1. Cochlear Implants Medical and Financial Disadvantages

2. Medical Risks and Disadvantages ●General Anesthesia risks ● allergic or coma ●Injury to the person's facial nerve ○ Partial facial nerve paralysis ●Cerebrospinal fluid leakage ●Meningitis ○ inflammation of the lining of the brain and spinal cord ●Taste disturbances ●Infection caused by rejection of implant ●Tinnitus ○ noises or ringing in the ears or head when no such external physical noise is present ●Vertigo ○ a sensation of whirling and loss of balance

3. Personal Disadvantages ●Environmental & practical living issues: ○ Static: radar detectors, playgrounds, trampolines, computers and carpeting ○ Pressure: some recommended restrictions, i.e. scuba diving ○ Magnetic: MRI restrictions ○ Trauma: restrictions from rough sports such as football. ○ Temporarily reduced hearing may also occur when ear infection is contracted together with the buildup of excessive fluids in the middle ear, interfering with the conveyance of the impulses. ○ Less control over prosthetic device, i.e., once a manufacturer’s device is implanted, the implantee has no option but to remain with that device for life, unless the device fails or the implantee elects to pay for another surgery/device.

4. Financial Disadvantages ●Cochlear implantation is expensive and financing is of great concern to many candidates. ●The average costs for the procedure exceed $40,000. ●More expensive than a hearing aid, the total cost of a cochlear implant, including evaluation, surgery, device, and rehabilitation can cost as much as $100,000. ●Health insurance may cover these initial costs, but plans are not unlimited. Additional insurance and maintenance contracts are frequently necessary.

5. Cochlear Implants Perspective From the Deaf Community

6. Deaf. Not Disabled. ●Cochlear implants raise many issues in the deaf community. Three of which are: "fixing" deaf children, giving a false sense of hope to hearing parents, and forcing a choice of culture upon deaf children. ●Members of the Deaf community don’t see themselves as having a “disability.” On the contrary, they view themselves as a minority culture group, one with their own language and similar life and cultural experiences. ●The stance against the use of cochlear implants is strongest among individuals of the deaf community who were born without the ability to hear. ●In the 1980's and 90's, members of the Deaf community held protests against the use of cochlear implants, especially in young children. ●The cochlear implant is often forced upon a deaf child by hearing parents. Hearing aids can be removed, but implants cannot. ●Children cannot actually regain their hearing with a cochlear implant. It is a synthetic digital sound.

7. National Association for the Deaf (NAD) Position ●Cochlear implants do not eliminate deafness. An implant is not a “cure” and an implanted individual is still deaf. Cochlear implants may destroy what remaining hearing an individual may have. Therefore, if the deaf or hard of hearing child or adult later prefers to use an external hearing aid, that choice may be removed. ●While the implant may work quite well for post-lingually deafened individuals, this result just cannot be generalized to pre-lingually deafened children for whom spoken language development is an arduous process, requiring long-term commitment by parents, educators, and support service providers, with no guarantee that the desired goal will be achieved. ●Parents face challenges when their child is born deaf or becomes deaf. At least ninety percent of deaf and hard of hearing children are born to hearing parents who usually want their children to be like themselves, to understand sound, to use their voices and verbally express their thoughts through spoken language, and to hear the voices and spoken language of those around them. ●Language and communication are not the same as speech, nor should the ability to speak and/or hear be equated with intelligence, a sense of well-being and lifelong success.

8. NAD (cont.) ●Medical professionals have historically been the first point of contact for parents of deaf children. Their expertise is valuable but is primarily limited only to their medical areas of expertise. They should not be viewed as, nor should they function as, experts with regard to larger issues such as the educational, psychological, social, and linguistic needs of the deaf child. ●Deafness is irreversible. Even with the implant and increased sound perception, the child is still deaf. Cochlear implants are not a cure for deafness. The most serious parental responsibility from the very beginning is total commitment to, and involvement with, their child’s overall development and well-being. ●Cochlear implant surgery is a beginning, not an end. The surgery decision represents the beginning of a process that involves a long-term, and likely, life-long commitment to auditory training, rehabilitation, acquisition of spoken and visual language skills, follow-up, and possibly additional surgeries. ●Throughout the developmental years, the deaf child -- implanted or not, mainstreamed or not – should receive education in deaf studies, including deaf heritage, history of deafness and deaf people, particularly stories and accounts of deaf people who have succeeded in many areas of life.

9. Sound and Fury preview

10. Sound and Fury: 6 Years Later

11. Melinda’s Story I was 6 years old in 1972, when I became ill with strep throat and a double inner ear infection. The pressure in my right ear was excruciating, and I went to an ENT to have it lanced, a procedure where they drain the fluid by incising the edge of the tympanic membrane (the ear drum). The lancing is one of the most vivid memories of my childhood. Since then, I have an extreme aversion to having anything touch my ear. In spite of the antibiotics and incision, the high fever had caused complete sensorineural deafness in my right ear, with slight hearing loss in my left ear. Since my auditory nerve was damaged, a typical hearing aid was not an option for me. I was taught lip-reading in speech classes throughout elementary school, in one-on-one classes with a speech therapist once a week. The FDA formally approved the marketing of the 3M/ House cochlear implant in November 1984,approved when I was a freshman in college. My parents and I researched the technology at the advice of my audiologist. I made the decision not to have a cochlear implant, primarily due to the disparity in quality of sound, as well as the considerable financial costs. Also, my hearing loss was never a seriously impactful disability. As the hearing in my left ear deteriorates as I age, I will reconsider the surgery if necessary.

12. References Albertini, John A. and Hintermair, Manfred. (2005). Ethics, Deafness, and New Medical Technologies. Journal of Deaf Studies and Deaf Education Vol 10 No 2. Enerstvedt, R. T. (1999). New medical technology: To what does it lead? American Annals of the Deaf, 144, 242–249. Hossain, Shaikat. (2013). Cochlear Implants and the Deaf Culture: A Transhumanist Perspective. H+ Magazine. www.hplus.magazine.com. National Association of the Deaf. (2000). NAD Position Statement on Cochlear Implants. www.nad.org. Sparrow, Robert. (2005). Defending Deaf Culture: The Case of Cochlear Implants. The Journal of Political Philosophy, Vol 13, No 2, pp 135 - 152. 2005.