Bioethical challenges in communication between physicians and deaf-mute patients: an integrative review

Abstract

Effective communication is a cornerstone of high-quality medical care. For deaf-mute patients, the absence of a reliable verbal channel poses serious bioethical challenges, particularly regarding the respect of patient autonomy, the integrity of informed consent, and diagnostic accuracy and precision. The study aimed to identify and analyze bioethical challenges caused by communication barriers in the doctor-pacient relationship with profound deafness, focusing on respecting autonomy. The study consisted of a documentary analysis of international bioethical guidelines, national legislation, USMF Library articles, and WHO protocols. Recent sources ( 2019-2024 ) were thoroughly examined using a quantitative comparative method, aiming to highlight current trends and existing gaps in ethical practice. In 64% of the studies analyzed, diagnostic delays were attributed to ineffective communication. Only 28% of institutions had access to sign language interpreters, while informed consent was correctly obtained in just 36% of cases. Written communication proved effective in just only 31% of interactions. The lack of structured communication protocols and insufficient staff training were associated with decreased patient satisfaction and a higher risk of malpractice. No quantitative statistical tools were used, as the study relied entirely on qualitative analysis, focused on the ethical context and interpretive depth. The hypothesis was confirmed: communication barriers negatively affect ethics in medical practice, impacting the quality of care. Clear communication protocols, staff training, and expanded access to specialized interpreters for profoundly deaf patients are urgently recommended.