Cochlear Implants for Healthy Deaf Babies and the Hippocratic Oath

[FreeThinker]

The question of the day: Could surgeons performing the cochlear implant surgery on healthy deaf babies be in violation of the Hippocratic Oath? A modern version of the Hippocratic Oath is shown below and look especially at the bold highlight: I will follow that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous

For some people the idea of having invasive cochlear implant surgery performed on healthy deaf babies is actually harming them; thus, violating the Hippocratic Oath. Babies with cochlear implants may grow up with the perception that they are not accepted as deaf children and need to "fix" a condition perceived as a defective by the hearing/speaking majority. If this idea is offensive to the members of the bilingual Deaf minority, then it might be considered as harmful or mischievous. Members of the bilingual Deaf community often do not view hearing-loss as a disability, but an empowering experience.

Yet, some people think that the surgery may hurt the babies initially, but it may benefit them in the long run. They would have the best chance of being asslimated into monolingual majority, which may be consistent with the Hippocratic Oath.

Just suppose that a surgeon invents a new kind of cochlear implant designed for hearing people who wants to have control over what sounds can enter their ears. They can turn it off and on whenever they want. I would imagine that some CODAs (Children of Deaf Adults) would like to have this kind of cochlear implants. So does this surgeon violate the Hippocratic Oath by making them selective deaf?

I am a bilingual Deaf person and I do have my own personal opinion on this oft-controversial issue on cochlear implants for healthy deaf babies. I would like to hear (see) all sides and angles on the issue - no personal attacks please!


The Hippocratic Oath
(A Modern Version)
I swear in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation.

To reckon all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.

I will follow that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform the utmost respect for every human life from fertilization to natural death and reject abortion that deliberately takes a unique human life.

With purity, holiness and beneficence I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient.

Whatever in connection with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret.

While I continue to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse be my lot.

 

[TechBill]

In order to be in violation of the Hippocratic Oath, it would have to be proven that Cochlear Implant is a harmful device.

And being CI user myself, I don't think cochlear implant is any more harmful than a pacemaker or a hip joint replacement etc.


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[Aleser]

^people -have- died from cochlear implantation. Arguably, every surgery is harmful, but there we draw the lines between "life saving" and "medically needed" and just "something helpful"

 

[TechBill]

The thread is about doctor willfully or knowing that they are harming a person or a child implanted with a CI.

Like I said it need to be proven that CI is a harmful device and doctor are willfully knowing that they are harming someone when they implanted them with it.

Do you think there are doctors out there whom doesn't care who get implanted and dies from it?

All those "Againist CI on Childern" posts or threads like this one is really a waste of time because it only will just stir thing up and goes no where but divide people.

I will say this

I will never ever dare tell another parents what they can or cannot do with their own children. They brought the child into this world and it is their responsibly to raise the child as they see fit.

We have laws that protect everyone including our own children so if you or anyone think that children should not have a CI implanted in them then you need to go and talk to your senator about getting a law passed preventing implants in children.

The other parents does not tell you what you can or cannot do to your child so they deserve equal respect from you.

99% of the "Againist CI" post I read on the internet is pretty much folks making rash judgement because they do not have the experience themseleves but "heard from others" also sound like a broken record repeating themseleves over and over again going nowhere. It all hearsay.

Be mature and if you truely don't want to see childern implanted then do the right way and get the laws change or pass on this intead of creating a "innocent threads/posts looking but gonna stir thing up". Your not gonna get laws passed by sitting behind monitor making post or thread like this you know.

I have a broken implant right now and was not able to use it for a month that there a good chance that I may have to go back and be re-implanted.

Yes I can die the second time around but I do know one thing. My doctor is going to everything in his power to make sure I don't die from it and if I do happen to die from the second implant then I nor my family will not hold him accountable but they know the doctor wasn't out to harm me when he implant me.




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[LadySekhmet]

^people -have- died from cochlear implantation. Arguably, every surgery is harmful, but there we draw the lines between "life saving" and "medically needed" and just "something helpful"

Yes, people have died from cochlear implantation, but what's TechBill is trying to say that the surgery isn't any more harmful than having a surgery for hip replacement, etc. You can have the best surgeon in the world, and complications arises unexpectedly due to the patients' physiology. Also, it's not just the surgeons themselves, but it's the other doctors/nurses in the room. Anesthesiologists have the toughest job because are the ones that has to monitor anesthesia levels. There's lousy surgeons in every type of surgery, not just CI. Have you heard about people leaving instruments in their patients' bodies? Screwed up plastic surgeries? Same idea. Even veterinarians botch up a simple cat neuter (I've seen it happen twice, and POOR cat!!).

More often, the only way surgeons can really learn from a case is if there's complications or sadly, even death. Because of the meningitis break out with AB users (most of them were children), now all CI users require the meningitis shot. If we didn't learn from the affected children, or the very few deaths (I only know one case), then more than half of us wouldn't have gotten the shot. Same thing applies to all surgeries, they learn from the past.

I draw the lines "medically needed", "something helpful", for people who get breast implants, face lift, lap bands, gastric bypass surgeries, but people still do it anyways and have been doing it for years. Who am I to tell them what to do? It's their choice.

Who's "we"? Don't make a hasty generalization. Instead, make it as "I".

 

[LadySekhmet]

Everything that TechBill said in post #4

 

[vallee]

Tech Bill and Lady Sekhmet - good postings

 

[TechBill]

Good posting ladysekhmet

 

[FreeThinker]

In order to be in violation of the Hippocratic Oath, it would have to be proven that Cochlear Implant is a harmful device.

And being CI user myself, I don't think cochlear implant is any more harmful than a pacemaker or a hip joint replacement etc.


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Umm, you do have a valid point. I have to admit that it would be difficult to prove that cochlear implant is a harmful device. I think it is about the perception of risks involving cochlear implant surgery. For example, if the medical community determines the risk of having a post-surgery complications of facial paralysis to be one patient out of 100 or whatever number of surgeries. The medical community may perceive it as an acceptable risk just like any other surgeries. But for the ASL-signing Deaf people, they may think that the risk is too great. Facial expressions are a crucial part of the ASL grammar. So if a cochlear implant patient has a facial paralysis and is not as successful as he or she is supposed to be with his or her hearing ability, then he or she would be having a hard time communicating with people who use ASL as a primary language. In an effort to put in a context that would make people without ASL background to understand better, facial expressions are just as important as the vocal intonation to convey the exact meaning of the message being carried out.

 

[Banjo]

From what I remember, the CI-related deaths were in fact, complications due to the gap left by a certain CI model. The gap itself allowed deadly bacteria to expand and then spread across the skull and neck. It's a common bacterial infection which resulted in deafness for many members here, it's known as meningitis. It's quite deadly, but the treatment they use would cause the child to become deaf. It is quite rare these days though. I believe they may had corrected that problem since then.

But there are still cases of facial paralysis due to accidentally severing the nerves. It's not deadly, but it's one of the complications that can occur after being implanted. Sometimes people will also experience numbness and sometimes foods would taste funny for the first few weeks.

But I do question the ethics of operating on a 6-month baby due to the accuracy of hearing tests on infants. What if the infant is in fact, hard-of-hearing or hearing but is mistaken for a deaf infant? Once they perform the surgery, the damage is done for life.

 

[FreeThinker]

Do you think there are doctors out there whom doesn't care who get implanted and dies from it?

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I do not believe there are doctors who are indifferent on who survived and who died on the operating table. This kind of attitude would put them out of work.

All those "Againist CI on Childern" posts or threads like this one is really a waste of time because it only will just stir thing up and goes no where but divide people.

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I am not too sure if it is a waste of time. The ASL-signing Deaf community is a minority group. As any other miniority groups, they have experienced rampant discrimination and oppression in their everyday living. Some of them have faced against the flow of society with great patience. Some of them may have short tempers and blurt out something that they later would regret. So there is a lack of understanding between the minority and the majority groups. Maybe we should open up meaningful dialogue with the minority groups.

I will say this

I will never ever dare tell another parents what they can or cannot do with their own children. They brought the child into this world and it is their responsibly to raise the child as they see fit.

.

I applaud you for saying that.

We have laws that protect everyone including our own children so if you or anyone think that children should not have a CI implanted in them then you need to go and talk to your senator about getting a law passed preventing implants in children.

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I won't lobby my Senators and House members about getting a law passed prohibiting implants in children. But I would lobby the medical community to ensure each child would be given full exposure to both English and ASL. Alexander Graham Bell Association for the Deaf advocates auditory-verbal therapy which involves no visual input. When a child is born, there is a crucial language acquisition period and want to take full advantage of this period by using the two pathways (ears and eyes). The baby's brain is prewired for lanuage and waiting for input (by either auditory or visual or both). What gets me mad is what if the child is not as successful as he or she is supposed to under the auditory-verbal therapy. This child does not have any back up plan and gets behind in his or her language development. We can remedy this problem by ensuring that each Deaf baby is exposed to two language. There is no evidence that learning two languages would slow down child's language acquistion. In fact, it would give the child greater cognitive flexiblily when he or she uses two or more languages. When this child grows up, he or she can choose one of languages to be his or her primary language.

99% of the "Againist CI" post I read on the internet is pretty much folks making rash judgement because they do not have the experience themseleves but "heard from others" also sound like a broken record repeating themseleves over and over again going nowhere. It all hearsay.

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I agree with you with people making rash judgement on the issue of cochlear implants, but I am not sure of the 99% figure. Please cite your source for the 99% figure. One prominent Deaf person with cochlear implant once said that the ASL users making negative comments about cochlear implants is not really about the cochlear implants itself. It is about the attitudes conveyed by the medical professionals. Such professionals often lacked sensitivity when dealing with people of various cultural backgrounds.

I have a broken implant right now and was not able to use it for a month that there a good chance that I may have to go back and be re-implanted.

Yes I can die the second time around but I do know one thing. My doctor is going to everything in his power to make sure I don't die from it and if I do happen to die from the second implant then I nor my family will not hold him accountable but they know the doctor wasn't out to harm me when he implant me.

.

I will be thinking of you on your second cochlear implant surgery. I hope it will be a successful one for you!

 

[vallee]

From what I remember, the CI-related deaths were in fact, complications due to the gap left by a certain CI model. The gap itself allowed deadly bacteria to expand and then spread across the skull and neck. It's a common bacterial infection which resulted in deafness for many members here, it's known as meningitis. It's quite deadly, but the treatment they use would cause the child to become deaf. It is quite rare these days though. I believe they may had corrected that problem since then.

But there are still cases of facial paralysis due to accidentally severing the nerves. It's not deadly, but it's one of the complications that can occur after being implanted. Sometimes people will also experience numbness and sometimes foods would taste funny for the first few weeks.

But I do question the ethics of operating on a 6-month baby due to the accuracy of hearing tests on infants. What if the infant is in fact, hard-of-hearing or hearing but is mistaken for a deaf infant? Once they perform the surgery, the damage is done for life.

I have a medical case of facial paralysis from giving birth to my daughter 9 years ago. I lost around 40% of feeling on my left side of my face and was under the care of a neurologist for the last 8 years. I had limited feeling from around my lip to my ear. After my CI surgery, my numbness on the left side has decrease to about 5% from 40%. Because of the nerve stimualater(something like that) it decreased the numbness. I has not increased 7 months after surgery. So I had the opposite effect. My neurologist said that everyone is different, but I am off all medicine for my facial numbness and migraines.

I also had my shot for meningitis.

 

[LadySekhmet]

I have a medical case of facial paralysis from giving birth to my daughter 9 years ago. I lost around 40% of feeling on my left side of my face and was under the care of a neurologist for the last 8 years. I had limited feeling from around my lip to my ear. After my CI surgery, my numbness on the left side has decrease to about 5% from 40%. Because of the nerve stimualater(something like that) it decreased the numbness. I has not increased 7 months after surgery. So I had the opposite effect. My neurologist said that everyone is different, but I am off all medicine for my facial numbness and migraines.

I also had my shot for meningitis.

Interesting...have your doctor ever consider of giving you a portable nerve/muscle simulator? Some people use it for their necks when it gives them issues. Happened to an interpreter of mine...her neck area gets very stiff after interpreting (due to bad car accident a few years ago), so she wears it while interpreting.

 

[shel90]

I do not believe there are doctors who are indifferent on who survived and who died on the operating table. This kind of attitude would put them out of work.




I am not too sure if it is a waste of time. The ASL-signing Deaf community is a minority group. As any other miniority groups, they have experienced rampant discrimination and oppression in their everyday living. Some of them have faced against the flow of society with great patience. Some of them may have short tempers and blurt out something that they later would regret. So there is a lack of understanding between the minority and the majority groups. Maybe we should open up meaningful dialogue with the minority groups.



I applaud you for saying that.



I won't lobby my Senators and House members about getting a law passed prohibiting implants in children. But I would lobby the medical community to ensure each child would be given full exposure to both English and ASL. Alexander Graham Bell Association for the Deaf advocates auditory-verbal therapy which involves no visual input. When a child is born, there is a crucial language acquisition period and want to take full advantage of this period by using the two pathways (ears and eyes). The baby's brain is prewired for lanuage and waiting for input (by either auditory or visual or both). What gets me mad is what if the child is not as successful as he or she is supposed to under the auditory-verbal therapy. This child does not have any back up plan and gets behind in his or her language development. We can remedy this problem by ensuring that each Deaf baby is exposed to two language. There is no evidence that learning two languages would slow down child's language acquistion. In fact, it would give the child greater cognitive flexiblily when he or she uses two or more languages. When this child grows up, he or she can choose one of languages to be his or her primary language.



I agree with you with people making rash judgement on the issue of cochlear implants, but I am not sure of the 99% figure. Please cite your source for the 99% figure. One prominent Deaf person with cochlear implant once said that the ASL users making negative comments about cochlear implants is not really about the cochlear implants itself. It is about the attitudes conveyed by the medical professionals. Such professionals often lacked sensitivity when dealing with people of various cultural backgrounds.



I will be thinking of you on your second cochlear implant surgery. I hope it will be a successful one for you!

 

[shel90]

From what I remember, the CI-related deaths were in fact, complications due to the gap left by a certain CI model. The gap itself allowed deadly bacteria to expand and then spread across the skull and neck. It's a common bacterial infection which resulted in deafness for many members here, it's known as meningitis. It's quite deadly, but the treatment they use would cause the child to become deaf. It is quite rare these days though. I believe they may had corrected that problem since then.

But there are still cases of facial paralysis due to accidentally severing the nerves. It's not deadly, but it's one of the complications that can occur after being implanted. Sometimes people will also experience numbness and sometimes foods would taste funny for the first few weeks.

But I do question the ethics of operating on a 6-month baby due to the accuracy of hearing tests on infants. What if the infant is in fact, hard-of-hearing or hearing but is mistaken for a deaf infant? Once they perform the surgery, the damage is done for life.

That's my concern as well. However, u used the word, "damage". What do you mean by that. Damage to their hearing or the phychological damage?

Thanks

 

[shel90]

I have a medical case of facial paralysis from giving birth to my daughter 9 years ago. I lost around 40% of feeling on my left side of my face and was under the care of a neurologist for the last 8 years. I had limited feeling from around my lip to my ear. After my CI surgery, my numbness on the left side has decrease to about 5% from 40%. Because of the nerve stimualater(something like that) it decreased the numbness. I has not increased 7 months after surgery. So I had the opposite effect. My neurologist said that everyone is different, but I am off all medicine for my facial numbness and migraines.

I also had my shot for meningitis.

Glad that your paralysis improved.

 

[vallee]

Interesting...have your doctor ever consider of giving you a portable nerve/muscle simulator? Some people use it for their necks when it gives them issues. Happened to an interpreter of mine...her neck area gets very stiff after interpreting (due to bad car accident a few years ago), so she wears it while interpreting.

they didn't because medicine was working. My CAT shows damaged to the nerves around the mouth. I was shocked to get the feeling back. They did say the migraines were from using a HA. My neurologist on the last visit said- just be thankful and hopeful it will not come back. I hope he is right.

 

[Banjo]

That's my concern as well. However, u used the word, "damage". What do you mean by that. Damage to their hearing or the phychological damage?

Thanks

I was referring to the residual hearing. I can't say much about the psychological damage as I don't know too much about that part.

 

[shel90]

I was referring to the residual hearing. I can't say much about the psychological damage as I don't know too much about that part.

Ok, thanks for clarifying. Let's just hope nothing like this will ever happen.

 

[jackiesolorzano]

In order to be in violation of the Hippocratic Oath, it would have to be proven that Cochlear Implant is a harmful device.

And being CI user myself, I don't think cochlear implant is any more harmful than a pacemaker or a hip joint replacement etc.


.

I agree with you completely.