Cultural “Deafness”: about more than language

Even before we arrive at medical school it is obvious that good communication skills are vital for a successful and hassle-free medical career. Nodding your head while a patient talks and you pretend to write, when you are in fact completing a sudoku (which, for those who don't know, is a numerical puzzle), is nobody's idea of good communication. But are we really doing our best to communicate?

One of the attractions of a medical career is that you can expose yourself to not only a wonderful array of pathogens but also a wide range of people. The opportunity to meet people from different backgrounds and cultures is for some one of the great allures of medicine (and also backpacking). But this is also one of the profession's greatest challenges.

A recent topic of discussion in the media is the refusal of Deaf parents to allow their deaf children to have cochlear implants, which could provide some form of audible stimulation. So what am I trying to say? Am I implying that all health professionals should run out and learn sign language? Well, that wouldn't be a bad idea. Or am I suggesting that through more effective communication all deaf parents would opt in favour of cochlear implants-certainly not.

One in seven people in the United Kingdom has some form of hearing loss, from mild to moderate to profound deafness.¹ Individuals view their hearing loss differently: some may refer to themselves as “deaf” (socialising within the hearing community), while others may refer to themselves as culturally “Deaf” (socialising within the Deaf community). These Deaf people do not view themselves as disabled, but as part of a proud linguistic minority with its own beliefs and culture whose preferred language is sign language. However, this is not universally true-for example, a person who is deafened may feel a sense of loss.

In Britain today, sign language is the main language of the Deaf. It is a language independent of English with its own structure and with no written form, meaning native users may have difficulty communicating in written English.

Like spoken language, sign language has national and regional variations, with different signs used to express the same meaning. Different people may use different forms of sign language instead of or as well as sign language-for example, sign supported English, which is a sign language based on English.

If a Deaf parent refuses a cochlear implant they may do so because they wish their child to grow up in the community that they experienced and may fear a cochlear implant would cause exclusion. A Deaf parent may also experience a sense of loss if their child is hearing, in the same way that hearing parents may experience a sense of loss if their child is deaf.

Communicating with Deaf people is not all about sign language and interpreting. Acknowledging that they may have differing beliefs and culture can make a huge difference towards understanding their position and helping them to make the best decision, though learning sign language always helps. See www.cacdp.org.uk for more information on learning sign language.

1. Royal Association for Deaf people. An introduction to deafness. www.royaldeaf.org.uk/page.php?id=100107 (accessed 7 Jun 2006).

       

           

	REVIEWS Cultural "Deafness": about more than language       Emma Joanne Wilding (July 2006)
	Jemima Tagal (July 1st, 2006)       3rd Year Medicine,UWCM, Cardiff jemmtt@yahoo.com
	I was pleased to read Emma Wilding's article 'Cultural "Deafness": about more than language'. It was an insightful take on the Deaf community, of which many of us know very little about. Miss Wilding highlights the fact that one in seven people in the UK have some form of hearing loss, hence they are a larger community than we realise. The deaf are a group of people with different views of their 'diability' - indeed, some do not even see it as such. Some would not even care to speak with non-deaf people, even if they knew how to Sign. Some may consider only the profoundly deaf 'the elite', choosing to socialise only within this group. What then are our roles as healthcare professionals who may come into contact with them? Well, as Miss Wilding says, learning Sign Language wouldn't be a bad idea. I am currently in the second part of the British Sign Language (BSL) Foundation course, having passed Basic BSL, and I am enjoying it immensely. However, I am not only learning a language, I am learning about another culture. I am learning that we are all different in very subtle ways. Even if we are blessed to be born with all senses intact, our religious, educational, social, cultural, and ethnic backgrounds make us very different from each other. Good communication is a vey fine skill of eliciting where the patient is coming from, what they want to know, and how they want this information disseminated. In my humble opinion, it is essential to the success of a doctor-patient relationship. A deaf person is, in essence, no different to you and me. If they are ill, they would like to be treated. They deserve effective communication about their condition, investigations and medication. And they should not be patronised by healthcare professionals, inadvertantly or otherwise. They deserve to be understood. Even if I never meet a deaf person in the course of my career, this insight is very valuable in understanding how to communicate effectively with the deaf community, without stigmatising, and with much empathy.