Abstract
Cochlear implants are the best treatment for congenital profound deafness. Pediatric candidates to implantation are seen as vulnerable citizens, and the decision of implanting cochlear devices is ultimately in the hands of their parents/guardians. The Brazilian Penal Code dictates that deaf people may enjoy diminished criminal capacity. Many are the bioethical controversies around cochlear implants, as representatives from the deaf community have seen in them a means of decimating their culture and intrinsic values. ObjectiveThis paper aims to discuss, in bioethical terms, the validity of implanting cochlear hearing aids in children by analyzing their vulnerability and the social/cultural implications of the procedure itself, aside from looking into the medical/legal aspects connected to their criminal capacity. Materials and MethodsThe topic was searched on databases Medline and Lilacs; ethical analysis was done based on principialist bioethics. ResultsCochlear implants are the best therapeutic option for people with profound deafness and are morally justified. The level of criminal capacity attributed to deaf people requires careful analysis of the subject's degree of understanding and determination when carrying out the acts for which he/she has been charged. ConclusionCochlear implants are morally valid. Implantations must be analyzed on an each case basis. ENT physicians bear the ethical responsibility for indicating cochlear implants and must properly inform the child's parents/guardians and get their written consent before performing the procedure.
Highlights
The vulnerability of patients involved in research or submitted to new therapeutic/ diagnostic procedures is an important matter, for ENTs
ENT physicians bear the ethical responsibility for indicating cochlear implants and must properly inform the child’s parents/guardians and get their written consent before performing the procedure
Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on August 19, 2011; and accepted on January 3, 2012. cod. 8735
Summary
The vulnerability of patients involved in research or submitted to new therapeutic/ diagnostic procedures is an important matter, for ENTs. Children with profound deafness picked as candidates for cochlear implants undoubtedly account for a vulnerable group. This group of patients may be categorized as vulnerable because they are children - imbued with diminished capacity and decision-making power - but because of the handicap that will accompany them into adult age. It should be noted that in the Brazilian legal system the deaf may be considered partially criminally capable or even criminally incapable. Given the presence of hearing loss and reduced cognitive skills, the legal system sees them as criminally incapable (or subject to lesser punishment) as they assumedly cannot understand the illegality of the acts they may perpetrate
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