ENSURING EFFECTIVE COMMUNICATION - THE DUTY OF HEALTH-CARE PROVIDERS TO SUPPLY SIGN LANGUAGE INTERPRETERS FOR DEAF PATIENTS

When a profoundly deaf patient arrives for treatment at a hospital or doctor's office, how should communication barriers be overcome? Are si gn language interpreters always required? Who is responsible for coord inating and paying for interpreting services? Many health care provide rs are uncertain about the answers to these questions and are unaware of their legal duty to establish effective communication with their de af patients. Consequently, patients encounter considerable difficulty in getting sign language interpretation in medical settings. Many heal th care providers lack comprehensive policies for the provision of sig n language interpreters. In addition, doctors practicing in their own offices are reluctant to pay for interpreting services out of their ow n pockets. Disturbingly, empirical evidence reveals that the absence o f interpreters in medical settings causes great anguish for individual deaf patients and endangers the overall health of the deaf community. This Note clarifies the extent to which health care providers have a duty to ensure effective communication with their deaf patients pursua nt to section 504 of the Rehabilitation Act and Title III of the Ameri cans with Disabilities Act. The author discusses the meaning of ''effe ctive communication'' and argues that, particularly in the case of pro foundly deaf patients, the use of a qualified sign language interprete r is virtually the only means through which effective communication ca n occur. The author also explains why lesser attempts at communication -such as written notes, lip reading, and the use of unqualified interp reters-are ineffective and should be discarded. Instead, health care p roviders have an affirmative duty to establish a policy for the provis ion of sign language interpreters. To this end, the author proposes sp ecific guidelines that health care providers should use in formulating such policies. The author also offers suggestions to assist health ca re providers in obtaining and financing the cost of qualified interpre ters. Various options for obtaining interpreters are considered, such as utilizing registries and interpreter services, hiring full-time int erpreters, and employing dual-status interpreters. Cost-saving measure s, such as using interpreter services economically, taking advantage o f tax credits, and supporting the creation of professional funds to pa y interpreters' fees, are also discussed.