Deaf or deaf? Questioning alleged antinomies in the bioethical discourses on cochlear implantation and suggesting an alternative approach to d/Deafness

Abstract

The assumption that there exist two mutually exclusive conceptions of d/Deafness – a medical/biological as opposed to a socially constructed one – is an underlying premise for much of the ongoing bioethical discourse on paediatric cochlear implantation. This text first presents this discourse and then analyses the alleged antinomy. Using the original Kantian conception of antinomies, it is argued that trying to judge which is more ‘true’, nature or convention, is futile. Against the backdrop of the history of deaf education and recognition of signed languages as fully fledged languages, a three-fold, intertwined approach to d/Deafness is suggested that includes: deafness as physical impairment, Deafness as lingual belonging and deafness as socially constructed disability. Whether or not cochlear implants represent something useful or something harmful to deaf children depends on how the interaction between the different notions of d/Deafness is understood.

Keywords:

• deafness
• ethics
• cochlear implants
• disability
• impairment
• language

Acknowledgements

The author's work is supported by the Department of Social Work and Health Science at the Norwegian University of Science and Technology (NTNU).

Notes

1. A cochlear implant is a technical device designed to improve the hearing ability of people with hearing impairments. Like conventional hearing aids, the external component of a cochlear implant picks up sound with a microphone. Conventional hearing aids amplify this sound and deliver it through a loudspeaker into the carrier's ear. This is however not very helpful for many people with a severe or profound hearing loss. Instead of amplification, the outer component of a cochlear implant transforms the sounds picked up by the microphone into an electric signal which is transmitted wirelessly to the inner (implanted) component. A small electrode is inserted surgically into the carrier's cochlea. The transformed sound signal is conveyed directly to the auditory nerve through this electrode, thus bypassing damaged portions of the ear. With training and rehabilitation a person can learn to interpret these signals as sounds.