The value of a life must be equal

It is often said, that in the face of death, we are all equal. But when it comes to emergency communication, this doesn’t always seem to be true. What is behind the statistics showing that persons who are deaf or hard of hearing use emergency communication 3-4 times more in the UK than in Sweden? And how come the Netherlands have legislation in place since 2014 that includes solutions that are deemed “impossible” in for example Sweden and in other EU member states?

It may seem absurd to calculate the worth of a life, but it is an economic measure used to assess the benefit of avoiding a fatality. It’s also known as the cost of life, value of preventing a fatality (VPF), implied cost of averting a fatality (ICAF), and maybe most often called the value of a statistical life (VSL).

In the realms of social and political sciences, it signifies the marginal cost of preventing death under certain circumstances. From a human perspective, it may seem morally questionable to see life as anything but priceless. But the concept of value of life holds significance across various fields including economics, healthcare, policymaking, insurance, workplace safety, environmental assessments, globalization, and industrial safety.

It must also be possible to apply when it comes to accessibility.

Laws, technology and understanding user needs

The European Electronic Communications Code (EECC 2018/1972) and its Delegated Regulation require that Real-Time Text (RTT) be implemented in all services that deliver voice by June 2025, and to Emergency Services by 2027. The EECC also requires that location information be sent when RTT calls are connected (also known as geolocation), and that access to 112 be available when travelling within the European Union to all citizens, including Deaf, DeafBlind and Hard of Hearing. No registration should be required to access Emergency Services.

The European Accessibility Act also includes requirements for emergency communication. An important part of making emergency communication even more accessible is to provide Total Conversation (voice, RTT and video), so that people who are Deaf, DeafBlind or Hard of Hearing can call an ambulance or the fire brigade on equal terms with what the majority of us does: make direct calls to emergency services, send geolocation, and enable the call taker to make a call back when necessary.

This is already implemented in some countries, for instance in France, the Netherlands and in the UK.

In France, four different numbers are used to call emergency services (police, ambulance, fire brigade, and one single number used by people who Deaf, DeafBlind and Hard of Hearing. RTT (OTT) is possible via the special number 114.

In the Netherlands, people who are Deaf, DeafBlind and Hard of Hearing can make direct calls to emergency services (112) and send geolocation on equal terms with everyone else since 2015, using RTT (over the top, OTT) to 112. Call back is possible using the app’s phone number. Starting 2024, the services are improved even more when Total Conversation including geolocation is required by law. Native RTT to 112 – making it even easier for users to handle – is being introduced during the first half of 2025.

In the UK, Total Conversation is already possible using the web or an OTT app, no registration is necessary. The call is made via an interpreter agency, geolocation is passed through to the 112/999 call taker. Callback is possible using the app’s phone number or a temporary number in the system.

Even though the UK is not a member of the European Union, OFCOM (telecom regulator) requires that sign language be accessible for Emergency calls. OFCOM also requires that geolocation is sent in Emergency calls, registration should not be required, and call back be available. Statistics show the importance of Total Converation: the UK, with a Deaf population 10 times larger than in Sweden, there is an average of 1500 calls to 999 (Emergency Service) per month using Total Conversation. In Sweden, there is only an average of 40 calls per month that are made by Deaf people using Total Conversation via the Relay Service to 112, which statistically represents 1/4 of the calls made in the UK. Moreover, it is not possible to send geolocation or to call back to the caller if needed, and the Deaf user needs to register before making a call.

In the Netherlands, there is an average of 55 calls per month made using RTT to 112 (Emergency Services). In Sweden, the average is 23 per month using RTT via the Text Relay Service. With a Deaf population that is 2/3 of the the Dutch Deaf population, the number of calls made using text to emergency services in Sweden are roughly 40%. Neither geolocation nor call back are possible in Sweden.

Statistics are challenging to interpret, but the stark variations observed among countries underscore a concern that certain individuals may be marginalized within society and denied the opportunity to seek assistance when needed.

For some reason, the need for RTT is one of the most difficult requirements to agree on among various stakeholders. To me, it seems obvious that we have to make sure that every life counts equally, no matter of abilities. EU legislation requires that RTT is available in June 2025, and Total Conversation in 2027. But when technology is available and proven to work effectively, why not implement the technology earlier in order to save lives? Or rather, what is the real cost of waiting?

Susanna Laurin, ETSI/CEN/CENELEC JTB eAccessibility Chair

Real-Time Text (RTT) is text transmitted instantly, character by character, as it is typed. Recipients can immediately read the text while it is being written, without waiting.

Total Conversation (TC) is a standard for synchronous communication that uses video, voice and Real-Time Text.

Over The Top (OTT) is technology (services or platforms) that delivers streamed content via internet-connected devices.

Native services are available on the network and directly on the devices, such as voice, SMS and RTT. RTT has been available natively in the devices and in the network in the US since 2019, but in Europe we will have to wait until June 2025.

Public- safety answering point (PSAP) is a call center where emergency calls are handled by first responders, who connect these calls to the police, fire department, emergency medical services/ambulance as necessary.