The Legal and Ethical Care of Patients Who are Deaf or Hard of Hearing with an Emphasis on Communication Methods

Background: As the deaf and hard of hearing population has increased over the last few decades, the prevalence of American Sign Language as a person’s primary language has increased with it. However, many optometrists are unsure as to how to approach an exam, and what the law requires to accommodate these patients. This literature review explores the legal and ethical considerations of examining and communicating with patients who are deaf or hard of hearing. Methods: Through literature review, information was gathered and summarized from many high quality publications and legal cases as to how to properly care for and communicate with a patient who is deaf or hard of hearing, with special attention to the legal and ethical requirements of an optometrist. Results: To optimize the health care environment for patients who are deaf or hard of hearing, the most important step is for optometrists to understand local resources, such as sign language interpreters, legal support, and community agencies, that can benefit both the patients and their chair time. This varies depending on what the deaf/hard of hearing patient needs and should be adjusted accordingly. The supplemental use of pictures or diagrams to illustrate tests or procedures may also help solidify communication between patient and doctor but may not be a substitute for “effective communication” as outlined in the Americans with Disabilities Act. Above all, it is important to meet these legal requirements, as well as address the specific needs of the patient, preferably with preparation before the exam. In addition, this information in this literature review is summarized in pamphlet format for distribution to the optometric community. Conclusion: The Americans with Disabilities Act lays out legal guidelines that physicians must follow when it comes to patients who are deaf or hard of hearing, including optometrists. It is important for optometrists to study these requirements and be aware of them, should the situation arise when a patient who is deaf or hard of hearing schedules or presents in a clinical setting.