Hearing Parents\u2019\xa0Voices: Parental Refusal of Cochlear Implants and the Zone of Parental Discretion

Owen M Bradfield

doi:10.1007/s11673-021-10154-8

Abstract

It has been forty years since the first multi-channel cochlear implant was used in Australia. While heralded in the hearing world as one of the greatest inventions in modern medicine, not everyone reflects on this achievement with enthusiasm. For many people in the Deaf community, they see the cochlear implant as a tool that reinforces a social construct that pathologizes deafness and removes Deaf identity. In this paper, I set out the main arguments for and against cochlear implantation. While I conclude that, on balance, cochlear implants improve the well-being and broaden the open futures of deaf children, this does not justify mandating implants in circumstances where parents refuse them because this may compound unintended harms when society interferes in the parent-child relationship. For this reason, I argue that parental refusal of cochlear implantation falls within Gillam’s concept of the zone of parental discretion.

Highlights

Cochlear implants are small electronic devices that bypass damaged nerve cells and transmit signals via the auditory nerve to the brain (National Institute on Deafness and Communication Disorders 2016)
Cochlear Implantation Undermines the Child’s Future Autonomy as an Adult. This argument asserts that prelingually deaf children are too young to be moral agents, so decisions that impact the child’s future linguistic and cultural identity should be deferred until the child can consent
While some people argue that the Deaf community should not impose its opposition to cochlear implants on parents and children with profound hearing loss, the same is true of the hearing world

Summary

Introduction

The Deaf community has been vocal in ensuring that the parents of deaf children are appropriately educated This argument asserts that prelingually deaf children are too young to be moral agents, so decisions that impact the child’s future linguistic and cultural identity should be deferred until the child can consent. While failing to implant a profoundly deaf child appears to be an ethically sub-optimal choice from a hearing world perspective, implanting that child against the strong opposition of parents may be far more damaging It seems, when applying Gillam’s concept of the zone of parental discretion to cochlear implantation, parental refusal ought to be tolerated. If intervening may cause more harm than not intervening, we ought not to intervene, as this is most consistent with the time-honoured principle of primum non nocere (Gillon 1985)

Conclusion

Findings

Conflicts of Interest None