By Anonymous Approximately 90% of deaf babies are born into hearing families. For a majority of these families, this will be the first time they will have encountered a deaf person and is likely that they “encounter deafness for the first time through the medicalized script” (Mauldin 2016, p. 51). This medical lens often frames deafness and cochlear implants in one of two ways - as a neurodivergent state and a tool for learning spoken language or as a physiological abnormality that needs to be remedied. In either case, the ultimate question remains: the ethical practice of implantation on deaf individuals (especially infants). Based on practices observed at the New York General Hospital (NYG), the medical practice of infant cochlear implantation is ethical, however, early intervention practices surrounding implantation remains in question. On a medical basis, Laura Mauldin (2016) shares her findings from her ethnographic study on diagnosing, counseling, qualifying, implanting, and intervention processes at the NYG ear, nose, and throat (ENT) department. Here she learns the in depth details of the long cochlear implant (CI) candidacy process and the ethical measures doctors take in order to ensure the health and success of their patients. Implantation is ultimately up to the doctor’s discretion and, as a result, they take several precautions to ensure each patient is a good candidate not only audiologically, but also medically (Mauldin, p. 90). While the question remains as to whether "elective" (non-lifesaving) surgery on a child is ethical, Mauldin shares the rigorous screenings known as “hard criteria” that are conducted for deaf infants. This includes findings of the type, degree of hearing loss, the physiology of the auditory system, and the amount of potential functional gain (or destruction) from a CI. Due to they Hippocratic Oath of “do no harm”, doctors shall not intentionally implant a child if they believe it will be medically harmful in any shape or form. CIs are not given based on quick decisions and are not used as an immediate form of medical treatment for deafness. According to Mauldin, insurance companies as well often enforce hearing aides as the first line of treatment and an arduous screening process to approve clients for a CI (p. 85). Therefore, as a result of these precautions, the medical practice of infant implantation is ethical.
One aspect the medical field fails to consider, however, is the emotional and cultural aspect of implantation. Though the physical act of implanting a child is ethical, often times, the preceding interventions (and proceeding) are not. Many doctors and medical professional are either unaware or fail to provide a well rounded education to parents. As a result, this failure to inform results in implanted children suffering through lack of access, delays, and traumas. In addition, Mauldin states that “the most crucial aspect of implantation is how much time it takes; it is not a onetime surgical event” (p. 3). This “time” typically includes several years of hard work in a strictly oral therapy plan. Whether successful or not, the child will always be deaf. As a result, implanted children are deprived of their natural language and culture (ie. sign language and the deaf community). This is unethical. The CI debate is more than a medical aspect. Many doctors adhere to strict processes for implantation and many recipients are happy with their devices. However, learning to use them is a different story. Instead of asking if implantation is ethical, the question should be if the enforcement and regulation of CI use is ethical. Reference: Mauldin, L. (2016). Made to hear: Cochlear implants and raising deaf children. U of Minnesota Press.
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