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More Specific Responses: 
ijed: I'm actually quite impressed with text-to-speech these days. My TTS GPS does an amazing job of reading road names in English, which, of course, is a notoriously non-phonetic language.

Spirit: Thanks for the link! I'm going to try to check that out. 
But Can They Say 'Guinness' 
That's the ultimate test ;)

I remember an article about HL2 praising the subtitle option. Seems obvious enough now, but a few short years ago it was new and inventive.

And it's still not applied as a standard. 
Although 
I like the criticism RPG raises, there is a metaphor that explains a lot of them away: a Quake level is an obstacle course made of art. 
Inertia 
Are all games an obstacle course made of art? If not, why is Quake different?

Maybe I'm not clear what you mean. I had fun making and running through obstacle courses as a kid. It didn't matter if I was climbing a "boring" wall or Michelangelo's David; it was still fun. 
RPG 
The point I intended to make is that no one bothers to make obstacle courses accessible to quadriplegics :) 
 
i think that pretty much fully addresses the issue here.

fps levels are visual medium first and an audio medium second.

if you can't see, you're missing out on say 70% of the level. even if there was a way to convey the visuals to someone who was blind, would they enjoy it at all?

i'm not blind, so i can't say for certain, but having a voice over explain to me what the atrium looks like and where the exits are isn't really appealing. i'd rather just put on a good song or something. 
So If You Have Any Disability, You Should Not Play Quake? 
inertia: But we make education accessible to people with mental disabilities, no? No one is expecting them to win a Nobel Prize (although some could--keep in mind there are far more types of mental disabilities than retardation and autism); however, our society says it is unacceptable not to make reasonable accommodations for them. Should we therefore make no effort to create a bionic suit so that a quadriplegic could run an obstacle course? Or if you lost a leg (god forbid), should we not provide you with a prosthetic limb so that you could still run the obstacle course?

necros: But not everyone who is disabled is blind. Even if we restrict the discussion to only visual impairment, there is a full range of problems. These include total blindness, color blindness, only having peripheral vision, only being able to see shapes and not fine detail, and the list goes on. For most visual problems it probably would be most effective to change the engine or monitor. But what about other disabilities? 
RPG 
I'm on your side here, I'm about as egalitarian as anyone I've ever met--but you can't pretend that listening to a symphony in Braille is equivalent to hearing it. I'd like the disadvantaged to have the ability to approximate the experience to the fullest extent possible, but it won't be the same (we should try, it's worth it, but it will not be the same (until we get our neural plugs)). With Quake, I really don't know how to approximate it for those who suffer from deafness/blindness/immobility. 
Don't Devolve The Conversation 
There are no sides.

Designing with impairment in mind is a short step away from what we do anyway. I think that's what RPG was driving at.

I'm guessing he's come into contact with someone recently who has trouble playing games but likes to.

Until the day that you plug cables into your head there'll always be problems. We don't lower the kerb on street corners because we're good people.

9/10 suffer from a mental disability. (9/10 statistics are made up on the spot). But why do we not just let the crippled, the useless, the broken, to die on the kerb. It's not guilt, or conscionce.

I like to think, through making games, that I'm not just wasting everone's time. That I'm contributing soemthing to the advancement of us.

Everything we do is based on what we know. Is anyone out there without friends or family that are fucked up in some way?

Good night, try the veal. Drink is the only thing that shuts the fucker down. 
Are There Painters That Try To Paint For Blind People? 
 
Was Beethoven Deaf? 
 
 
rpg, you're looking at this the wrong way. you're under the mistaken assumption that i don't think people with disabilities should play-- let's use the example: quake.

this is not the case at all. my post above was trying to say that (in the example) a blind person wouldn't enjoy playing quake because they wouldn't be able to see the level. in my example, i arbitrarily chose the breakdown of a map's components to be 70% visual and 30% audio. they would only be able to hear ambient sounds.

i just can't imagine a way to impart the visual aspect to the person in a way that would allow them to enjoy it.

Should we therefore make no effort to create a bionic suit so that a quadriplegic could run an obstacle course?

ok, if you want to go sci-fi, then sure. just feed to visual input directly into the brain. but my post assumed that you were talking about stuff that was possible at this time or the near future.

re 17439:
that's not a rebuttal at all. him being deaf doesn't mean anything because he wasn't making music for deaf people. 
That's Kind Of What I Meant 
Rebuttal wasn't my intention. 
Let's Stick To Game Design 
I'd really prefer to focus on the level and game design aspects of this rather than the ethics.

It looks like no one wants to discriminate, but to answer my original question it also appears that no one has ever thought about accessibility for their levels/mods/games. What I really wanted to talk about is what people are doing, or what can be done, to improve accessibility. So far, a lot of comments have pointed to extreme cases and concluded that not a lot can be done. Going back to the real world example, let's not focus on the quadriplegic just yet; instead, let's focus on the guy who needs a prosthetic. What can be done?

P.S. friends have told me of at least two people they know who are deaf (or very near deaf) but still enjoy listening to music--they turned the volume up really high and feel the music. And for megaman: http://autodios.blogspot.com/2009/04/paintings-for-blind-project.html

P.P.S. I'm in no way trying to make people feel guilty for making a map/mod/game that gives a handicap to disabled people. However, I am really interested in the exchange of ideas, and I've always felt that the people here have a lot of potential for that. 
 
rpg, i don't how anything can be done from a level design point of view. if you want to let a guy who has a prosthetic hand (or whatever non-critical disability) play a game, it's in the hands of the guys making input devices and such. if his hand is missing, it doesn't matter how i build my level, he still needs a special controller which is out of my (sorry) hands. 
Append 
after a bit more thought, i can only think of one obvious and fairly easy thing to alleviate handicap for disability and that would be to not rely solely on colour differentiation for those who are colour blind.

but anything more complex than that (say, making a map that would be playable and appealing to someone who's autistic) is beyond me because i just don't know enough about these more complicated problems. you'd have to understand how an autistic mind works (as well as the varying levels of autism) to be able to create something appealing to someone with the condition, there's not much common frame of reference. 
Quake 
Quake is particularly limited in what it can do for somebody who is visually impared, because almost all the media editing tools are geared to change visual elements. In stock ID1 you have no ability to add custom sounds, whereas you can include any number of new textures to a map.

Although you can overcome that limitation with a QC mod, you are still fighting an uphill battle. The quake sound engine is very limited. When you want to play a sound, you can only control the volume and attenuation. Once you have begun playing the sound, the only thing you can do it play another sound on the same channel to override it. The engine does not support moving sound sources at all, and I think that is a critical omission. These things can be fixed, but by now it's something that requires a coder - that can't just be achieved by mapping. 
Let Me Reemphasize That 
are there painters that paint for blind people? 
 
I agree that Quake itself, as it is, isn't really translatable for the blind. However, I think you could come up with something in the Quake universe that would be with a little imagination. Something less visually oriented and more about sound, force feedback, etc. 
Megaman 
What you're talking about does not really apply to what I'm talking about. Let me make an analogy about what you're asking: are there game developers that make games for non-gamers?

Gaming is not an inherently visual medium; many video games utilize at least two senses, and most don't require perfect perception from either of those. And I'll repeat myself again: disability is not binary.

And why is everyone so hung up on blind people? 
This Dialogue Feels Like A GILL Radioplay! 
I saw a TV program on new sciense skill that handled about helping people who had a physic damage like missing an arm.
Docters had made a electonic arm attached to some neural imputs.
The patient could move this arm by really thinking hard he had to weighten something. This made the arm go. He could also pick up a glass of water and drink from it.

The only bad aspects were that the patient had to think really hard to make the process go. Also when he had to pick up an egg, the thing just broke, becayse he hadn't the attitude to give the process more accumilation.

So maybe there will be a time people with handicaps can play Quake. Although they will really affirmative the nightmare Quake's Gill horror.

And megaman, let me only say that there are people that paint,
not severly for blind people.
Only you miss the fact that there is structure, smell, empathy.
It may be hard to say for someone in good health, but I can even like a picture from some foot or mouthpainter. 
Metlslime 
Going back to the web example, accessibility is just as relevant to the content developers (website developers) as it is to the interface developers (browser developers). I feel that the same goes for game development: you can't aim for comprehensive accessibility without the support of both, but you can still make progress with just one.

You also said that Quake is more a medium of art. To me, video games in general should always primarily be a medium of strategy, interaction, and entertainment; to me, this is the message that is being delivered. Art is a secondary, but still very important, goal. Tetris is not fun and addicting because of its artistic contribution--but I know I'm not telling you anything new. Adjusting gl_picmip would certainly detract from the art of Quake, but it will still be fun to play. 
Some Accessibility Guidelines That I've Thought Of 
By no means an exhaustive or fine-tuned list, and I'd love to hear to some comments, criticisms, and additions (but please, no more comments about blind people, ok? Let's be more open-minded):

Dextrous interaction: The required set of in-game maneuvers should not require above-average dexterity. While this will make your map/game accessible to novice gamers, it will also prevent exclusion from gamers who lack fine motor control.

Audio signals: Avoid requiring the gamer to hear a sound in order to proceed, or otherwise penalizing the gamer for not hearing a sound.

Visual signals: Similar to audio signals, avoid using subtle visual cues as the only signal to the player; especially if these cues will be lost by changing the visual display settings (e.g. turning off lighting, disabling colors, or removing textures).

Input devices: Avoid requiring interaction from a specific input device or input style.

Examples of the input devices guideline: A simple example would be to avoid requiring fine, precise input such as from a mouse. A more extreme, but to me, still highly relevant example would be to avoid interaction styles that are difficult without the use of both hands. Doom and Quake were the only games I played a few years ago when I broke my arm because the controls are simple enough that I could map them onto a 5-button mouse and play only with my right hand. How about trying to play Stalker one-handed? 
L4D And Visual Access 
Left 4 dead has two accessibility functions that I know of. One is the aforementioned closed-captions. It's worth noting that these have different levels of detail. You can just turn them on for dialogue if you want to be sure you get what the characters are saying. You can also turn on full captioning of sound effects. Then you get captions for other vital sound cues, like the sound of a tank ripping a rock from the ground to throw.

The other option it offers is assistance for colour-blind players, by offering a different HUD colour scheme. This includes making player who are on very low health showing up as cyan rather than red, and drawing the outlines thicker to give a visual cue even when the player cannot read the hue. 
It Seems 
we need abstraction! What's the equivalent to display markup for Quake? How can we say signal the player that a trap is about to be sprung, and have different modes of communicating that, based on the settings of the client?

I guess I'd call this a "gameplay API". 
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