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Sign Language Studies

American Annals of the Deaf

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Surgical Consent: Bioethics and Cochlear Implantation

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The rate of childhood implantation in many countries is now estimated to involve 90 percent–95 percent of all children born deaf. The number of children implanted since 1990 has increased from one in ten total recipients to one in two recipients in 2002 (Christiansen and Leigh 2002). The implementation of programs to screen the hearing of newborns, including programs recently introduced in the United States and Australia, has resulted in children being identified and referred to implant clinics at a very young age. The Sydney Cochlear Implant Clinic (SCIC), for example, reports that 93 percent of profoundly deaf children in New South Wales are now being referred to it for assessment (SCIC n.d.). With the high rate of childhood implantation worldwide, the historical split between spoken and signed languages is poised to become even deeper. At the same time, the emerging field of gene technology continues to push the debate about the nature of deafness, medical intervention, and the future of Deaf communities beyond the question of cochlear implantation. The contributors to this volume have considered cochlear implants within this broader field of biotechnology.

This volume starts and ends with the voices of Deaf people. Their essays provide a penetrating view into the concerns of Deaf leaders, academics, and researchers who, in my view, have the strongest speaking rights about issues that affect Deaf people. At the same time, their insight into issues of power, positioning, and minority–majority group relations are critical to the dominant group’s understanding of diversity and globalization.

The use of capitalized Deaf generally distinguishes those people who are deaf (in the medical sense of the word) and who use sign language and consider themselves to be part of the Deaf community, a cultural and linguistic minority. Where the cultural and linguistic status of deaf individuals is unknown or diverse, most authors have used the term deaf; making reference to deaf children, deaf education, and teachers of the deaf. A stronger view is held by academic and Deaf rights activist, Paddy Ladd. In the opening chapter, Ladd uses Deaf for all contexts—referring to Deaf children, teachers of the Deaf and Deaf education. Deaf children, in his view, are automatically members of “Sign Language Peoples” (a term he coins to identify the importance of sign language to these people) and thus, to Deaf communities. His use of the latter terms—teachers of the Deaf, and Deaf education—adopt the capitalized Deaf in a bid to reclaim their education and decolonize the territory of Sign Language Peoples. In a similar vein, his reference to Oralism is capitalized as a marker of the colonialist tradition forced onto Deaf peoples. Despite differences between Ladd and other authors in the degree to which the politicalization of deafness is highlighted, his chapter in this volume provides the context for later chapters. It unpacks the ways in which Deafness has been constructed by the dominant society and situates cochlear implants within broader social contexts. Ladd presents a powerful and highly theorized account of colonialism (and the waves of neocolonialism) that frames the topic of cochlear implantation. Cochlear implantation, he says, is just the latest in a number of waves of neocolonialism that have swept over Deaf people and their rights. His historical account of the response to cochlear implantation by deafness organizations in the United Kingdom provides the reader with an inside view of the struggle for human rights and response to biotechnology. He warns that the possibility that signed language training is “added” for implant recipients is a rationalized approach by those who believe that although cochlear implantation cannot be halted it nonetheless results in a breach of deaf children’s rights.


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