What is the most appropriate approach when discussing goals of care with a patient who speaks only Spanish in an ICU setting?

The most appropriate approach when discussing goals of care with a patient who speaks only Spanish in an ICU setting is to request the use of a hospital interpreter. This ensures that the communication is accurate and clear, which is crucial in a high-stakes environment like the ICU, especially when discussing complex topics such as goals of care.

Using a professional interpreter minimizes the risk of miscommunication and misunderstandings that could arise from language barriers. Professional interpreters are trained to accurately convey medical information and to facilitate discussions in a sensitive manner, respecting the nuances of the patient's language and cultural context. This approach helps build trust between the healthcare team and the patient, ensuring that the patient's preferences and values are adequately communicated and understood.

Involving family members as translators can lead to potential conflicts of interest, inaccuracies, or emotional challenges that may interfere with the discussion. Speaking slowly and clearly in English might not be effective if the patient has limited proficiency in the language, and simply writing down information does not allow for an interactive dialogue or clarification of understanding. Thus, using a hospital interpreter is the best practice in this scenario.