There is an unfortunately high number of ways that translation in healthcare can go wrong. We won’t dwell on the more obvious ones in this post since they’re, well, pretty obvious! It’s disturbingly easy to find news stories and social media posts about the alarming consequences of neglecting to translate or relying on unqualified translators and interpreters to communicate health information and provide translation in healthcare. We’ll be turning our attention in this post to some of the less evident, but equally important, challenges of translation in healthcare.
One of these is the question of whether a certain word, phrase, or idea “translates well.” If you look up “hygge” or “saudade,” you’ll find plenty of assertions that attempts to translate these terms into English never truly capture their full essence. For terms like these, it can be appropriate to say that the word has no direct translation, and a longer explanation for what they mean is generally not unwelcome. This is tricky territory for translation in healthcare. It’s crucial that patients fully understand their condition and/or treatment, and it would never be appropriate to simply say that a medical term “doesn’t translate” into the target language. Fortunately, giving a brief explanation of the English term may be a straightforward solution to something that “doesn’t translate well.”
For example, we translated a patient handout about a certain medication’s side effects in 2023. One of the side effects listed was “chills or shaking chills.” The German translation was originally back translated as “excessive chills or cold shivers.” Our client was concerned that the use of the word “excessive” might cause a patient to ignore chills as a symptom of a life-threatening reaction to the medication. When we asked the translator about the slight discrepancy, they provided the following explanation:
“There are no two separate terms — “chills” and “shaking chills” are usually both translated with the term for “shaking chills” (Schüttelfrost).”
They further explained that to capture the difference in German, they translated “chills” as “feeling excessively cold” (Übermäßiges Frieren). The back translator, working within the context of a medical document, chose the translation “excessive chills,” as that sounds more like something you’d read in a medication insert compared to “feeling excessively cold.” Since the latter, however, is a more literal translation and alongside “cold shivers” captures the meaning of original English, that is the back translation we submitted to PRC.
Another translation in healthcare that can be challenging is “quality of life claims.” As the name suggests, these are claims that using a certain drug (or other product) will result in an improved quality of life. The FDA stipulates that pharmaceutical advertisements cannot lawfully “make claims that are not supported by adequate evidence” or “overstate the drug’s benefits.” FDA regulations also require that prescription drug advertising “reveal material facts about the drug.” What adequate evidence can support that a drug will “give you a new life” or “help you get more out of your daily activities”? Since those assertions are very difficult, if not impossible, to verify with quantitative evidence, it is safer not to use them. It could also be argued that without some sort of measure for what a “new life” or “getting more out of life” means, it wouldn’t necessarily be incorrect to say that these are overstatements of a drug’s benefits. In order to avoid disciplinary action that can not only cost a company money but also compromise its reputation, it’s best to steer clear of quality of life claims when doing translation in healthcare.
We encountered this issue when working on a translation for the hepatitis B drug VEMLIDY. The slogan “It’s about the moments” appears on their website and in some of their patient brochures. This could hardly be construed as a claim, but the trade-off is that this wording can be very challenging, or even impossible, to capture in translation. For example, what is “it” referring to? Not all languages have an equivalent way to capture such a generalization. And speakers of some languages may even reject a subtle rewording such as “life is about the moments” as a meaningless platitude. Specifying what type of moments could be a good start, but even then, you may run into skeptical attitudes towards attempting to define what “life is about” in a single sentence. Translation in healthcare marketing is a fascinating and sometimes complicated intersection between appealing to consumers and abiding by regulatory requirements. (Incidentally, we’ve worked on similarly challenging marketing copy for an alcohol brand – you can read about it in our blog post about common challenges in marketing translations.)
If you’re new to translation in healthcare, you may need to focus on overcoming the most glaring difficulties that this field can present. If you’ve been in the healthcare translation space for a while, you may need to address the more subtle issues that creep in, especially when creative copy and/or regulatory review is involved. Either way, we’d love the opportunity to help you communicate effectively with non-English-speaking patients.
