The ideal person to act as an interpreter in these situations is a cultural interpreter. This person can not only translate the words and conversation but interpret the appropriate social customs and mores and help in dealing with areas of cultural incongruity by interpreting the worldview and resultant desire for care on each side of the physician/patient relationship. Unfortunately, cultural interpreters are uncommon and difficult—if not impossible—to obtain for all cultures that an intensivist may come into contact with. Many persons who act as interpreters can, although not trained, act as a valuable cultural resource. This, however, requires the practitioner to understand their limitations and the potential problems, and to ask the interpreter the proper questions about approach to the family and patient, and manner of dealing with them. A true interpreter, as opposed to a translator, will perform some of these tasks. They may say, for example, that in a particular culture the phrase “we' ll think about it” generally means “we have decided to proceed but must wait a respectable period of time.” That is the difference between a strict translator of words and an interpreter of meaning. An interpreter is the least that is required for true understanding; but again, this is not possible in many hospitals and in many situations, e.g., in the middle of the night where decisions are crucial and the abilities and resources at hand must be used. All too often a family member is recruited to translate. To make matters worse this is often a minor who knows English by virtue of school. Only under extreme circumstances should a family member be used to translate. Conscious and unconscious filtering are common in this situation. Almost as bad, a person who is available but untrained in either communication skills or medical interpreting is drafted into service. Hospitals have lists of translators but these persons have generally received little or no formal training. If these persons must be used (and realistically it cannot be avoided), training should be mandatory. It should not be forgotten, however, as with any other tool in the ICU, that using a strict translator is not using the optimal resource and obtaining the optimal information, and that inaccurate information may well be transmitted.