The cochlear implant is a small electronic medical device that can help a hard-of-hearing or profoundly deaf person restore or improve the ability to understand speech. The device is implanted by a surgical procedure. To fully utilize the cochlear implant, following the surgery, there must be a significant amount of speech therapy to learn or relearn the sense of sound (Lantos, 2012).
When we hear sounds that are transmitted in the air, the sound wave causes vibrations in the eardrum and the middle ear bones. This vibration reaches the inner ear, the cochlea. The sound waves are converted by the cochlea to electrical signals which are then transmitted to the auditory nerve to the brain. The cochlear implant works by replacing the function of the cochlea. Instead of the cochlea, the cochlear implant will turn the sound into an electrical signal. The electrical signal can then be used to stimulate the cochlear nerve to send sound signals to the brain (Cochlear Implant, 2020).
In the eyes of the medical community, the cochlear implant device is thought to revolutionalize the management of hearing loss in adults and children (Naples & Ruckenstein, 2020). However, in the eyes of some members of the Deaf community, this is not the case, especially the use of cochlear implants in children. They consider the devices to threaten their culture and language and threaten the child’s Deaf identity. The Deaf community has objected to this idea of “curing” deaf children. Lee (2012) states, in the medical perspective, that deafness is a “chronic illness or impairment” and the search for a cure for deafness indicates the desire of the majority hearing culture to impose its speaking language and values on the Deaf rather than adjust its institutions to take into consideration of the perspectives and needs of the Deaf Culture. The Deaf Community does not view themselves as a disability group that should be medically cured. Rather, they view deafness as a difference (Lee, 2012). "One spokesperson from the National Association of the Deaf has said, that they do not say hearing parents are not qualified to make decisions for their deaf children, however instead they state that hearing parents need to contact deaf people to make educated decisions. The same holds true for pediatricians as well." (Lantos, 2012). As previously discussed in our classes, there are always other perspectives to take into consideration when treating patients. The case with the cochlear implant controversy presents another case where healthcare providers have to be aware, well-informed and understand the data, options, and perspectives to help patients make a well-informed decision.
References:
Lantos J. D. (2012). Ethics for the pediatrician: the evolving ethics of cochlear implants in
children. Pediatrics in review, 33(7), 323–326. https://doi.org/10.1542/pir.33-7-323
Lee C. (2012). Deafness and cochlear implants: a deaf scholar's perspective. Journal of child
neurology, 27(6), 821–823. https://doi.org/10.1177/0883073812441248
Naples, J. G., & Ruckenstein, M. J. (2020). Cochlear Implant. Otolaryngologic clinics of North
America, 53(1), 87–102. https://doi.org/10.1016/j.otc.2019.09.004
U.S. National Library of Medicine. (2020, February 16). Cochlear Implant. MedlinePlus.
Retrieved from https://medlineplus.gov/ency/article/007203.htm
This post opened my eyes to a different side of the biomedical ethical value of justice. Although I do understand the issue of disregarding the child’s autonomy (and therefore, identity) when providing cochlear implants to deaf children, I cannot justify the act of not treating the medical condition when a revolutionary device is available. I find that the benefits of obtaining cochlear implants as a child outweighs the risk that the deaf community highlights. An example of a benefit is maximizing the child’s development using cochlear implants. This is an example of beneficence. Furthermore, it is the parents’ autonomy to decide what is best for their child until the child can make an informed decision for themselves.
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