Variation in knowledge and attitudes among overdose prevention collaborations: Insights from fatality review teams.

Historically, the understanding of deafness has transitioned from a pathological view towards a human rights approach. Under the traditional medical-rehabilitative paradigm, the deaf person was considered a «body with a deficit» that required correction to integrate into the hearing norm. This perspective, called audism, operates as a structure of discrimination that values the ability to hear and speak over visual and gestural experience, ignoring the psychosocial dimension of deafness . However, the emergence of the social model of disability and deaf studies ( have redefined this condition not as a deficiency, but as an experience of human diversity that gives rise to a community with its own identity, history, and language through sign language (SL) . From public health, this paradigm shift is decisive because it positions the deaf community as a linguistic minority whose access depends on the adequacy of healthcare environments. The sociocultural approach and deaf studies have consolidated this perspective by recognizing a community with its own identity and culture, sustained by the use of SL, in contrast to the medical model . In articulation with the disability discourse, this has favored the recognition of rights and the demand for adjustments to guarantee equitable access to health, education, and other services . However, globally, close to 70 million deaf people continue to face barriers in health, mainly due to communication difficulties . Evidence shows that this gap operates as a social determinant of health, increasing the risk of erroneous diagnoses, weakening therapeutic adherence, violating informed consent, and being associated with worse health outcomes . Therefore, linguistic access constitutes an ethical and human rights imperative. In Chile, it is estimated that more than 500 thousand deaf people or people with hearing disabilities live, who continue to face access limitations and persistent forms of exclusion due to the insufficiency of state policies that effectively incorporate the sociocultural approach . Although normative advances and the ratification of international treaties have established explicit obligations to protect their linguistic and cultural rights, including linguistic autonomy recognized in recent laws such as Law N.º 21.303 , these frameworks have not consistently translated into sustained transformations within the public health institutionality. In this context, the growing judicialization of health care expresses the gap between legal recognition and health practice, and suggests the persistence of audist dynamics that hinder the effective incorporation of SL and perpetuate exclusion .