Author: Michele Juskowitz

Healthcare’s Lack of ASL Interpreters

Henry Ford Health is an integrated healthcare organization based in Michigan, and in an ongoing federal court case, Sparks v. Henry Ford Health System et al., the organization was sued for alleged disability discrimination in violation of the Patient Protection and Affordable Care Act (ACA).

The Plaintiff in this case, Kerri Sparks, is a frequent patient of one of the organization’s hospitals and requested an in-person interpreter for an upcoming pre-surgery education class since she is deaf and can only communicate through American Sign Language (ASL) and by lip reading. Due to a clerical error, the hospital’s in-person ASL interpreter was unavailable, so the hospital deployed a Video Remote Interpreter (VRI). Due to connection issues, Sparks was left without an interpreter. Sparks was given a printout of the information covered in the class and the instructor wore a clear face shield so that Sparks could lip read, but despite these efforts, Sparks was unable to understand what the instructor was saying and left the class confused about her upcoming surgery.

Despite Sparks’ request for an interpreter on the day of her surgery, the hospital failed to provide one. Although not fluent in ASL, the hospital had Sparks’ boyfriend interpret for her, leaving Sparks once again confused and unable to communicate with staff regarding her surgery.

Section 1557 of the Affordable Care Act prohibits “discrimination on the basis of race, color, national origin, sex, age or disability in a health program or activity, any part of which is receiving Federal financial assistance.” Congress implemented this provision with the understanding that discrimination in healthcare settings can contribute to disparities, especially when it results in a patient being unable to comprehend the nature and consequences of the healthcare services being provided to them. Section 1557 stipulates that healthcare providers receiving federal financial assistance, like Henry Ford Health, must “take appropriate steps to ensure that communications with individuals with disabilities are as effective as communications with others in such programs or activities.”

The U.S. District Court in the Eastern District of Michigan found there to be genuine issues as to whether the hospital provided Sparks with the auxiliary aid necessary to ensure effective communication for surgery and was unable to resolve this question on summary judgment. The parties have yet to settle and are moving towards trial.

Deaf patients like Sparks experience significant health disparities and are at an increased likelihood of experiencing inadequate communication with doctors and other medical staff. It is estimated that there are around 500,000 to one million deaf users of American Sign Language (ASL) in the United States, and many of whom have experienced interpreter-related barriers to healthcare services. Deaf patients are more likely to experience misunderstandings and a lack of communication when sign language interpreters are not provided to them because only a small percentage of deaf patients who use ASL have to opportunity to directly communicate with their healthcare providers.

The lack of ASL interpreters in healthcare settings is a persist issue and will continue to disadvantage the deaf community until such needs are met. Patient-provider trust relationships and effective communication have been shown to result in positive health outcomes in patients, but when ASL interpreters are either not provided or are insufficient, there is an increased likelihood that the relationship between deaf patients and their providers will be negatively impacted. To protect patients like Sparks and ensure that they are provided with the necessary information to make informed decisions about their health, medical schools should consider implementing a Deaf Health Pathway (DHP) seminar. During DHP seminars medical students shadow medical interpreters to learn the intricacies of interpretation. Through DHP, medical students learn basic ASL and grammar before progressing to learning how to communicate with deaf patients themselves. DHP immerses students in ASL and deaf culture so that America’s future doctors can bridge the gap in care for deaf communities across the country. Although DHP seminars are currently in the early stages of development and studies are needed to explore the long-term outcomes of such programs, DHP seminars might be a solution for the lack of ASL interpreters in the healthcare industry.