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 sign language interpreters always required? Who is responsible for coordinating and paying for interpreting services? Many health care providers are uncertain about the answers to these questions and are unaware of their legal duty to establish effective communication with their deaf patients. Consequently, patients encounter considerable difficulty in getting sign language interpretation in medical settings. Many health care providers lack comprehensive policies for the provision of sign language interpreters. In addition, doctors practicing in their own offices are reluctant to pay for interpreting services out of their own pockets. Disturbingly, empirical evidence reveals that the absence of 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 pursuant to section 504 of the Rehabilitation Act and Title III of the Americans with Disabilities Act. The author discusses the meaning of ''effective communication'' and argues that, particularly in the case of profoundly deaf patients, the use of a qualified sign language interpreter is virtually the only means through which effective communication can occur. The author also explains why lesser attempts at communication-such as written notes, lip reading, and the use of unqualified interpreters-are ineffective and should be discarded. Instead, health care providers have an affirmative duty to establish a policy for the provision of sign language interpreters. To this end, the author proposes specific guidelines that health care providers should use in formulating such policies. The author also offers suggestions to assist health care providers in obtaining and financing the cost of qualified interpreters. Various options for obtaining interpreters are considered, such as utilizing registries and interpreter services, hiring full-time interpreters, and employing dual-status interpreters. Cost-saving measures, such as using interpreter services economically, taking advantage of tax credits, and supporting the creation of professional funds to pay interpreters' fees, are also discussed.