Translators of patient information leaflets: translation experts or expert translators? A mixed methods study of lay-friendliness

Patient Information Leaflets (PILs) are mandatory texts in the EU accompanying all medication. They must inform users about dosage, side effects, etc. in order to foster informed decision-making and patient empowerment. By its nature, the PIL genre is complex aiming at instructing lay people about complex medical content, i.e. mediation of specialized medical knowledge across a knowledge asymmetry. Legally, PILs must be “written and designed to be clear and understandable” (Article 63(2) of EU Directive 2001/83/EC, European Parliament and of the Council, 2001), here termed “lay-friendly”; however, many studies have shown that PILs are generally difficult to understand for laypeople. Askehave and Zethsen found in their 2002 study that translated Danish PILs are linguistically more complex than their English source texts. One possible explanation could be that PILs are frequently translated by pharmacists, who do not possess the linguistic tools and translation knowledge necessary for expert-to-layman translation or interlingual translation. This PhD explores this by use of a mixed methods research design involving three empirical studies: 1) The first study identifies Danish PIL translators as professional translators and pharmacists, and it maps these profiles against a model of translation competence and a literature review of research on medical translators. The outcome of this study is the hypothesis that Pharmacists – compared to professional translators - lack translation competence in relation to lay-friendly PIL translation. 2) The second study aims to explore the above hypothesis by identifying possible differences in two translation corpora of pharmacists and professional translators in terms of lay-friendliness. The analysis of the two corpora uses a contrastive linguistic framework focussing on elements such as the use of nominalization, compounds nouns and medical terminology. Results show that both corpora contain many instances of literal translation choices to the detriment of lay-friendliness and choices leading to increased complexity. However, in the pharmacist corpus, significantly more Latin-based terms and nominalizations are found than in the professional translator corpus. 3) The third study seeks to gain an understanding of the reasoning behind the translation strategies used in PILs by conducting two focus groups with professional translators and pharmacists, respectively. Results show that the lack of lay-friendliness in PILs is not mainly linked to lack of translation competence or intratextual reasons, but extensively to contextual constraints such as tight deadlines for translation, poor mandatory templates and authoritative bodies and reviewers with limited interlingual and intralingual translation knowledge.