member (2010)
French to Spanish
+ ...
Feb 15, 2019

Hello,

I am translating a review of medical literature and I find a study where women participants about to give birth are *randomized* to get an apisiotomy or not. Now, episiotomies are only to be given under certain circumstances and the extensive use of episiotomies is considered abusive and a form of violence against women. This practice also goes againts WHO guidelines and all guidelines I know. I would like to report this study. Can anyone direct me to any guidelines of ethics
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Hello,

I am translating a review of medical literature and I find a study where women participants about to give birth are *randomized* to get an apisiotomy or not. Now, episiotomies are only to be given under certain circumstances and the extensive use of episiotomies is considered abusive and a form of violence against women. This practice also goes againts WHO guidelines and all guidelines I know. I would like to report this study. Can anyone direct me to any guidelines of ethics for translators that talk about actions to be taken when finding proof of illegal/unethical activity in a translation, please?

Thanks,
Lucía
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Samuel Murray  Identity Verified
Netherlands
Local time: 03:27
Member (2006)
English to Afrikaans
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SITE LOCALIZER
You can't (or: you have to wait) Feb 15, 2019

Lucia Moreno Velo wrote:
I would like to report this study.

Can anyone direct me to any guidelines of ethics for translators that talk about actions to be taken when finding proof of illegal/unethical activity in a translation, please?


I'm not going to comment on whether episiotomy (a form of vaginal mutilation that is often elective and often perform against the express wish of the patient) is illegal/unethical, because whether it is or isn't shouldn't be relevant to your question.

If you believe that your translation will be used illegally, or be used in illegal activities, then you can refuse to do the translation and inform the client about it. You can also choose to become a whistle blower and report this to the authorities, but if you do that, then you're breaking confidentiality and if your actions become known, it could mean the end of your translation career.

If you know that something is not illegal, but you personally feel that it is unethical, then your duty of confidentiality towards your client or potential client weighs stronger than your own beliefs, even if you are confident that your belief is the majority opinion. In such a case, you can refuse to do the translation, and you can inform the client of your concerns, but you can't run to the authorities until after the information becomes public.

If the activity is not illegal but you want to object to it, then you may feel that not reporting this right now might mean missing out on an opportunity to strike while the iron is hot (since it is less likely that the study will be cancelled if objections to it are received later instead of sooner), but that is your unfortunate burden as a translator.

Can anyone direct me to any guidelines of ethics for translators that talk about actions to be taken when finding proof of illegal/unethical activity in a translation, please?

[Added: I had assumed that you meant that you want to report the literature review itself. If you want to report something that is already public knowledge (e.g. a past study that is mentioned in the literary review), then you are free to follow your conscience, unless you believe that your actions will harm the client.]


[Edited at 2019-02-15 11:27 GMT]


Morano El-Kholy
Dylan Jan Hartmann
Sonia Cunha-Goldner
Claudia Leão
Jorge Payan
Lucia Moreno Velo
neilmac
 

Chris S  Identity Verified
United Kingdom
Swedish to English
+ ...
Just do what you feel is right Feb 15, 2019

I am not aware of any such guidelines for translators.

As this is a review of the literature, the study results are already in the public domain, so there is no confidentiality issue.

The big question for me is whether there is anything to blow the whistle on. Maybe the underlying study took place many years ago or in a country with weak ethical standards. Maybe this is just a typo or error in the text you are translating. Maybe there was a genuine and wholly ethical ca
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I am not aware of any such guidelines for translators.

As this is a review of the literature, the study results are already in the public domain, so there is no confidentiality issue.

The big question for me is whether there is anything to blow the whistle on. Maybe the underlying study took place many years ago or in a country with weak ethical standards. Maybe this is just a typo or error in the text you are translating. Maybe there was a genuine and wholly ethical case for this randomisation. But if not, go for it!
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Teresa Borges
neilmac
 

B D Finch  Identity Verified
France
Local time: 03:27
Member (2006)
French to English
+ ...
Reporting to the authorities is not the first step Feb 15, 2019

The first thing you need to do is to notify the client of your concerns. However, I agree with Samuel's comments that you should continue to do the translation. A review of medical literature is very different from an instruction to clinicians and there is no prima facie reason to suppose that your translation would lead to women suffering unnecessary episiotomies.

Many years ago, I worked for a professional veterinary journal as Manuscripts Secretary. I received new manuscri
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The first thing you need to do is to notify the client of your concerns. However, I agree with Samuel's comments that you should continue to do the translation. A review of medical literature is very different from an instruction to clinicians and there is no prima facie reason to suppose that your translation would lead to women suffering unnecessary episiotomies.

Many years ago, I worked for a professional veterinary journal as Manuscripts Secretary. I received new manuscripts submitted and met with the Editor to do an initial review of them, send manuscripts out for peer review and reply to the authors. One day, I received a manuscript of a research study from an Indian academic, supported by a major international pharmaceutical company. I won't go into the repulsive details, but it was immediately obvious to me that this "research" was absolutely unethical and involved gratuitous and extreme cruelty to animals. The Editor agreed with me and rejected the manuscript without sending it for peer review. A few days later, the pharmaceutical company contacted the Board and threatened to withdraw their very important advertising from the journal if the paper was not published. The Editor was called up to a Board meeting and stuck to his guns, even though he was threatened with dismissal. He won the backing of the Board and the pharmaceutical company was told in no uncertain terms what they could do with their advertising if they tried to interfere in editorial policy. The whole office celebrated with a, more alcoholic than usual, trip to the pub for lunch.

In that case, publishing would have given the imprimatur of professional acceptability to something quite disgusting. However, I am sure that had it gone to peer review, it would have been rejected anyway. There are safeguards in the medical and veterinary professions that don't rely on the intervention of us mere translators. Indeed, it might be important for the paper to be translated in order for the bodies concerned to be alerted to the unethical nature of the research and to take action.

That said, I did once refuse to do a translation for ethical reasons. This was the translation of a book by an alternative medicine practitioner and self-publisher, intended for a general public readership, that recommended some very dubious ways of boosting the immune system of infants by exposing them to a high level of random and unknowable hazards. I told the agency and they agreed with my ethical concerns. I believe that they did not send it to another translator, but refused the job.

[Edited at 2019-02-15 11:28 GMT]
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Sara Massons
Sonia Cunha-Goldner
Christine Andersen
Jorge Payan
Lucia Moreno Velo
Oriana Bonan
 

Lucia Moreno Velo  Identity Verified
Spain
Local time: 03:27
Member (2010)
French to Spanish
+ ...
TOPIC STARTER
Thank you! I have reported it. Feb 15, 2019

Thank you all for your answers.

I agree with you all that I should translate the literature review. I have no question that this is the right thing to do, as I have no question that reporting the study is the right thing to do.

The study is clearly unethical and raises a human rights issue. It might have been legal because the laws of the country where it was conducted might allow it, but it should never have been published, as several of you have pointed out.
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Thank you all for your answers.

I agree with you all that I should translate the literature review. I have no question that this is the right thing to do, as I have no question that reporting the study is the right thing to do.

The study is clearly unethical and raises a human rights issue. It might have been legal because the laws of the country where it was conducted might allow it, but it should never have been published, as several of you have pointed out.

I contacted a human rights lawyer in my town and, since the study was not conducted in Spain, she has put me in contact with human rights watch organizations that work in the right region. I have reported the study to them. The study is published so, you guys are right, it is perfectly legal and does not violate my contract with the client to report it. I have not disclosed any information about my client or the file. I have only quoted information found in the abstract of the study, which is publicly available on the Internet.

I seem to remember that here in ProZ I had read, years ago, some kind of ethical manifesto about these types of situations and I'm sure that some professional organization must have issued some kind of guideline or best practices declaration about these issues. I will keep looking.

Thank you again for your answers.

Cheers,
Lucía
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Kay Denney
B D Finch
Manuel Bas y Mansilla
 

The Misha
Local time: 21:27
Russian to English
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Jeez! An unethical study! Feb 15, 2019

Ask yourself if you are out to change the world or simply want to make a living translating texts. If it's the former, good luck with it. I'll talk to you again in ten years.

Liviu-Lee Roth
Jorge Payan
neilmac
 

Tom in London
United Kingdom
Local time: 02:27
Member (2008)
Italian to English
@ the Misha Feb 15, 2019

The Misha wrote:

Ask yourself if you are out to change the world or simply want to make a living translating texts. If it's the former, good luck with it. I'll talk to you again in ten years.


I have a construction document here for the erection of a large furnace in which people of a particular kind will be incinerated. How much would you charge for the translation?

[Edited at 2019-02-15 14:59 GMT]


Teresa Borges
B D Finch
Morano El-Kholy
Mirko Mainardi
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Gerard de Noord
AkoSix
 

B D Finch  Identity Verified
France
Local time: 03:27
Member (2006)
French to English
+ ...
Ethics? What's that? Feb 15, 2019

The Misha wrote:

Ask yourself if you are out to change the world or simply want to make a living translating texts. If it's the former, good luck with it. I'll talk to you again in ten years.


Thank you to The Misha for reminding us that there are people in our profession who really don't give a toss about ethics. Perhaps those of us who manage to both make a living and maintain a moral conscience are not only better translators (professional bodies consider codes of ethics an important aspect of professionalism), but also have more self-respect.


Kay Denney
Mirko Mainardi
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Tom in London
Melanie Meyer
Christine Andersen
 

Tina Vonhof
Canada
Local time: 19:27
Member (2006)
Dutch to English
+ ...
You were right to report it Feb 15, 2019

It is not the episiotomy per sé that was unethical. It may be necessary in difficult deliveries. What was unethical in this study is the randomization, assigning women to a group, regardless of whether their condition required an episiotomy or not. This may have exposed some of the women to unnecessary risk and suffering. You were right to report it to the client and the human rights watch and I would also have reported it to the publisher of the journal. I think is editors of journals who shou... See more
It is not the episiotomy per sé that was unethical. It may be necessary in difficult deliveries. What was unethical in this study is the randomization, assigning women to a group, regardless of whether their condition required an episiotomy or not. This may have exposed some of the women to unnecessary risk and suffering. You were right to report it to the client and the human rights watch and I would also have reported it to the publisher of the journal. I think is editors of journals who should be particularly watchful for such a breach of ethics.Collapse


Liviu-Lee Roth
Lucia Moreno Velo
neilmac
MollyRose
 

Eliza Hall
United States
Local time: 21:27
Member (2018)
French to English
+ ...
Misunderstanding Feb 15, 2019

Lucia Moreno Velo wrote:

I am translating a review of medical literature and I find a study where women participants about to give birth are *randomized* to get an apisiotomy or not. Now, episiotomies are only to be given under certain circumstances and the extensive use of episiotomies is considered abusive and a form of violence against women. This practice also goes againts WHO guidelines and all guidelines I know. I would like to report this study. Can anyone direct me to any guidelines of ethics for translators that talk about actions to be taken when finding proof of illegal/unethical activity in a translation, please?


When and in what country was the study done? Where was it published? It's possible that at the time and/or in the country where it was done, it did not violate any ethical rules. There was a time not so long ago when episiotomies were routinely done as a preventive measure, to avoid severe tearing that would be more difficult to fix than a clean and straight episiotomy.

It's also possible (please don't take offense, I have to point this out) that you are misunderstanding what it says. After all, you're not translating the study where women were allegedly randomized to get episiotomies. You're translating a medical review -- that is, an article examining and summarizing a number of different studies. Could you have misunderstood the text? Or are you perhaps assuming that when women were randomized, their consent was not obtained? Just because study subjects are randomized doesn't mean they haven't given consent.


Dan Lucas
Liviu-Lee Roth
neilmac
 

Samuel Murray  Identity Verified
Netherlands
Local time: 03:27
Member (2006)
English to Afrikaans
+ ...
SITE LOCALIZER
On whether randomization is unethical Feb 15, 2019

Tina Vonhof wrote:
What was unethical in this study is the randomization, assigning women to a group, regardless of whether their condition required an episiotomy or not.


Well, none of us here know which study the OP is referring to, so it is difficult to state a position on whether randomization by itself was unethical in this particular case.

For example, there was a study on this issue in Brazil, which was randomized, but not blinded, so all of the participants knew into which group they were randomized (and were free to withdraw from the study at any time), and clinicians were allowed to deviate from the group characteristic if there were exceptional circumstances. In this study, group 1 never received an episiotomy except under exceptional circumstances, and group 2 always received an episiotomy if the clinician judged that it was in line with the institution's usual practice. It is difficult for me to imagine that such a study would be more ethical simply because participants would be allowed to choose in which group they wanted to be (as opposed to only being allowed to choose in which group they do not want to be).


[Edited at 2019-02-15 17:21 GMT]


Jorge Payan
Kaspars Melkis
 

Kaspars Melkis  Identity Verified
United Kingdom
Local time: 02:27
English to Latvian
+ ...
more information is needed indeed Feb 15, 2019

From what Samuel writes it seems that clinicians clearly believed that episiotomy is necessary in certain circumstances and the women fullfilling those criteria would have received the procedure in any case. Most likely, the study was done to prove that it is not necessary (except in exceptional cases) and women were chosen to not receive the procedure which would be otherwise done.

The risk was inevitable in either case whether the study confirmed the current practice or refuted i
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From what Samuel writes it seems that clinicians clearly believed that episiotomy is necessary in certain circumstances and the women fullfilling those criteria would have received the procedure in any case. Most likely, the study was done to prove that it is not necessary (except in exceptional cases) and women were chosen to not receive the procedure which would be otherwise done.

The risk was inevitable in either case whether the study confirmed the current practice or refuted it. Before reporting to human rights watch, I would contact the ethics committee (if there was one) who issued permission for this study and see their reasoning.

It is possible that there was a different study in another country were this procedure was still accepted at the time when there was already sufficient accumulated scientific evidence that it is too harmful. Regulatory bodies can be slow to update their guidelines to clinicians. Assuming that is the case, the study may not have scientific merit at all because it wouldn't tell anything that isn't already known. Invoving patients in a useless study is certainly unethical.
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B D Finch  Identity Verified
France
Local time: 03:27
Member (2006)
French to English
+ ...
To return to the subject Feb 15, 2019

I really don't think that it is the role of this forum to decide whether or not Lucia's concerns about the ethics of the research paper she is translating are justified. The point is that she has such concerns and asked for advice on what to do about it. There are, therefore two ethical problems here:

1) Whether the research was ethical. We don't have adequate information to judge that and it is a question that should be judged by the medical authorities AND by women. The medical pr
... See more
I really don't think that it is the role of this forum to decide whether or not Lucia's concerns about the ethics of the research paper she is translating are justified. The point is that she has such concerns and asked for advice on what to do about it. There are, therefore two ethical problems here:

1) Whether the research was ethical. We don't have adequate information to judge that and it is a question that should be judged by the medical authorities AND by women. The medical profession has a history of treating women extemely badly, particularly with regard to gynaecology and obstetrics. Feminists are changing that situation by challenging those misogynistic attitudes, though not in all countries. So, it is right that Lucia has raised her concerns in the way she has. Whether or not the research was legal or considered acceptable by the medical establishment in the country where it took place is irrelevant insofar as what is legal and acceptable is open to challenge;

2) The ethics of translating a research paper or review that appears to be unethical. This is about the role and responsibilities of the translator, including the duties to the client. It is wrong for us to try to judge whether Lucia has correctly understood the possible unethical nature of the research. What matters is whether she is concerned and what she should do about it. That depends on the context of the use that will be made of the translated paper and the available organisations with which the issue can be raised. There is also the issue of the translator having become aware of the research itself and whether that should be reported and whether doing so would be a breach of the confidentiality owed to the translation client.

With regard to the contributions by Samuel and Tina, the ethical issues with randomisation are very complex. It's not just a question of whether the women were given a choice, but also of what information they were given, how they were given it, whether they were pressured in any way in making their choice. There are also issues around how freely and under what conditions clinical judgement was exercised by the medical staff to override the allocation of women to groups. The design of the research would also need to control for bias introduced by choices made by participants, as those choices would involve factors, e.g. education and class that would affect the randomisation. So, the research would need to be assessed in detail.

[Edited at 2019-02-15 21:26 GMT]

[Edited at 2019-02-15 21:29 GMT]
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Teresa Borges
Carolina Finley
Morano El-Kholy
Lucia Moreno Velo
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jyuan_us  Identity Verified
United States
Local time: 21:27
Member (2005)
English to Chinese
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If the study was published, Feb 16, 2019

it may have been read by tens of thousands of healthcare professionals. Let's say 10,000 healthcare professionals have read it. If 1 out of 10 has the conscience of reporting it as unethical, what would happen?

Guess people have better things to do nowadays.

[Edited at 2019-02-16 20:27 GMT]


Liviu-Lee Roth
Jorge Payan
 

Philip Lees  Identity Verified
Greece
Local time: 04:27
Member (2008)
Greek to English
Ethics of randomisation Feb 16, 2019

Let me just make the point here that the only method currently accepted by the medical profession for evaluating a medical procedure objectively is by comparing its risks and benefits through randomised, controlled trials. This is the basis of so-called "evidence-based medicine" and such trials determine which drugs, therapies, etcetera, will become a part of standard medical practice.

It's possible that the OP's study was one of these randomised trials and was included in the liter
... See more
Let me just make the point here that the only method currently accepted by the medical profession for evaluating a medical procedure objectively is by comparing its risks and benefits through randomised, controlled trials. This is the basis of so-called "evidence-based medicine" and such trials determine which drugs, therapies, etcetera, will become a part of standard medical practice.

It's possible that the OP's study was one of these randomised trials and was included in the literature review for historical reasons.
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Kaspars Melkis
neilmac
 
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