Introduction
A nine-year old child who has been deaf since age three is to be decided whether or not to undergo a cochlear implantation. It is necessary to understand what a cochlear implant is, the benefits it could give the child and as importantly, the risks involved in the surgery to be able to decide in the best interest of the child.
Cochlear Implant
The National Institute on Deafness and Other Communication Disorders or NIDCD explains a cochlear implant as an electronic device implanted to directly stimulate auditory nerves. It does not restore normal hearing but provides a sense of sound to a profoundly deaf or a severely hard-of-hearing person, giving him a useful representation of sounds in his environment and help him understand speech.
The implant has an external piece that sits behind the ear and another piece surgically implanted under the skin. It has a microphone, which picks up sounds; a speech processor, which selects and arranges these sounds; a transmitter and receiver/stimulator, which converts signals from the speech processor into electric impulses that the electrode array collects and sends to different areas of the auditory nerve (NIDCD).
Argument For Cochlear Implant
Cochlear implant provides a choice for profoundly deaf and hard-of hearing people that would have none in the past. It is a technological advancement that is here to help and to give hope to hearing impaired people. It is better than a hearing aid as it does not only amplify sound but stimulates the auditory nerves directly.
A child should be given every advantage that he or she could get. It is his or her chance to have a relatively normal life and enjoy the same things that normal people do. It would help him lip-read and in better results, understand who he or she is talking to without having to attentively look at the person. It would help the child to communicate better with the general public since very few people understand sign language. The child could fit in better socially if he or she could communicate with his or her peers. He or she could go to a mainstream school and have the same career opportunities if he or she does not have hearing limitations.
This may be expensive, but it should not matter if this will be able to improve the child’s quality of life. The child would be able to recognize everyday sounds and perhaps enjoy the subtle sounds of nature or experience the pleasure of music. These things may be easily neglected by people with normal hearing but are priceless to those who were deprived of it.
A cochlear implant may even one day save the child’s life. There are sounds in our environment that are important to be heard like oncoming vehicles and alarms during emergencies.
The child would no longer be hindered by everyday technology. In addition, he or she would be able to talk on the phone or watch television or listen to the radio without assistance from other technologies for translation and relay.
This is the time to do it. Auditory memory is a factor for the success of the implant. It has not been that long, only six years, after he or she lost his or her hearing and had three years of experience hearing sounds that would help in the adjustment with the implant. The effectivity of the surgery would be maximized by taking measures earlier than much later. It is also a generally accepted fact that children learn and adjust better than adults; therefore, the child would benefit largely if he or she gets the implant while at a young age.
If a person cannot see well, he or she gets prescription glasses, contact lenses, or maybe even surgery; if a person cannot walk he or she gets crutches, a wheelchair, or maybe even prosthetics. Why then should this child be deprived of the technology that would improve hearing and aid in day to day life?
Argument Against Cochlear Implant
A cochlear implant is not a guaranteed miracle. The results vary from person to person and in some cases, the patient has no hearing at all. With the many risks involved and without guaranteed results, it is not that much of an obvious choice.
There are also the ethical considerations. Is it automatically to be considered that the child would be inferior to his or her peers because of hearing difficulty? Also, the unusual device may even call more attention to him or her in school and make him or her an easy target for bullies. It is not the child’s fault that he or she has limitations and should not be required to bend over backwards to comply to the mainstream idea of normalcy.
The surgery is very expensive and some insurance policies do not cover the expenses and without guarantees, it is a gamble. Also, just with any surgery, there are risks involved. Risks include meningitis, which is of higher risk in children than in adults; damage to the facial nerve, which may cause temporary or permanent paralysis of the facial muscles; cerebrospinal fluid leakage; perilymph fluid leak, infection of skin wound; intermittent dizziness or vertigo; tinnitus or ringing in the ears; taste disturbances; numbness around ears; reparative granuloma, which can occur if the body rejects the implant; and other complications in long term implantation that are unforeseen and cannot be predicted (FDA). Body functions are interconnected and interdependent with one another that if the implant is not successful, a lot of things could go array.
There is a considerable time period for adjustment and rehabilitation after the implant. The child has to undergo a lot of training and learning to properly utilize the implant. This again would cost so much time, energy and money with no absolute guarantees.
The US FDA says that children are slower to improve with the implant and the adults are the ones that benefit immediately. Perhaps, among other things, the timing is also a consideration. Maybe the child should be given more time to adjust to his or her situation and have the operation as a last resort. The operation should not be treated like a savior to what arguably is even a predicament. The child is a complete person with or without hearing and should not be treated otherwise and be required of a surgical procedure. When the child comes of age, then perhaps he or she can make a decision if the implant is something he or she finds necessary. As an adult, an individual would be more matured in dealing with the adjustment period and could benefit quicker. Also, he or she would be given the autonomy to decide for him or herself. To reiterate, it should be a choice if the individual feels that he or she should get a cochlear implant, not a requirement.
Conclusion
The cochlear implant is an advancement in modern science to make available a device to help people with advanced hearing problems have a chance to hear better. Along the benefits are the risks that should be weighed considerably before getting the implant. Consulting with experts would be wise before going through the surgery in order to be prepared for other factors that come with it like rehabilitation and adjustment. There are also other considerations if the patient is a child as there are a few differences in the reaction with the operation between adults and children. It is a modern option that could be taken advantage of but not uncritically. People should be well informed and have realistic expectations before making a decision. The procedure does give hope that was not available before but results vary from person to person and thus should be decided on a case to case basis tailored to each person’s needs, resources and disposition.
Works Cited
“Cochlear Implants.” May 2007. National Institute on Deafness and Other Communication Disorders (NIDCD). 8 April 2009 <http://www.nidcd.nih.gov/health/hearing/coch.asp>.
“Benefits and Risks of Cochlear Implants.” 15 October 2007. US Food and Drug Administration. 8 April 2009 <http://www.fda.gov/cdrh/cochlear/riskbenefit.html>.
