Lawsuit filed to eliminate patient translator requirement

By: EDWARD SIFUENTES - Staff Writer | Monday, August 30, 2004 10:06 PM PDT ∞

SAN DIEGO ---- Several doctors and an advocacy group filed a lawsuit Monday seeking to repeal a four-year-old executive order that requires some hospitals and doctors to provide translation services for patients who don't speak English.

The suit was filed on behalf of several doctors, a national doctors' association and an organization that promotes making English the nation's official language.

The law that requires translation services costs doctors and hospitals too much and could drive up the cost of health care, said attorneys with the Pacific Legal Foundation, a Sacramento-based legal advocacy group that filed the suit. Coldwell said patients' family members who may speak English are sometimes the best translators available. Family members also may be the best advocates for their loved ones, he said.

"The decision about whether or not an interpreter is needed, or is truly in the best interest of the patient, is no longer up to the physician in charge," said Dr. Clifford Coldwell, a San Diego doctor who is one of the plaintiffs in the case. "It is established by remote government bureaucrats."

Representatives of some of the area's largest hospitals said they disagreed with the group that filed the suit, saying that providing translation services for patients is an expensive but necessary service in such a diverse region. About 25 percent of the county's 3 million residents are Latino, and many of them are new immigrants.

"We are absolutely committed to provide information to patients in a language that they understand," said Gustavo Friederichsen, a spokesman for Palomar Pomerado Health, which operates two North County hospitals, Palomar Medical Center in Escondido and Pomerado Hospital in Poway.

The suit, filed in federal court in San Diego, targets Executive Order 13166, which was signed in 2000 by then-President Bill Clinton. The order said federally funded services, such as Medicare, should be made accessible to people who do not speak English.

President George W. Bush's administration reaffirmed the executive order in 2001, saying the order would prevent service providers from discriminating on the basis of national origin in violation of the Civil Rights Act of 1964.

The lawsuit names the U.S. Department of Health and Human Services and Tommy Thompson, head of the agency, as defendants.

The Pacific Legal Foundation is a group that has taken up conservative causes, such as eliminating benefits for illegal immigrants and barring bilingual education.

Arthur Mark, an attorney with the group, said including language as a basis for discrimination stretches the legal limits of the Civil Rights Act.

"This mandate is a prime example of executive and bureaucratic fiat stretching clear statutory language beyond recognition just to advance a political agenda," he said.

Attorneys for the plaintiffs said the executive order could lead to lawsuits that could hike up insurance rates, forcing doctors to opt out of government-funded programs. However, they said they had no evidence of that happening.

Immigrant rights groups took issue with the suit.

Dr. Jane Delgado, president of the National Alliance for Hispanic Health, a Washington-based group that works to improve the health of Latinos, said patients with limited English skills need to fully understand what their doctor is saying.

Relying on family members to translate opens the door for problems, she said, adding that some patients don't want relatives to know about their medical conditions and some relatives lack the skills to translate medical terms accurately.

Coldwell, who is medical director of Scripps Clinic Center for Orthopaedic Research, said he joined the lawsuit because he felt it was "the right thing to do." He said his son, Christopher Coldwell, an emergency room doctor in Denver, was threatened by a patient with a civil rights claim if an interpreter was not immediately provided.

Coldwell's son is also named as a plaintiff in the lawsuit. The other plaintiffs include ProEnglish, a nonprofit advocacy group, and the Association of American Physicians and Surgeons, a group representing about 5,000 doctors.

Dr. Jane Orient, executive director of the association, said the federal mandate could make doctors liable for discrimination under the Civil Rights Act if they are unable to provide translators or fail to comply with the mandate.

"In order to keep their doors open, physicians must be able to pay their bills," she said. "They cannot afford to routinely see patients at a cost that exceeds the fee they are allowed to charge."

The Associated Press contributed to this report.

Contact staff writer Edward Sifuentes at (760) 740-5426 or esifuentes@nctimes.com.

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