When interpreting live, we tend to use a general term for something common like baby bottle or shortness of breath, and then reflect back whatever word the patient uses, so we can get aligned with that individual. But we don’t have the luxury of direct feedback and harmonizing with the patient when we do written translations. We have to choose at a great distance from our nebulous potential readers. And everyone has a personal lexicon, so three translators on a project means three opinions.
If there are two or three (or five) words that different patients use, say, for baby bottle nipple, then should we just list all of them in our written documents, and use hyphens, slashes, or parentheses? Well, no. Not if our patient population has difficulty reading even simple text, as many refugees do. The use of symbols, such as parenthesis, cuts of the flow of the text and acts as a hindrance for comprehension.
Use the most general term, then, but what does that mean? Which word is most general? Which is correct? Which is best understood? Translation teams can spend hours of research proving to each other that their specific term is “best”. And a lot of it is simply personal preference or style.
One word for baby bottle nipple in my target language comes from teat. But more patients use a word that comes from mammary. That word, to complicate matters, is used by some patients to mean the whole baby bottle, and by others to mean just the nipple. There are also a couple of versions of baby bottle nipple that come from the word to suckle, but various patients consider that a pacifier and not a baby bottle nipple. Then we have a subgroup who use an indigenous term that is part of the name for Mother Earth, but also means both time and space as a combined concept.
Of course, I personally prefer the last one, as it is lovely. The life-giving maternal nipple providing space-time nourishment so that the infant can remain embodied and continue to travel through time. I also prefer this term because I happened to have lived among the people who use it, and I feel comfortable and even comforted by the term. It is in the collection that makes up my personal lexicon – the words that are my familiar tools.
But getting back to documents for publication at hospitals. One of the best sources, in an ideal world, would be to look through prior translations and continue the path begun by presumably professional translators in the past. But unless they are done with computer-assisted translation memory, I have found that all the organizations I have worked for, both large and small, have pretty much a mishmash of random choices made by the random translators, even on words as simple as breast. So this is not reliable or definitive, either.
In the end, translators may have to use a search engine and see how many millions (or mere thousands) of hits a specific term has. Then look at sources written in the target language by reputable groups. We can ask our patients, but it ends up being such a tiny sample size, and I am not sure all patients would be comfortable being asked “how do you say baby bottle” while they are trying to get their own medical care.
So we do the best we can and settle down on a general term, after our best judgment. We do research to resolve any doubts. And hopefully if the chosen term is used consistently throughout all our documents, patients have a good chance of understanding it. An imperfect science, like many others.