When a patient who is deaf arrives at an emergency room, instead of providing an in-person sign language interpreters, some hospitals offer them VRI, which is immediately available. If the hospital were to use an in-person sign language interpreter instead of VRI, there would be a delay in providing the service, often several hours, depending on the travel time for the interpreter. Where time is of the essence, provision of a sign language interpreter through VRI makes sense, and is a reasonable option, despite the drawbacks of VRI, which will be discussed further below. However, where time is no longer of the essence, VRI should not be used - instead, an in-person sign language interpreter should be provided.
According to the Registry of Interpreters for the Deaf (RID) and a position paper by the National Association of the Deaf (NAD):
"If at any time the deaf consumer is not comfortable with the physical set-up, the technology and/or the remote interpreter, it is the consumer’s right to decline use of VRI in medical settings." http://www.rid.org/UserFiles/File/pdfs/Standard_Practice_Papers/VRI_SPP.pdf#page5.
According to RID:
"As with any medical situation, assessment of the individual’s communication needs and the nature of the event will determine which service is optimal for effective communication. Medical situations that may not be conducive for VRI include:
• Some mental health settings (see the Mental Health Section for more information);
• Initial meetings with a specialist;
• Highly sensitive communications (e.g., diagnosis of a serious illness);
• Eye exams;
• Some occupational and physical therapy sessions;
• Patient transport.
An onsite interpreter may be preferable in these situations due to the communication and logistical complexities involved. A patient’s stress level is often elevated during a medical visit; introducing a new technology may increase their discomfort."
It is important for hospitals to be aware of the concern of patients who are deaf, regarding use of VRI. When a doctor is conducting an examination of a patient, communication occurs not only through what is said, but also through body language and physical gestures. Where VRI is used, the patients ability to observe the doctor's body language and physical gestures is severely compromised. As a result, use of VRI in these circumstances likely violates the ADA, since effective communication does not result, due to the failure to provide the appropriate auxiliary aid or service.