When a deaf patient demands an interpreter

Q: One of my deaf patients is capable of communicating with me in writing or by typing on a computer. However, she insists on having a sign-language interpreter present when she comes to the office. Does the Americans with Disabilities Act oblige me to provide one?

A: It depends. The ADA requires you to make every effort to ensure that a hearing-disabled patient can understand you and express herself to you as effectively as your other patients. If you can achieve this with a computer, you don't have to provide an interpreter just because the patient prefers one.

However, before you reject her request, you'll need to assess both your patient's communication abilities and your own. How well can she read and write? Will her typing skills affect her communication? Can you explain complicated medical matters in ways she'll understand if you have to do it in writing? For lengthy conversations involving complex matters, a sign-language interpreter simply may be necessary for effective communication.

Be aware that even though the law may not obligate you to provide an interpreter, your patient may still file a complaint or bring a discrimination suit if she's unhappy with the computer solution. So be sure to document that you considered the patient's request, discussed the options with her, and based your decision on your evaluation of her communication needs.