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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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In chapter 2, Harlan Lane, professor at Northeastern University in Boston, Massachusetts, develops a robust argument for the recognition of Deaf ethnicity and the Deaf world. He deconstructs (and debunks) the medicalized view of deaf people as members of a disability group. Predicated on a misunderstanding, the disability construction of deafness, he says, brings “bad solutions to real problems.”

In chapter 3, Linda Komesaroff, a senior lecturer at Deakin University, Melbourne, presents a comprehensive analysis of the media representation of cochlear implants from articles that appeared in the daily press in the first decade of media exposure. Her analysis identifies the ways in which the press has characterized deafness and biotechnology as well as the ways that members of the dominant group have positioned deaf people within society. A textual analysis of a sample of articles highlights the devices used by authors (deaf and hearing) to represent their world views and to position the reader in the debate.

Chapters 4 and 5 deal with issues of medical ethics and legal rights. In chapter 4, Priscilla Alderson, professor from the University of London, reviews the background social and ethical debates and decision-making frameworks concerned with surgery for children. She views cochlear implants as part of the powerful social trend to use technical aids to alter, adapt, or “improve” the natural body. She takes a critical social perspective of cochlear implantation, highlighting the importance of informed decision making, critical thinking, and choice making (avoiding assumptions and trends that may otherwise be taken for granted). She asks: “Whom do they really benefit? Are such aids as essential and beneficial as is usually claimed?” If people do little reflection on such questions, she suggests that people are then liable to opt for the treatment in question, believing “TINA—There Is No Alternative.”

Chapter 5 is written by lawyer Eithne Mills, from Deakin University, Melbourne. Beginning with the United Nations Declaration of the Rights of the Child, she considers the interaction between medicine and the law in cases related to medical intervention. She introduces the reader to key legal doctrines, international conventions, and established general precedents that must be understood in relation to legal action and medical intervention such as implantation in childhood. The chapter begins with a discussion of patriarchal power, the rights of the child, and the principle of “best interests” in family law. The second part of the chapter discusses what constitutes valid consent and analyzes three cases of medical intervention in children. The third case was heard in the Federal Magistrates Court of Australia in relation to a dispute between two deaf parents involving issues of residence and contact as well as disagreement over the implantation of their profoundly deaf child who was age eighteen months. The child’s mother had applied to the court seeking authorization of the proposed medical intervention involving the implantation of a cochlear device. The court noted that at the heart of the dispute were the parents’ differing views about how their deaf child should be raised in a mainly hearing world.

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