It is possible to develop foreign language consent forms, but medical terms are often idiosyncratic to regional dialects. For example, there are many patient education materials available in Spanish. These materials may be in textbook Spanish, perfectly intelligible to nonnative Spanish speakers who learned Spanish in school. They may be in the dialect of the translator. They may be hybrid documents in a Pan-American patois. Whatever the case, they may be unintelligible to Spanish speakers who did not learn formal Spanish.

The major problem with dialects is not just that parts of a translated form will not be intelligible to the patient. The same idiomatic medical terms may be used in different dialects but with different meanings. Sometimes this is just embarrassing. Usually it results in the patient’s believing that he or she understands the form, which he or she does in the context of the dialect, but misunderstands what is about to be done. This problem is similar to the functional illiterate who recognizes some words but cannot make out the subtle meaning of the document.

The best solution for non-English speakers who may not read standard-school Spanish or another well-defined national languange is to have someone who is medically knowledgeable explain the treatment to the patient in his or her own dialect, with the physician present to answer questions. Ideally the physician should be able to understand enough of the patient’s language to know if the translation is appropriate. Real informed consent is very difficult if the patient and the physician have no common language.