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Perspect Biol Med ; 65(2): 179-188, 2022.
Article in English | MEDLINE | ID: mdl-35938425


Requesting accommodations such as signed language interpreters in health-care settings is an activity that can present risk to the deaf patient. By providing space for considerations of risk-taking for particular kinds of experiences that are not universally shared, such as interpreter-mediated experiences, the notion of the dignity of risk can be expanded. The author uses two examples of signed language interpreting in health-care settings to demonstrate how the dignity of risk emerges. This is followed by an analysis of the concept of epistemic injustice as applied to insider knowledge of the deaf community and the potential harms to one's dignity resulting from this asymmetry of knowledge. The essay concludes with an evaluation of concerns about dignity and risk for deaf individuals.

Respect , Sign Language , Humans
Am J Public Health ; 110(10): 1523-1527, 2020 10.
Article in English | MEDLINE | ID: mdl-32816541


This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician-patient communication, nondiscrimination and reasonable accommodations, and rationing of medical goods), and indicate possible solutions. Finally, we suggest clinical and public health policy measures to ensure that people with disabilities are included in the planning of future pandemic-related efforts.The devastation evoked by the COVID-19 pandemic raises challenging dilemmas in bioethics. It also speaks to social justice issues that have plagued historically marginalized communities in the United States.Responses to the pandemic must be bound by legal standards, principles of distributive justice, and societal norms of protecting vulnerable populations-core commitments of public health-to ensure that inequities are not exacerbated, and should provide a pathway for improvements to ensure equitable access and treatment in the future.

Coronavirus Infections/epidemiology , Delivery of Health Care/ethics , Disabled Persons , Health Policy , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , Disabled Persons/legislation & jurisprudence , Emergency Medical Services , Health Care Rationing , Health Planning , Humans , SARS-CoV-2 , United States/epidemiology , Vulnerable Populations
Hastings Cent Rep ; 50(3): 28-32, 2020 May.
Article in English | MEDLINE | ID: mdl-32596899


In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) "Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations," which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both distributive and recognitive justice. The disability rights movement's demand "Nothing about us, without us" requires substantive inclusion of disabled people in decision-making related to their interests, including in crisis planning before, during, and after a pandemic like Covid-19.

Coronavirus Infections/epidemiology , Disabled Persons , Health Equity/ethics , Pneumonia, Viral/epidemiology , Social Justice/ethics , Standard of Care/ethics , Betacoronavirus , COVID-19 , Communication , Health Equity/legislation & jurisprudence , Humans , Pandemics , SARS-CoV-2 , Social Justice/legislation & jurisprudence , Standard of Care/legislation & jurisprudence
Kennedy Inst Ethics J ; 27(2): 267-299, 2017.
Article in English | MEDLINE | ID: mdl-28736422


This paper carves out a topic space for discussion about the ethical question of whether input from signing Deaf consumers of interpreting services ought to be included in the provision of signed language interpreter accommodations. The first section provides background about disability accommodations and practices, including how signed language interpreting accommodations are similar and dissimilar to other kinds of disability accommodations. In the second section, I offer a personal narrative of my experience as a Deaf academic who has been excluded from the interpreter selection process, highlighting some of the harmful consequences of such exclusion. In the subsequent two sections, I describe and analyze the process of choosing interpreter accommodations, starting with the process of requesting signed language interpreters and the institutionalization of this process, followed by a brief overview of privacy and autonomy concerns from the standpoint of the signing Deaf consumer. The penultimate section considers some objections to the proposal of involving more consumer choice in signed language accommodations. I conclude the paper with some concrete suggestions for a more Deaf-centered, inclusive process for choosing interpreter accommodations.

Choice Behavior , Deafness , Disabled Persons/psychology , Sign Language , Translating , Communication Barriers , Humans