Sammendrag
Perhaps the most dominating question in the bioethical discourse on paediatric cochlear implantation is that of whether or not a prelingual deaf child should undergo surgery. This paper argues that other, possibly more important questions can be posed if the bioethical discourse is based on a better empirical understanding of what cochlear implantation might mean for a prelingual deaf child. Many contributors for and against paediatric cochlear implantation base their arguments on the theoretical premise that choosing whether or not to implant is effectively the same as choosing between having a hearing and speaking child or a (culturally) Deaf and signing child. This notion is rejected analytically as oversimplified. Methodologically it is paramount to distinguish between hearing ability, the ability to pick up and utter words or sentences and the ability to use language to successfully interact with others. The text argues that more epistemological weight should be placed on the latter. Unfortunately, it is not only the greater part of the bioethical discourse that fails to do this, much of the clinically conducted outcome research does the same. To make the proposed distinction, it is necessary to reflect over the methodological requirements empirical investigations should meet. A pilot study modelled according to these suggested requirements is presented and discussed. The foregrounding of communicative practises in this pilot study highlighted several bioethical aspects of cochlear implantation. These aspects are connected to questions of identity formation and adult expectations in relation to the technology. The paper suggests that these new questions should be adopted in the ongoing bioethical discussion and recommends further research in order to reach a better assessment of practices related to cochlear implantation.
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