本研究的目的有二：了解同理心如何融入醫療口譯，以及試圖解釋為何醫療口譯服務使用者對不同醫療口譯員的角色看法不同。本研究整理醫療口譯服務使用者對醫療口譯員的觀點調查和醫療口譯員的倫理守則，發現醫療口譯員的四種角色中，傳聲筒、澄清者、文化中介者的角色行為被視為恰當行為，倡議者的角色行為則有許多爭議。本研究假設這個現象和口譯員的態度中立與否有關，由於中立態度非常抽象，但剛好是同理心的必備條件，因此本研究用同理心理論來檢驗各個口譯員角色的態度，以驗證研究假設並達成第二個研究目的。同理心理論同時用以探討同理心融入醫療口譯的方法，並達成第一個研究目的。

本研究比對醫療口譯和同理心，發現在情境、口譯員和同理者的溝通技巧與態度中立上有很多相似處，並由此驗證口譯員也有同理口譯服務使用者。本研究因此依據單語醫療情境中的同理心理論模型，加入雙語情境的特性，發展雙語醫療情境中的同理心理論模型，包括表達同理心模型和同理心環模型。用這些理論模型以及同理心的表達技巧檢驗各醫療口譯員角色的態度，研究結果發現：
1.傳聲筒、澄清者、文化中介者都忠實翻譯使用者的語意，並表達對講者的同理心給聽者聽，但倡議者的多數角色行為既非翻譯，也沒有表達同理心。因此傳聲筒、澄清者、文化中介者的態度是中立的，而倡議者的態度多為不中立，此發現驗證本研究的假設。
2.擔任文化中介者的醫療口譯員在翻譯講者的語意時，因為同理聽者和講者的文化差異，而表達對講者的高層次同理給聽者聽，亦即在譯文中顯化(explicitation)講者未明確說出的文化意涵，或歸化(domestication)講者的表達至符合聽者文化背景的表達方式，以增進雙方對彼此的了解並協助溝通。
3.傳聲筒角色只負責語言轉換，澄清者、文化中介者則認為協助溝通是他們的首要工作，倡議者則最重視捍衛醫療口譯服務者的權利或表達其個人意見。

本研究提出醫療口譯員的角色架構，並強調同理心和態度中立的重要，應用至醫療口譯理論中，能幫助口譯員清楚覺察角色轉換、了解採取非中立角色行為可能的負面影響，並學習如何在醫療口譯中融入同理。本研究建議政府建立醫療口譯中介機構，由該機構負責培訓口譯員、提供口譯員諮詢、媒合口譯服務、協調服務使用者和口譯員的溝通、提供客訴服務…等，倡議者角色的非中立行為即可由該中介機構負責，讓口譯員的角色功能更一致。本研究結果亦可運用至口譯員訓練課程，幫助口譯員了解自己的角色及功能、同理心的概念與技巧、態度中立的重要，以及和中介機構的合作與角色分工。

This study aims to understand how empathy is demonstrated in medical interpreting and explain the inconsistent views of medical interpreting service users on different medical interpreters’ roles. Among the four roles adopted by medical interpreters, surveys on service users and interpreter’s codes of ethics show that some tasks taken by an advocate are regarded controversial while behaviors of a conduit, a clarifier and a culture broker are considered appropriate.

Comparing settings, communicative skills and attitudes of neutrality between medical interpreters and empathizers, great similarities are identified. Based on the confirmation that medical interpreters empathize with service users, this study expands levels of expressed empathy and empathy cycle models in a monolingual two-way setting to a bilingual three-way setting. Published cases of medical interpreting are analyzed to find that:
1.Roles of conduit, clarifier and culture broker perform interpreting and express empathy while an advocate neither performs interpreting nor expresses empathy in most of the cases. Roles of conduit, clarifier and culture broker are thus neutral while an advocate is mostly not neutral;
2.A culture broker also empathizes with the receiver of the rendition and thus expresses advanced empathy with the speaker by making implicit culture factors explicit in rendition or domesticating the source utterance in the way the receiver is used to;
3.A clarifier and a culture broker prioritize their tasks of communication facilitation over merely linguistic transformation like a conduit while an advocate values on defending service users’ rights or more often on expressing personal opinions.

Findings of this study can be utilized to provide a theoretical framework of roles for medical interpreters in practice. Medical interpreters therefore can have a clearer awareness of role switching, the possible negative consequences of adopting the non-neutral role and how to demonstrate empathy. In addition, to establish an independent organization of medical interpreting is suggested. The organization should be responsible for medical interpreters’ training and supervision, dispatch of medical interpreting services, mediation between interpreters and stakeholders of medical services when conflicts arise and so forth. Through this system, medical interpreters are more likely to maintain a neutral stance. In terms of training medical interpreters, results suggest that the content of training should include clear framework of roles, concept and skills of empathy, the demonstration of neutral attitudes and how to work with the organization.

Alexander, C., Edwards, R., Temple, B. with Kanani, U., Zhuang, L., Miah, M., &
Sam, A. (2004). Access to services with interpreters: User views. Retrieved from Joseph Rowntree Foundation website:
http://www.jrf.org.uk/publications/using-interpreters-access-services-user-views
Alexieva, B. (1997/2002). A typology of interpreter-mediated events. In F. Pöchhacker & M. Shlesinger (Eds.), The interpreting studies reader (pp.218-233). New York, NY: Routledge.
Anderson, L. (1994). Simultaneous interpretation: Contextual and translation aspects. In S. Lambert & B. Moser-Mercer (Eds.), Bridging the gap: Empirical research in simultaneous interpretation (pp.101-120). Amsterdam & Philadelphia: John Benjamins.
Angelelli, C. V. (2000). Interpretation as a communicative event: A look through Hymes’ lenses. Meta: Translators’ Journal, 45(4), 580-592.
Angelelli, C. V. (2004). Revisiting the interpreter’s role: A study of conference, court, and medical interpreters in Canada, Mexico, and the United States. Amsterdam: Benjamin.
Avery, M.-P., B. (2001). The role of the health care interpreter: An evolving dialogue. Retrieved from The National Council on Interpreting in Health Care: http://www.a2hc.org/articles/The%20role_of_health_care_interpreter.pdf
Baker, M. (1992). In other words: A coursebook on translation. London & New York: Routledge.
Barrett-Lennard, G. T. (1981). The empathy cycle: Refinement of a nuclear concept. Journal of Counseling Psychology, 28(2), 91-100.
Barrett-Lennard, G. T. (1993). The phases and focus of empathy. British Journal of Medical Psychology, 66, 3-14.
Boland, Jr. R. J., & Tenkasi, R.V. (1995). Perspective making and perspective taking in communities of knowing. Organization Science, 6(4), 350-372.
Borgatta, E. F., & Montgomery, R. J. V. (Ed.). (2000). Encyclopedia of sociology (2nd ed., Vol.4). New York, NY: Macmillan Reference.
Brown, J. D. (2001). Using surveys in language programs. New York, NY: Cambridge University Press.
Cambridge, J. (2004). Public service interpreting: Practice and scope for research. In C. Schäffner (Eds.), Translation research and interpreting research: Traditions, gaps and synergies (pp.49-51). Clevedon, England: Multilingual Matters.
Carkhuff, R. R. (1969). Helping and human relations (Vol. 1 and 2). New York, NY: Holt, Rinehart & Winston.
Chen, J. W. (2006). Explicitation through the use of connectives in translated Chinese: A corpus-based study (Unpublished doctoral dissertation). University of Manchester, the United Kingdom.
Clark, A. J. (2010). Empathy and sympathy: Therapeutic distinctions in counseling. Journal of Mental Health Counseling, 32(2), 95-101.
Colman, A. M. (2001). A dictionary of psychology. New York, NY: Oxford University Press.
Corey, G. (2001). Theory and practice of counseling and psychotherapy (6th ed.). Belmont, CA: Wadsworth/Thomson Learning.
Davou, B. (2007). Interaction of emotion and cognition in the processing of textual material. Meta, 52(1), 37-47.
Duan, C., & Hill, C. E. (1996). The current state of empathy research. Journal of Counseling Psychology, 43(3), 261-274. doi: 10.1037/0022-0167.43.3.261
Dysart-Gale, D. (2005). Communication models, professionalization, and the work of medical interpreters. Health Communication, 17(1), 91-103.
Egan, G. (1975). The skilled helper: A model for systematic helping and interpersonal relating. Monterey, CA: Brooks/Cole.
Egan, G. (1998). The skilled helper: A problem-management approach to helping (6th ed.). Pacific Grove, CA: Brooks/Cole.
Eisenberg, N., & Strayer, J. (1987). Critical issues in the study of empathy. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp. 3-13). Cambridge: Cambridge University Press.
Fan, M.-y. (2011). Healthcare interpreting in Taiwan: A case study of healthcare interpreters in public health centers in New Taipei City (master’s thesis). Retrieved from http://www.lib.ntnu.edu.tw
Gamal, M. Y. (2009). Court interpreting. In M. Baker & G. Saldanha (Eds.), Routledge encyclopedia of translation studies (2nd ed., pp.63-67). London & New York, NY: Routledge.
Gentile A., Ozolins, U., & Vasilakakos, M. (1996). Liaison interpreting. Melbourne: Melbourne University Press.
Gladstein, G. A. (1983). Understanding empathy: Integrating counseling, developmental, and social psychology perspectives. Journal of Counseling Psychology, 30, 467-482.
Håkansson, J., (2003). Exploring the phenomenon of empathy (Doctoral dissertation, Stockholm University, Department of Psychology). Retrieved from http://www.emotionalcompetency.com/papers/empathydissertation.pdf
Hale, S. B. (2007). Community interpreting. Basingstoke, Hampshire: Palgrave Macmillan.
Harres, A. (1998). But basically you’re feeling well, are you? Tag questions in medical consultations. Health Communication, 10, 111-23.
Hill, C. E. (2009). Helping skills: Facilitating exploration, insight, and action (3rd ed.). Washington: American Psychological Association.
Hornby, A. S. (Ed.). (2010). Oxford advanced learner’s dictionary of current English (8th ed.). Oxford: Oxford University Press.
Hsieh, E. (2006). Conflicts in how interpreters manage their roles in provider–patient interactions. Social Science & Medicine, 62(3), 721-730.
Hsieh, E. (2007). Interpreters as co-diagnosticians: Overlapping roles and services between providers and interpreters. Social Science & Medicine, 64(4), 924-937.
Hsieh, E. (2008). “I am not a robot!” Interpreters’ views of their roles in health care settings. Qualitative Health Research, 18(10), 1367-1383.
Huang, H. H. (1991). 助人歷程與技巧 [Helping process and skills]. Taipei, Taiwan: Living Psychology Publisher.
International Association of Conference Interpreters (AIIC) (2005). How do we interpret. Retrieved from http://aiic.net/page/1739/how-do-we-interpret/lang/1
International Association of Conference Interpreters (AIIC) (2012). Interpreting is not translating. Retrieved from http://aiic.net/page/4002/interpreting-is-not-translating
Jones, R. (1998). Conference interpreting explained. Manchester, England: St. Jerome Publishing.
Kaufert, J. M., & Putsch, R. W. (1997). Communication through interpreters in healthcare: Ethical dilemmas arising from differences in class, culture, language, and power. The Journal of Clinical Ethics, 8, 71-87.
Keller, S., & Stricker, G. (2004). Countertransference. In W. E. Craighead & C. B. Nemeroff (Eds.), The concise Corsini encyclopedia of psychology and behavior science (3rd ed., pp. 233). Hoboken, NJ: John Wiley & Sons.
Kelly, N. (2008). Telephone interpreting: A comprehensive guide to the profession. Victoria, Canada: Trafford.
Klaudy, K. (2009). Explicitation. In M. Baker & G. Saldanha (Eds.), Routledge encyclopedia of translation studies (pp. 104-108). London: Routledge.
Kohut, H. (1959). Introspection, empathy, and psychoanalysis: An examination of the relationship between mode of observation and theory. Journal of American Psychoanalytic Association, 7, 459-483.
Liaw, C. C. (2004). A pilot study on counselor’s inner information processing of expressed empathy (master’s thesis). Retrieved from http://www.lib.ntnu.edu.tw
Marcus, L. J., Dorn, B. C., & McNulty, E. J. (2011). Renegotiating health care: Resolving conflict to build collaboration (2nd ed.). San Francisco, CA: Jossey-Bass.
Mesa, A. M. (2000). The cultural interpreter: An appreciated professional. Results of a study on interpreting services: Client, health care worker and interpreter points of view. In R. Roberts, S. Carr, D. Abraham & A. Dufour (Eds.), The critical link 2: Interpreters in the community (pp.67-79). Amsterdam & Philadelphia: John Benjamins.
Moser-Mercer, B. (1997/2002). Process models in simultaneous interpretation. In F. Pöchhacker & M. Shlesinger (Eds.), The interpreting studies reader (pp.148-161). New York, NY: Routledge.
Munday, J. (2008). Introducing translation studies: Theories and applications (2nd ed.). New York, NY: Routledge.
National Council on Interpreting in Health Care (NCIHC) (2004). A national code of ethics for interpreters in health care. Retrieved from http://hospitals.unm.edu/language/documents/ncihc.pdf
Nida, E. A. (1995). Dynamic equivalence in translating. In S.-W. Chan & D. E. Pollard (Eds.), An encyclopaedia of translation: Chinese-English, English-Chinese (pp. 223-230). Hong Kong: Chinese University Press.
Niska, H. (2000). Community interpreter training: Past, present, future. In G.Garzone & M.Viezzi (Eds.), Interpreting in the 21th century: Challenges and opportunities (pp. 133-144). Amsterdam: John Benjamins.
Pickett, J. P. (Ed.). (2000). The American heritage dictionary of the English language (4th ed.). Boston, MA: Houghton Mifflin.
Pöchhacker, F. (2000). The community interpreter’s task: Self-perception and provider views. In R. Roberts, S. Carr, D. Abraham & A. Dufour (Eds.), The critical link 2: Interpreters in the community (pp.49-66). Amsterdam &Philadelphia: John Benjamins.
Pöchhacker, F. (2004). Introducing interpreting studies. London & New York: Routledge.
Pugh, M. A., & Vetere, A. (2009). Lost in translation: An interpretative phenomenological analysis of mental health professionals’ experiences of empathy in clinical work with an interpreter. Psychology and Psychotherapy, 82, 305-321.
Redmond, M. V. (1989). The functions of empathy (decentering) in human relations. Human Relations, 42(7), 593-605.
Reynolds, W. J., & Scott, B. (1999). Empathy: A crucial component of the helping relationship. Journal of Psychiatric and Mental Health Nursing, 6, 363-370.
Roat, C. E. (2011). Healthcare interpreting in small bites: 50 nourishing selections from the “Pacific Interpreters Newsletter,” 2002-2010. Lexington, KY: Traford.
Robinson, D. (1998). Paraphrase. In M. Baker (Eds.), Routledge encyclopedia of translation studies (pp.166-167). London: Routledge.
Rogers, C. R. (1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centered framework. In S. Koch (Eds.), Psychology: A study of science. Study 1. Conceptual and systematic: Vol. 3. Formulations of the person and the social context (pp. 184-256). New York, NY: McGraw-Hill.
Rogers, C. R. (1975). Empathic: An unappreciated way of being. The Counseling Psychologist, 5(2), 2-10.
Roy, C. B. (1993/2002). The problem with definitions, descriptions and the role metaphors of interpreters. In F. Pöchhacker & M. Shlesinger (Eds.), The interpreting studies reader (pp. 345-53). London & New York: Routledge.
Rubovits-Seitz, P. F. D. (1999). Kohut’s Freudian vision. Hillsdale, NJ: Analytic Press.
Scott, J., & Marshall, G. (Ed.). (2009). Oxford dictionary of sociology (3rd ed.). New York, NY: Oxford University Press.
Seleskovitch, D. (1978). Interpreting for international conferences. Washington, DC: Pen and Booth.
Smaby, M. H., & Maddux, C. D. (2011). Basic and advanced counseling skills: The skilled counselor training model. Belmont, CA: Brooks/Cole, Cengage Learning.
Tebble, H. (1999). The tenor of consultant physicians: Implications for medical interpreting. The Translator, 5(2), 179-99.
Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psychotherapy: Training and practice. Chicago, IL: Aldine.
VandenBos, G. R. (Ed.). (2007). APA dictionary of psychology. Washington, DC: American Psychological Association.
Vasquez, C., & Javier, R. A. (1991). The problem with interpreters: Communication with Spanish-Speaking patients. Hospital and Community Psychiatry, 42(2), 163-165.
Venuti, L. (1994). Translation and the formation of cultural identities. Current Issues in Language & Society, 1(3), p. 201-217.
Venuti, L. (2008). The translator's invisibility: A history of translation (2nd ed.). London: Routledge.
Viany, J.-P., & Darbelnet, J. (1995). Comparative stylistics of French and English: A methodology for translation (J. C. Sager & M.-J. Hamel, Trans. & Eds.). Amsterdam & Philadelphia: John Benjamins.
Wadensjö, C. (1998). Interpreting as interaction. London & New York: Longman.
Wadensjö, C. (2009). Community interpreting. In M. Baker & G. Saldanha (Eds.), Routledge encyclopedia of translation studies (2nd ed., pp.43-48). London & New York: Routledge.
Wilcox, S., & Shaffer, B. (2005). Towards a cognitive model of interpreting. In T. Janzen (Eds.), Topics in signed language interpreting (pp. 135-164). Amsterdam & Philadelphia: John Benjamins.
Wispé, L. (1986). The distinction between sympathy and empathy: To call forth a concept, a word is needed. Journal of Personality and Social Psychology, 50(2), 314-321.
Wispé, L. (1987). History of the concept of empathy. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp. 17-37). New York, NY: Cambridge University Press.
Yang, W.-F. (2010). Brief study on domestication and foreignization in translation. Journal of Language Teaching and Research, 1(1), 77-80.