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Patient Care

thumb HSE guidelines re interpreting 2011 2HSE guidelines re interpreting 2011.pdf.zip798.68 KB

zipDeaf Adults for whom ISL (Irish Sign Language) is their first or preferred language form a linguistic community.  They expect to be able to access the expertise of health care givers from a professional language service professional.  They as adults are entitled to the same degree of privacy from family members as patients with average hearing.  A deaf adult may wish not to inform his/her family of the full facts of their illness or condition until they choose to do so.  Using the services of a qualified and professional interpreter ensures that you are communicating through a competent and highly skilled interpreter.  The patient can have confidence in the quality of the communication.  ISL is not a visual or manual representation of English.  It differs significantly in grammar and structure from English.  As in all communities, literacy levels in a second language range from the proficient to severely impaired.  Research indicates that many deaf people (80%, Irish Deaf Society website, 2009) do not have functionally proficient levels of skill in English and many studies attribute this to education systems.

Using family members to assist with communication in medical / health settings

We do not recommend this practice.  A family member is not neutral or impartial.  They are emotionally involved and may not aware or in a position to operate within the confines of the role.  This is very important; in particular to ensure that the deaf patient’s concerns are addressed, and to ensure that any decisions made are actually the decision deaf adult’s decision based on clearly conveyed information.  While in spoken language one might find children born in Ireland to parents from another country who may be balanced bilinguals in both languages.  However, in the vast majority of cases, the deaf person is the only member of the family to use sign language.  Sometimes a family member will learn sign language to a level sufficient for social conversation.  They do not have the degree of fluency to convey accurately medical histories, information regarding experience of pain, etc.

Quality Assurance

At CSL Studies, we strive to excel through high performance standards in the services we provide.  We will only appoint interpreters with appropriate training and skills who are registered as category R1 to facilitate communication in medical settings.  It is important to be vigilant and avoid serious errors by engaging assistance from family members or friends who have limited knowledge of sign language, or from students of sign language who have only studied the language at beginner levels in courses designed to teach social conversational skills.  90% of deaf people are the only deaf member of their families.  This creates a different home-language than that of bilingual families with two spoken languages.  Children may grow up with a foreign language as the home language and English as the language they use in education and subsequent employment.  Deaf children have traditionally acquired their signing skills at schools for the deaf and other deaf friends.  Their families may not know sign language and may study a very basic level course giving them rudimentary skills.  Deaf people should be provided with competent practitioners who will have the skills to convey messages between medical professionals and a deaf client with efficiency and accuracy.

Video Link via web cam

Interpretation may happen via video-link.  At this early stage in the development and usage of video-link interpreting, CSL remain open minded to its potential but are cautious about its usage in order to ensure ‘safe and accurate’ working environments.  At this point we recommend that the video-link be used only in a limited range of routine appointments and in situations where an interpreter can not be made available locally. We will monitor the progression of video-link cautiously.

Using an interpreter and interpreting are personal experiences. Communication isn’t only about knowing a language and having qualifications. It’s about understanding the needs, choices and personality of the other people. It’s about expecting to feel comfortable in a situation, and not having to explain yourself all the time or fight for what you need. (


HSE National Service Plan 2009
Fairness and Equity,


‘We will pursue equality of access and delivery of the full range of services for everyone, based on need.’ Page ii.

Irish Sign Language is Different to English!

The vocabulary and grammatical structure of Irish Sign Language is very different to that of the English language.  ISL is not a manual gestural representation of English.  ISL has a relatively small number of ‘fixed’ items of vocabulary but utilises a facility called ‘productive’ lexicon to extend its vocabulary.  This means that ISL is a high context language, the manual form representing a concept is produced with a finite set of handshapes and a range of movement rules are applied to mark for grammatical functions such as manner and aspectual information. The Irish Deaf Community identifies themselves as a linguistic community with a culture and heritage of their own.  ‘Culture and communication are inseparable because culture not only dictates who talks to whom, about what, and how the communication proceeds, but it also helps determine how people encode messages, the meanings they have for messages, and the conditions and circumstances under which various messages may or may not be sent, noticed or interpreted.’ Samovar and Porter 1982:32 in Mindness 1999:20.