By J. Parrish Lewis
I am writing this letter to you in hopes that you will be enlightened by a health-related crisis that is affecting the Deaf community.
I would like to start out by saying that your profession is a noble one. Your work is valued worldwide. It is challenging, and sometimes may feel thankless. Your costs are often increasing, which we can understand have the potential for frustration. Your education was expensive, and you may have loans to pay off.
Sometimes, when you have a deaf patient, you see the cost of the interpreter, and it may seem like one more cost you cannot shoulder.
You might tell the patient, “Bring your own interpreter,” not knowing that the patient would have mixed feelings about bringing a family member. Whether or not that family member is qualified to interpret, they are still emotionally tied to the patient. That family member might step out of his/her role, taking the lead away from the deaf patient. That family member might not interpret everything you say. Perhaps the information is summarized. Perhaps things are omitted.
Or worse, you tell your patient that he has cancer, and it’s his daughter who has to relay that information through signs. You saved money by not paying for an interpreter, but now she has to tell her Dad that he’s got cancer.
Of course, a situation doesn’t need to be that extreme to have a measurable impact. You tell a mom, through her son interpreting, that she needs to watch her diet. You give valuable guidance. You see the son signing, and you assume that he’s qualified, not knowing that he’s not skilled enough to explain it adequately. She thinks she’s following your advice, but much like the game of Telephone, your words got distorted.
Your deaf patients want to know what you are saying. They want your words expressed in a language they understand. They want effective communication, protected by laws such as the Americans With Disabilities Act. And, you will be following the HIPAA Privacy Rules.
For a wheelchair user, barriers are physical: Doorways, steps, hallways, and other architectural issues that you need to keep in mind in order to provide access to services. These are accommodations you readily make, because you know it’s the right thing to do. For the deaf and hard of hearing, language access is where our barrier lies. It’s not about hearing. It’s about receiving your words, your language, your advice. Our accommodations have been invented and crafted and developed, ready for us to use. A qualified and certified American Sign Language interpreter remains one of the deaf community’s treasured resources and follows code of ethics. For deaf and hard of hearing patients who do not sign, perhaps detailed notes are what is needed. Your patient will tell you.
You don’t expect wheelchair users to pay for renovations to give them access to your office and restrooms. Likewise, accommodations addressing language access need to be provided to the deaf and hard of hearing. If your office does not provide an interpreter, patients may resort to either doing without an interpreter or bringing someone who may not be qualified. This impedes proper healthcare.
As a doctor, you want your advice followed. You chose the profession because you care about people. Let your words be heard through the hands of a sign language interpreter when requested by the patient. Or, if the patient asks you to write everything down, both questions and answers, please take the time to meet this request.
You don’t want those patients walking out of the door confused, misinformed, or uncertain about what is next. You want your patients leaving your office, ready and able to take charge of their health with information gained from you.
I took the time to write this letter because I know you truly care about the clients you serve and strive to ensure that the essential healthcare needs of your patients are met to the very best of your abilities. I ask that you please keep what I have written in mind when you are asked to make decisions in your practice about the interpreter needs of your patients. I thank you for your time and consideration.
For information about the legal obligations of Doctors, as pertains to deaf and hard of hearing patients, please visit the Department of Justice’s ADA website at http://www.ada.gov/
For a handy guide, the National Association of the Deaf has a very informative page on this topic: