The fact that we have technology that allows deaf people to hear through the use of a cochlear implant is incredible. People can become deaf in many different ways; however, the physiological reason why a person cannot hear is usually due to damage or absence of sensory hair cells in the cochlea. For a hearing person, these hairs turn sound waves into action potentials that are carried to the brain via the cochlear nerve ganglia. When these hairs are damaged, they cannot properly send a signal to the brain. A cochlear implant bypasses the hairs by directly stimulating the cochlear nerve ganglia with electrical signals that are then carried to the brain to be interpreted. (Russell, Pine,& Young, 2013)
To the average hearing person, it seems clear that obtaining a cochlear implant should be a high priority for anyone who the implant will help. As if gaining the ability to hear were not enough, obtaining a cochlear implant can help someone avoid some of the difficulties that are known to come with being deaf. Education levels and salary levels are lower on average, and medical costs are higher for deaf people (Russell, Pine, & Young, 2013). However, for some people in the deaf community the decision to obtain a cochlear implant is not clear. In addition, deaf parents may debate on whether or not allow their deaf child to obtain a cochlear implant (Byrd, Shuman, Kileny,& Kileny, 2011).
The deaf community has a culture that they consider to be their own; and by giving their child an implant, parents would deprive their child of that culture. However, cochlear implants are less effective when they are put in after the age of 2 which eliminates the option of waiting until the child is old enough to decide whether they want the implant or not. (Byrd, Shuman, Kileny, & Kileny, 2011) It is difficult to say which option is more ethically correct, especially since few to no people can truly experience both sides of the argument.
Although the decision on whether or not to get a cochlear implant seems obvious to the hearing population, it is more complicated for the deaf population; and it is important for us to empathize with the deaf point of view and attempt to work with them in order to provide deaf people, particularly children, with the best chances in life while also respecting their wishes.
References
Byrd, S., Shuman, A. G., Kileny, S., & Kileny, P. R. (2011). The right not to hear: the ethics of parental refusal of hearing rehabilitation. The Laryngoscope, 121(8), 1800-4.
Russell, J. L., Pine, H. S., & Young, D. L. (2013). Pediatric cochlear implantation: expanding applications and outcomes. Pediatric Clinics Of North America, 60(4), 841–863. https://doi-org.dml.regis.edu/10.1016/j.pcl.2013.04.008
Why does this implant not work as well after 2 years of age? What about it doesn't function or why does age matter? I like how you put the ethical significance of this, it's really interesting!
ReplyDeleteI do not believe it is totally understood why the implant is less effective when received after 2 years of age. When the implant is received at a young age, recipients have better speech, language, and auditory development than those who receive the implant later in life. The paper from 2011 credits this difference to the neurological plasticity that exists early in life when the brain is still rapidly developing. (Byrd, Shuman, Kileny, & Kileny, 2011) This difference could also be due to the fact that when the implant is received at a young age, the child is able to adjust to being able to hear earlier on in life and then move on to further development. Meanwhile, people who receive the implant later must start over by going through the adjustment period and then moving on to further development in areas such as speech and language.
Delete