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Cochlear Implants: For the Deaf or the Hearing? by Kirstin Shafer

Cochlear Implants: For the Deaf or the Hearing? by Kirstin Shafer

Nonfiction, Vol. 1.1, June 2007

Cochlear implants are often seen by the larger hearing population as a cure for deafness; many find it unfathomable that a person would choose to be deaf if an alternative existed. It may come as a surprise, then, that there is a controversy over the device within the Deaf community, especially in regards to the implantation of young children. Many Deaf people believe that implanting children before they are old enough to make the decision themselves could, and likely will, result in the end of Deaf culture. However, it is believed that the earlier it is implanted, the better a device will work; from the hearing perspective, the more likely it is that a child will learn to speak. Cochlear implants can make it easier for deaf children and adults to interact with the hearing world, however if all deaf people were to be implanted, the loss to society could be detrimental, a rich culture, language, and diverse group of people may cease to exist. Since its invention, the cochlear implant has sparked controversy from hearing and Deaf people alike. The debate brings to focus the definitions of both culture and disability. It also raises moral and ethical questions about a parent’s right to make decisions in their child’s best interests, whether or not those decisions may lead to the destruction of a culture founded in silence.

The majority of culturally Deaf adults see themselves as belonging to a minority group that is as rich and diverse as any other. It is often suggested by Deaf community members that instead of seeing deafness as a disability, as hearing people often do, it should be viewed as part of the natural human variation, akin to having different eye or hair color, or being left handed. According to Robert Sparrow, Deaf people often suggest that they should be seen as “members of a minority cultural group” and not as disabled (1). Deaf people have a rich history, often full of oppression from the larger hearing population. They have a culture that is unique, unlike other hearing cultures; it is not passed down from parent to child, but in residential schools and daily interactions with other Deaf people. Harriet Kaplan, a speech language pathologist at Gallaudet University, a primarily Deaf university, suggests that Deaf culture “has a distinctive gestural-visual language which is not English. This culture is transmitted through everyday social interaction” (72). Through participation in Deaf clubs, residential schools, and conferences, Deaf people have managed to persevere and pass on their culture, especially in today’s society. Members of the Deaf community lead comfortable and happy lives, and often have higher levels of education. Authors Lane, Hoffmeister, and Bahan suggest that there are many factors that bring Deaf people together, “language, schools and sports, […] organizations, arts and oppression, it is no surprise that well acculturated Deaf men and women find great strength in their Deaf identity” (173). Deaf people are connected in many ways, and because of this connection, they do not feel as if they are missing out on anything. In fact, many Deaf people believe that they gain experiences because they are deaf, because a unique language, and interactions with hearing people. They see their experiences as shaping their Deaf identity.

Deaf people may see themselves as a minority culture, but often, hearing people see them as disabled. In general, hearing people view deafness in terms of what is missing, the ability to hear, instead of what is gained because of the value placed on sight. Sparrow believes that “[there] is a tendency in our society to think of human variation solely in terms of derivation from some imagined perfection. In particular it is easy to think of disability as a merely negative phenomenon; as a loss of capacities only” (4). As with many other disabilities, hearing people feel that deafness is something to be fixed, or avoided at all costs. There is also the popular idea, that if deafness could be cured, it should be, in every situation. In Neil Levy’s article “Reconsidering Cochlear Implants: The Lessons of Martha’s Vineyard,” he states, “it is not true that the deafness is not a disability, since it is not the case that all the disadvantages associated with it are social in origin. However, there is no doubt that a very significant portion of these disadvantages are social in origin” (16). The debate over cochlear implants stems from the different views of deafness. If it is just a natural human variation, as Deaf people believe, then there is no reason to cure it, if it is a disparaging disability, the hearing view, then every possible opportunity to correct it should be utilized. The controversy over attempting to cure deafness is fueled by the different views of what being deaf means. For Deaf people it is access to a unique culture and a group of people with similar beliefs and language systems. Hearing people view the same hearing loss as the inability to listen to music, to talk on the phone, to interact with the population at large.

The latest technology created in attempt to eliminate or greatly reduce deafness, is the cochlear implant. Sparrow states that “‘[cochlear] implants’ are a technology which attempts to ‘cure’ deafness by bypassing the outer ear through electrical stimulation of the auditory nerve” (1). The way that a cochlear implant works is by surgically inserting electrodes into different locations in the cochlear, part of the inner ear. It uses a transmitter located on the outside, which converts sound into electrical impulses to the receiver which sends the impulses to the electrodes in the cochlea. It is important to note that, although the cochlear implant provides some form of hearing, it is not the same as natural hearing, and not all deaf individuals are good candidates. Another issue with cochlear implantation is that it destroys all residual hearing in whichever ear it is implanted, usually the ear with more residual hearing. Author Bonnie Tucker points out that “cochlear implants do not, and likely will not, eliminate deafness altogether. An individual who has an implant is still deaf” (1). A cochlear implant is always an option for many deaf people. To have the surgery, a patient must be profoundly deaf, have tried other methods of amplification (hearing aid), have a cochlea, be able to afford both the surgery and the necessary speech therapy and implant programming services after implantation. Implants also work best when implanted young. Even if a candidate meets all of these requirements, sometimes cochlear implants malfunction and stop working. The official statement regarding cochlear implants from the National Association of the Deaf, the NAD, is as follows:

Cochlear implants are not appropriate for all deaf and hard of hearing children and adults. Cochlear implantation is a technology that represents a tool to be used in some forms of communication, and not a cure for deafness. Cochlear implants provide sensitive hearing, but do not, by themselves, impart the ability to understand spoken language through listening alone. (1)

The NAD statement goes on to explain that the implant may not be effective for all individuals, and that even if it is considered a success, the implanted individual may still be unable to understand speech in all situations. Although a cochlear implant can improve speech and speech comprehension which is often their goal, they are still, by no means, a “cure” for deafness.

Deaf people see themselves as belonging to a minority group and do not identify with a disability; therefore, many members of the Deaf community see attempts to cure deafness as offensive, a form of genocide. The documentary Sound and Fury, directed by Josh Aronson, portrays a Deaf family and their frustration with the cochlear implant debate and its impact on their relationship. An article in response to the film states that, “[the family] asserts that Deafness is both natural and cultural; it is not a medical condition, and therefore, they argue, medical interventions are not miraculous cures but acts of genocide” (Edwards 2). This culture often reacts to attempts to cure deafness with disdain and frustration. The Deaf community is connected by the use of sign language and because of an emphasis on all things visual, a hearing person, no matter how connected to the Deaf community, cannot truly belong to the deaf world. Cochlear implants place an emphasis on speech and hearing, two things that are unnecessary within Deaf culture. Lane, Hoffmeister, and Bahan suggest that “childhood implantation has a primary goal to permit Deaf children to acquire the majority spoken language in place of a minority signed language they would have acquired” (403). In a sense, the goal of implantation is to allow a deaf person access to the things that hearing culture values: speech and hearing capabilities. The Deaf culture, however, places no value on these things and there is some amount of resentment involved with people who do not have the same agendas, making decisions for others with different beliefs and values.

Although the majority of the Deaf community is not in support of cochlear implants, they respect the right to choose to have the surgery. Currently in the United States, children as young as twelve months can receive a cochlear implant if they meet the requirements, and there is also the ability to petition to have a child implanted younger. The Deaf community at large believes that children that young should not be implanted, because they have not been given the choice to decide for themselves whether or not they want an implant. Author Bonnie Tucker suggests that Deaf advocates believe that the deaf children, not the hearing parents, should make the decision regarding cochlear implants (1). This is the view held by many culturally Deaf adults who believe in making an educated decision regarding implantation. In their official statement on cochlear implants, the NAD states that they “[recognize] the [right] of parents to make informed choices for their deaf and hard of hearing children, [respect] their choice to use cochlear implants and all other assistive devices, and strongly support the development of the whole child and of language and literacy” (1). Most Deaf people would accept a deaf child or adult’s decision to get a cochlear implant; however when the decision is taken away from the deaf person and given to a hearing person, the Deaf community does not support implantation.

Hearing people view cochlear implants in a different way than most Deaf individuals. Many mistake cochlear implants for a cure of deafness, and think that any hearing would be better than no hearing. Robin A Gaines III believes that hearing society often has difficulty comprehending why many deaf people choose not to attempt to regain any hearing. Hearing people cannot imagine a world without sound, and this is why it is unfathomable to them that anyone would choose a world of silence (1). The main goal of cochlear implantation is speech and hearing, two things that the hearing community values immensely. They see speech as the only means of communication, whereas Deaf people see sign language as an equally effective method of communication. In her article about the ethics of mandating cochlear implants, Gaines III states that “[forcing] the language and the ways of the hearing implies that the majority hearing culture is more desirable and superior to deaf culture” (1). In their minds, hearing professionals and parents are doing what they believe is best for the deaf child, providing them a world of sound. “Anita Michael Cobbs, a hearing mother of a profoundly deaf daughter with an implant [declared], ‘I do not understand why the so—called ‘deaf community’ is against anything that improves quality of life…. Deafness is not a culture” (Edwards 29). Often, hearing people project their own feelings of what it would be like not to hear onto those that are deaf, and cannot understand how anyone could be happy in such a situation. Many hearing people are uninformed or unaware of the culture and language that they are preventing the child from experiencing. The majority of Deaf individuals are frustrated when decisions affecting them and their culture are left up to hearing people who are not a part of their community. They believe in a deaf person’s right to choose to which culture they wish to belong. Hearing people believe in fixing what they see as broken, although these decisions are made with the best of intentions, hearing parents are uninformed and in the case of cochlear implants, often unwelcome.

If every deaf child born to hearing parents were to receive a cochlear implant it would lead to the death of a culture, a term known as ethnocide. Lane, Hoffmeister, and Bahan define ethnocide as, “the systematic blocking of a language minority from coming into its own and from pursuing its way in life” (403). The end may be near for Deaf culture as it is today, because it is so grounded in sign language, not speech, and vision not hearing, the opposite of the cochlear implant goals, it may cease to exist in several years. Neil Levy believes that, “[the] implant would signal the end of this culture because it would effectively prevent Deaf culture from reproducing itself” (2). Deaf culture is passed down differently than all other hearing cultures because the majority of deaf people have hearing parents; it is learned through interactions with other Deaf individuals. If there are too few culturally Deaf advocates to pass on the culture, then it will cease to exist. Cochlear implants emphasize speech and hearing, Deaf culture emphasizes sign and sight. As it exists now, the Deaf community will face extinction, ethnocide, in the face of cochlear implants.

The debate over implantation is complex, because it involves two groups of people that cannot adapt to see the other side. Hearing people cannot be deaf, just as deaf people cannot be hearing. It is difficult for both sides to understand each other. Deaf people feel that hearing people are saying, when they choose to implant a child who has yet to experience the world, that they are unwanted in the world. Neil Levy suggests that

[by] curing them of their disability, we send a message to the adult Deaf, who are too old to be candidates for the implants or simply refuse to have them, that their lives are of lesser worth. By treating the disability as an object for medical intervention, we send a message to the bearers of that disability. The message is that we want no more people of ‘your kind’ – no more disabled people, no more Deaf people. (9)

Hearing people see their actions differently, they focus on what the deaf person is missing, what they cannot do, instead of realizing that they can do almost everything that anyone else can except hear. The message that hearing people send when they ignore the views of the Deaf people is that “[the] parents have the rights, and the hearing professionals have the knowledge, so the views of Deaf people are simply of no concern” (Lane, Hoffmeister and Bahan 406). Because neither group can easily and effectively see things from the other’s perspective, actions are misconstrued leading to misunderstandings, and hearing people believe that they are improving quality of life and making things easier for the Deaf person. Deaf people believe that there is nothing wrong with them, that there is nothing to be fixed, and are insulted when hearing people cannot see that their hearing loss makes the individual who they are and shapes their experiences.

When cochlear implants are misrepresented as a cure for deafness, complications arise between the larger hearing population and the Deaf community. Hearing people make decisions in what they believe are the best interests of deaf people, often without consulting or taking into consideration the opinions of the individual or the Deaf community affected by the decisions. If every child born deaf receives a cochlear implant before they are allowed to make the decision themselves, then there will be no Deaf culture in twenty or thirty years. The decision regarding cochlear implantation should be left up to the deaf individual; it is a permanent choice that affects much of that person’s life and experiences. Although hearing people mean well, making such a decision for a child is, in effect, taking away their right to choose how they want to live their lives, and what role they will take later in life.

Edwards, R. A. R. “Sound and Fury; or, Much Ado about Nothing? Cochlear Implants in
Historical Perspective.” Journal of American History 92.3 (2005): 892-920. Academic
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Gaines III, Robin A. “The Value of Deaf Culture: Should States Have the Right to
Mandate Placement of Cochlear Implants?.” Current Surgery 60.6 (2003): 600. Academic
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Kaplan, Harriet. “The Nature of Deaf Culture: Implications for Speech and Hearing
Professionals.” Journal of the Academy of Rehabilitative Audiology (1996): 71-84.

Lane, Harlan, Robert Hoffmeister, and Ben Bahan. A Journey into the Deaf-World. San
Diego: Dawn Sign Press, 1996.

Levy, Neil. “Reconsidering Cochlear Implants: The Lessons of Martha’s Vineyard.”
Bioethics 16.2 (2002): 134. Academic Search Premier. 2 April 2007.
<http://search.ebscohost.com>.

NAD Cochlear Implant Committee. “Cochlear Implants: NAD Position Statement.” 6
October 2000. National Association of the Deaf. 10 April 2007
<http://www.nad.org/site/>.

Sparrow, Robert. “Defending Deaf Culture: The Case of Cochlear Implants.” Journal of
Political Philosophy 13.2 (2005): 135-152. Academic Search Premier. 2 April 2007.
<http://search.ebscohost.com>.

Tucker, Bonnie Poitras. “Deaf culture, cochlear implants, and elective disability.”
Hastings Center Report 28.4: 6. Academic Search Premier. 2 April 2007.
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