A study by the World Health Organization (WHO) reports that over 1.5 billion people worldwide have hearing loss, accounting for roughly 20% of the global population. Of these, 430 million individuals have severe hearing loss, which is projected to increase to 700 million by the year 2050. This is a pressing issue since the number of hard-of-hearing individuals is extremely high; however, little to no interventions are present to accommodate their needs in medical settings.


In this article, we delve into the importance of American Sign Language (ASL) as a vital communication tool for these communities and explore the challenges and opportunities it presents in medical settings.

American Sign Language: A Vital Tool for Medical Communication

American Sign Language (ASL) is a visual language used by the hard-of-hearing community in the U.S. and parts of Canada. In itself, ASL is a complete language, with its grammar, syntax, and vocabulary, which are very different from spoken languages. ASL is the lifeline for hard-of-hearing individuals, providing access to information and education and serving as a basis for them to express themselves. ASL is a foundational stone in the hard-of-hearing community and facilitates essential aspects of their life. It enables them to interact with their peers, acts as a source of cultural expression storytelling, helps them advocate for their rights and equality, and helps them seek healthcare and mental health services.

Problems Faced By the Hard of Hearing Community in Healthcare Settings

Hearing-impaired individuals often face profound barriers in clinical settings, discouraging them from going for timely follow-ups and decreasing the quality of healthcare services.

  1. Communication Barriers: Hearing-impaired individuals often face communication barriers. Many of them rely on ASL or written communication. In the absence of interpreters, correct and in-depth information about their health conditions does not reach them.
  2. Lack of Access to Information: The complexity of our healthcare system is mind-boggling to everyone. The hard-of-hearing community suffers the most in this regard. With no or underqualified interpreters, it becomes perplexing for them to understand the cost, requirements, and other documentation needed for a medical procedure.
  3. Technological barriers: Telehealth services have now become a major part of our healthcare system and have proven to be beneficial in desperate times. Unfortunately, not many hospitals and community centers are equipped with this technology resulting in a non-inclusive environment for deaf individuals.
    Legal and Ethical dilemmas: Making informed decisions is a crucial step to starting any medical procedure. There may be legal and ethical dilemmas related to informed consent when communication barriers prevent hard-of-hearing patients from fully understanding their medical procedures and options.

ASL Interpretation: The Key To Inclusivity

ASL interpretation can help the deaf community in various settings. It is the key to bridging the communication gap between healthcare professionals and deaf patients.

  • ASL interpretation helps deaf patients relay proper history and symptoms to the doctors. This is the key to an accurate diagnosis. This is of prime importance in emergencies.
  • It gives the patients their right to informed decision-making. It helps them understand and weigh the risks, benefits, and alternatives.
  • ASL interpreters can help patients understand their medicines’ dosage and time duration. This approach achieves improved patient compliance and reduced risk of medication errors.

The availability of effective communication between hard-of-hearing patients and doctors enables them to have the same level of healthcare services as any other individual. This reduces the risk of potential complications and increases the quality of healthcare provided. It also has a huge benefit of increased adherence to treatment plans and, in general, a much more enhanced success of treatment plans.

You might be wondering, if ASL is such an important component of the hard-of-hearing community, are there any legal rights for the availability of ASL interpreters in healthcare settings?

Good news, yes, there are!
Under the Americans with Disabilities Act (ADA) of 1990, healthcare providers must provide effective communication to the hard of hearing individuals by all means. It becomes more essential to ensure the presence of an interpreter when the exchange with the patient is long and complex. Examples may include discussing a patient’s medical history, obtaining informed consent, and permission for treatment.
This includes the availability of a qualified sign language interpreter, tactile interpreter, real-time captioning, video relay services, remote interpretation through telecommunication, or any other means possible. Appropriate auxiliary aids and services, as denoted by ADA, include equipment or services a person needs to understand aural communication. For example, qualified
interpreters, assistive listening devices, notetakers, written materials, television
decoders, and telecommunications devices for the hard of hearing individuals.
According to the ADA, a qualified sign language interpreter should be able to understand and interpret hard-of-hearing patients and convey information to them effectively. The interpreter should be present at all times when exchange of formation is required; such as, history taking, informing the patient about their condition, explaining to them the different treatment options, gaining consent, prescribing medications, etc.

Risks And Consequences of Miscommunication In Healthcare

The first step to making any diagnosis is noting the medical history. The signs and symptoms occurring to the patient tell a lot about the disease they might be having. For diagnosing hard-of-hearing patients, history-taking becomes a huge challenge without an ASL interpreter.

  • Miscommunication leads to misdiagnosis, eventually leading to the wrong treatment choice and even more complications.
  • The patient might be unable to inform the doctor about his allergies, which can even be fatal. For example, penicillin and nut allergies.
  • In certain conditions, some drugs are highly contraindicated. Without an interpreter, the deaf patient might be unable to explain his comorbidities, and the doctor may end up prescribing a drug that should not be given.
  • Before any treatment, explaining the potential risk factors to the patient is important. This helps the patient in making informed decisions and giving consent.
  • People who are hard of hearing often find it difficult to understand instructions, which can result in over or underdose of medications.
  • Another important aspect of a good treatment is familiarizing the patient with any treatment or surgery they are about to undergo. This helps in reducing anxiety and often helps with keeping the vitals normal. Deaf patients may be stressed if they fail to discuss their procedure with an interpreter.

Key Takeaways

Ensuring easy access to healthcare services is a fundamental human right that should be extended to everyone, including our hard-of-hearing population. Unfortunately, there has been a glaring lack of measures in place to accommodate their unique communication needs within healthcare settings. This oversight is especially concerning given that even minor miscommunications can lead to severe complications in medical care. A solution to this pressing issue is the widespread inclusion of professional translation services for ASL interpretation in hospitals and healthcare facilities. By facilitating efficient and accurate exchanges of information, ASL interpreters play a pivotal role in ensuring effective communication, a critical factor, particularly in emergency medical situations.