THE DECISION OF REFUSING COCHLEAR IMPLANTATION IN CHILDREN: BIOETHICAL CONSIDERATIONS

Resumo

Abstract: Starting from the observation that the cochlear implantation represents a “therapeutic frontier” that has radically changed the scenarios of irremediability in the most serious cases of deafness and, above all, of deep congenital deafness that cannot be compensated with hearing devices, the article aims at clarifying the ethical and legal problems arising by the application of the method in the case of young children. With the intent to address and unravel the problematic issue of refusing intervention by some parents, proponents of the “deaf culture”, the benefit for the child is highlighted, in terms of protection of psycho-physical health, and not only of the protection of life, as a criterion intended - according to the law in force in Italy - to shape (and limit) the choices that the parental responsibility holders are called to make on behalf of the child. Because of this criterion, it is stressed that the parent’s conviction that their child's life is at their disposal has no legal and ethical justification. On the contrary, the emphasis is placed on the fact that parents have the duty to not compromise their child's quality of life based on their choices, as is the case when an intervention has proven positive effects on cognitive and relational development. However, it is argued that the removal of parents’s right to decide in order to put it back to the tutelary judge (Guardianship) should be the last resort, in the hope that, thanks to the adoption of the most appropriate communication strategies and an open approach to confrontation, it will be possible to overcome resistance and make shared decisions.

Keywords: Cochlear implants, Children, Informed consent, Bioethics.