Skip to main content

Advertisement

Log in

Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions

  • Original Paper
  • Published:
Science and Engineering Ethics Aims and scope Submit manuscript

Abstract

Biomedical engineering technologies such as brain–machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be “human” if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism’s reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation’s unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation—and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. Google describes him as “vice president and Chief Internet Evangelist for Google” and “widely known as a ‘Father of the Internet’.” http://research.google.com/pubs/author32412.html.

References

  • Adams, V., Murphy, M., & Clarke, A. E. (2009). Anticipation: Technoscience, life, affect, temporality. Subjectivity, 28, 246–265.

    Article  Google Scholar 

  • Agar, N. (2007). Whereto transhumanism? The literature reaches a critical mass. The Hastings Center Report, 37(3), 12–17.

    Article  Google Scholar 

  • Andersson, Y., & Burch, S. (2010). Deaf and disability studies: A conversation with Yerker Andersson. In S. Burch & A. Kafer (Eds.), Deaf and disability studies: Interdisciplinary perspectives (pp. 193–203). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Atkins, D. V. (2010). Therapeutic issues with recipients of cochlear implants. In I. W. Leigh (Ed.), Psychotherapy with deaf clients from diverse groups (pp. 300–319). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Balkany, T., Hodges, A. V., & Goodman, K. W. (1996). Ethics of cochlear implantation in young children. Otolaryngology: Head and Neck Surgery, 114(6), 748–755.

    Google Scholar 

  • Béland, J.-P., Patenaude, J., Legault, G. A., Boissy, P., & Parent, M. (2011). The social and ethical acceptability of NBICs for purposes of human enhancement: Why does the debate remain mired in impasse? Nanoethics, 5(3), 295–307.

    Article  Google Scholar 

  • Bishop, J. P. (2010). Transhumanism, metaphysics, and the posthuman god. Journal of Medicine and Philosophy, 35(6), 700–720.

    Article  Google Scholar 

  • Blume, S. (2010). The artificial ear: Cochlear implants and the culture of deafness. New Brunswick, NJ: Rutgers University Press.

    Google Scholar 

  • Bodner-Johnson, B., & Benedict, B. S. (2012). Bilingual deaf and hearing families: Narrative interviews (p. 2012). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Boot, B. P., Partridge, B., & Hall, W. (2012). Better evidence for safety and efficacy is needed before neurologists prescribe drugs for neuroenhancement to healthy people. Neurocase, 18(3), 181–184.

    Article  Google Scholar 

  • Bostrom, N. (2005). In defense of posthuman dignity. Bioethics, 19(3), 202–214.

    Article  Google Scholar 

  • Bostrom, N. (2009). Why I want to be a posthuman when I grow up. In B. Gordijn & R. Chadwick (Eds.), Medical enhancement and posthumanity (pp. 107–136). Netherlands: Springer.

    Chapter  Google Scholar 

  • Bostrom, N., & Sandberg, A. (2009). Cognitive enhancement: Methods, ethics, regulatory challenges. Science and Engineering Ethics, 15(3), 311–341.

    Article  Google Scholar 

  • Buller, T. (2013). Neurotechnology, invasiveness and the extended mind. Neuroethics, 6(3), 593–605.

    Article  Google Scholar 

  • Campbell, C. S., Keenan, J. F., Loy, D. R., Matthews, K., Winograd, T., et al. (2008). The machine in the body: Ethical and religious issues in the bodily incorporation of mechanical devices. In B. A. Lustig, B. A. Brody, & G. P. McKenny (Eds.), Altering nature, volume two: Religion, biotechnology, and public policy (pp. 199–257). Berlin: Springer.

    Chapter  Google Scholar 

  • Camporesi, S. (2008). Oscar Pistorius, enhancement and post-humans. Journal of Medical Ethics, 34, 639.

    Article  Google Scholar 

  • Cavuoto, J. (2002). The market for neurotechnology. Journal of Medical Marketing, 2(3), 263–274.

    Article  Google Scholar 

  • Chandler, J. A. (2013). Autonomy and the unintended legal consequences of emerging neurotherapies. Neuroethics, 6(2), 249–263.

    Article  Google Scholar 

  • Chatterjee, A. (2013). The ethics of neuroenhancement. In J. L. Bernat & H. R. Beresford (Eds.), Handbook of clinical neurology (Vol. 118, pp. 323–334). Amsterdam: Elsevier B.V.

    Google Scholar 

  • Chorost, M. (2005). Rebuilt: How becoming part computer made me more human. New York: Houghton Mifflin.

    Google Scholar 

  • Chorost, M. (2011). World wide mind: The coming integration of humanity, machines, and the internet. New York: Free Press.

    Google Scholar 

  • Christiansen, J. B., & Leigh, I. W. (2004). Children with cochlear implants: Changing parent and deaf community perspectives. Archives of Otolaryngology: Head and Neck Surgery, 130(5), 673–677.

    Article  Google Scholar 

  • Christiansen, J. B., & Leigh, I. W. (2011). Cochlear implants and deaf community perceptions. In R. Paludneviciene & I. W. Leigh (Eds.), Cochlear implants: Evolving perspectives (pp. 39–55). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Clausen, J. (2009). Man, machine and in between. Nature, 457(7233), 1080–1081.

    Article  Google Scholar 

  • Clausen, J. (2011). Conceptual and ethical issues with brain–hardware interfaces. Current Opinion in Psychiatry, 24(6), 495–501.

    Google Scholar 

  • Coeckelbergh, M. (2013). Human being @ risk: Enhancement, technology, and the evaluation of vulnerability transformations. Dordrecht: Springer.

    Book  Google Scholar 

  • Cohen, R. L., Alfonso, Y. N., Adam, T., Kuruvilla, S., Schweitzer, J., & Bishai, D. (2014). Country progress towards the Millennium Development Goals: Adjusting for socioeconomic factors reveals greater progress and new challenges. Globalization and Health. doi:10.1186/s12992-014-0067-7.

    Google Scholar 

  • Commey, P. (2014). Lessons in justice. New African, 543, 6–7.

    Google Scholar 

  • Cooper, R. (2012). Can it be a good thing to be deaf? In P. V. Paul & D. F. Moores (Eds.), Deaf epistemologies: Multiple perspectives on the acquisition of knowledge (pp. 236–252). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Cosetti, M. K., & Waltzman, S. B. (2011). Cochlear implants: Current status and future potential. Expert Review of Medical Devices, 8(3), 389–401.

    Article  Google Scholar 

  • Crouch, R. A. (1997). Letting the deaf be deaf: Reconsidering the use of cochlear implants in prelingually deaf children. Hastings Center Report, 27(4), 14–21.

    Article  Google Scholar 

  • Danaher, J. (2014). Hyperagency and the good life—Does extreme enhancement threaten meaning. Neuroethics, 7(2), 227–242.

    Article  Google Scholar 

  • Diep, L., & Wolbring, G. (2013). Who needs to fit in? Who gets to stand out? Communication technologies including brain–machine interfaces revealed from the perspectives of special education school teachers through an ableism lens. Education Sciences, 3(1), 30–49.

    Article  Google Scholar 

  • Douglas, T. (2013). Human enhancement and supra-personal moral status. Philosophical Studies, 162(3), 473–497.

    Article  Google Scholar 

  • Elliott, C. (2011). Enhancement technologies and the modern self. Journal of Medicine and Philosophy, 36(4), 364–374.

    Article  Google Scholar 

  • Farman, A. (2012). Re-enchantment cosmologies: Mastery and obsolescence in an intelligent universe. Anthropological Quarterly, 85(4), 1069–1088.

    Article  Google Scholar 

  • Farwell, L. A., & Donchin, E. (1988). Talking off the top of your head: Toward a mental prosthesis utilizing event-related brain potentials. Electroencephalography and Clinical Neurophysiology, 70, 510–523.

    Article  Google Scholar 

  • Fjord, L. (2010). Contested signs: Deaf children, indigeneity, and disablement in Denmark and the United States. In S. Burch & A. Kafer (Eds.), Deaf and disability studies: Interdisciplinary perspectives (pp. 67–100). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Gerland, P., Raftery, A. E., Ševčíková, H., Li, N., Gu, D., et al. (2014). World population stabilization unlikely this century. Science, 346(6206), 234–237.

    Article  Google Scholar 

  • Goyal, A. K., Rath, G., & Malik, B. (2014). Emerging nanotechnology approaches for pulmonary delivery of vaccines. In M. Giese (Ed.), Molecular vaccines: From prophylaxis to therapy (Vol. 2, pp. 580–601). Cham: Springer.

    Google Scholar 

  • Hang, A. X., Kim, G. G., & Zdanski, C. J. (2012). Cochlear implantation in unique pediatric populations. Current Opinion in Otolaryngology and Head and Neck Surgery, 20(6), 507–517.

    Article  Google Scholar 

  • Hardonk, S., Daniels, S., Desnerck, G., Loots, G., Van Hove, G., et al. (2011). Deaf parents and pediatric cochlear implantation: An exploration of the decision-making process. American Annals of the Deaf, 156(3), 290–304.

    Article  Google Scholar 

  • Hermsen, L. (2011). Manic minds: Mania’s mad history and its neuro-future. New Brunswick, NJ: Rutgers University Press.

    Google Scholar 

  • Hiddinga, A., & Crasborn, O. (2011). Signed languages and globalization. Language in Society, 40(4), 483–505.

    Article  Google Scholar 

  • Hollinger, D. (2013). Biotechnologies and human nature: What we should not change in who we are. Ethics and Medicine, 29(3), 173–190.

    Google Scholar 

  • Hyde, M. B., Punch, R. J., & Komesaroff, L. (2010). Coming to a decision about cochlear implantation: Parents making choices for their deaf children. Journal of Deaf Studies and Deaf Education, 15(2), 162–178.

    Article  Google Scholar 

  • Jebari, K., & Hansson, S.-O. (2013). European public deliberation on brain machine interface technology: Five convergence seminars. Science and Engineering Ethics, 19(3), 1071–1086.

    Article  Google Scholar 

  • Johnson, S., & Capdevila, R. (2014). ‘That’s just what’s expected of you… so you do it’: Mothers discussions around choice and the MMR vaccination. Psychology & Health, 29(8), 861–876.

    Article  Google Scholar 

  • Kermit, P. (2012). Enhancement technology and outcomes: What professionals and researchers can learn from those skeptical about cochlear implants. Health Care Analysis, 20(4), 367–384.

    Article  Google Scholar 

  • Kerr, I. & Wishart, J. (2008). “A tsunami wave of science”: How the technologies of transhumanist medicine are shifting Canada’s health. Health Law Journal, Special Edition, 13–40.

  • Kirmayer, L. J., Raikhel, E., & Rahimi, S. (2013). Cultures of the internet: Identity, community and mental health. Transcultural Psychiatry, 50(2), 165–191.

    Article  Google Scholar 

  • Kline, R. (2009). Where are the cyborgs in cybernetics? Social Studies of Science, 39(3), 331–362.

    Article  Google Scholar 

  • Koch, T. (2010). Enhancing eho? Enhancing what? Ethics, bioethics, and transhumanism. Journal of Medicine and Philosophy, 35(6), 685–699.

    Article  Google Scholar 

  • Kurzweil, R. (2005). The singularity is near: When humans transcend biology. New York: Viking Press.

    Google Scholar 

  • Lane, H. L. (2002). Do deaf people have a disability? Sign Language Studies, 2(4), 356–379.

    Article  Google Scholar 

  • Larriviere, D., Williams, M. A., Rizzo, M., & Bonnie, R. J. (2009). Responding to requests from adult patients for neuroenhancements: Guidance of the ethics. Law and Humanities Committee. Neurology, 73(17), 1406–1412.

    Google Scholar 

  • Leigh, I. W., & Maxwell-McCaw, D. (2011). Cochlear implants: Implications for deaf identities. In R. Paludneviciene & I. W. Leigh (Eds.), Cochlear implants: Evolving perspectives (pp. 95–110). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Levy, N. (2002). Reconsidering cochlear implants: The lessons of Martha’s Vineyard. Bioethics, 16(2), 134–153.

    Article  Google Scholar 

  • Mauldin, L. (2014). Precarious plasticity: Neuropolitics, cochlear implants, and the redefinition of deafness. Science, Technology and Human Values, 39(1), 130–153.

    Article  Google Scholar 

  • Mehlman, M. J. (2012). Transhumanist dreams and dystopian nightmares: The promise and peril of genetic engineering. Baltimore: The Johns Hopkins University Press.

    Google Scholar 

  • Menuz, V., Hurlimann, T., & Godard, B. (2013). Is human enhancement also a personal matter? Science and Engineering Ethics, 19(1), 161–177.

    Article  Google Scholar 

  • Michael, K. (2014). Beyond human: Lifelogging and life extension. IEEE Technology and Society Magazine, 33(2), 4–6.

    Article  Google Scholar 

  • Miller, Margery. (2012). Deaf worldviews, views of the deaf world, and the role of deaf children of hearing parents in creating a deaf epistemology. In P. V. Paul & D. F. Moores (Eds.), Deaf epistemologies: Multiple perspectives on the acquisition of knowledge (pp. 147–157). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Mills, M. (2011). Do signals have politics? Inscribing abilities in cochlear implants. In K. Bijsterveld & T. Pinch (Eds.), The Oxford handbook of sound studies (pp. 320–346). Oxford: Oxford University Press.

    Google Scholar 

  • More, M. (2013). The philosophy of transhumanism. In M. More & N. Vita-More (Eds.), The transhumanist reader: Classical and contemporary essays on the science, technology, and philosophy of the human future (pp. 1–17). Chichester: John Wiley & Sons.

    Chapter  Google Scholar 

  • Nario-Redmond, M. R., Noel, J. G., & Fern, E. (2013). Redefining disability, re-imagining the self: Disability identification predicts self-esteem and strategic responses to stigma. Self and Identity, 12(5), 468–488.

    Article  Google Scholar 

  • O’Brien, L. C., Kenna, M., Neault, M., Clark, T. A., Kammerer, B., et al. (2010). Not a “sound” decision: Is cochlear implantation always the best choice? International Journal of Pediatric Otorhinolaryngology, 74(10), 1144–1148.

    Article  Google Scholar 

  • Patil, P. G., & Turner, D. A. (2008). The development of brain–machine interface neuroprosthetic devices. Neurotherapeutics, 5(1), 137–146.

    Article  Google Scholar 

  • Paulesu, E., Harrison, J., Baron-Cohen, S., Watson, J. D. G., Goldstein, L., Heather, J., et al. (1995). The physiology of coloured hearing A PET activation study of colour-word synaesthesia. Brain, 118, 661–676.

    Article  Google Scholar 

  • Quadri-Sheriff, M., Hendrix, K. S., Downs, S. M., Sturm, L. A., Zimet, G. D., & Finnell, S. M. E. (2012). The role of herd immunity in parents’ decision to vaccinate children: A systematic review. Pediatrics, 130(3), 522–530.

    Article  Google Scholar 

  • Quet, M. (2014). It will be a disaster!. How people protest against things which have not yet happened: Public Understanding of Science. doi:10.1177/0963662514533752.

    Google Scholar 

  • Ramsey, N. F., Aarnoutse, E. J., & Vansteensel, M. J. (2014). Brain implants for substituting lost motor function: State of the art and potential impact on the lives of motor-impaired seniors’. Gerontology, 60(4), 366–372.

    Article  Google Scholar 

  • Roberts, D. (2010). The social immorality of health in the gene age: Race, disability, and inequality. In J. Metzl & A. Kirkland (Eds.), Against health: How health became the new morality (pp. 61–71). New York: New York University Press.

    Google Scholar 

  • Sarant, J. (2012). Cochlear implants in children: A review. In S. Naz (Ed.), Hearing loss (pp. 356–362). InTech. doi:10.5772/32762.

  • Schlaepfer, T. E. (2014). Deep brain stimulation of the human reward system for major depression—rationale, outcomes and outlook. Neuropsychopharmacology, 39(6), 1303–1314.

    Article  Google Scholar 

  • Sharon, T. (2014). Human nature in an age of biotechnology: The case for mediated posthumanism. Dordrecht: Springer.

    Book  Google Scholar 

  • Siebers, T. (2010). In the name of pain. In J. Metzl & A. Kirkland (Eds.), Against health: How health became the new morality (pp. 183–194). New York: New York University Press.

    Google Scholar 

  • Sorkin, D. L. (2013). Cochlear implantation in the world’s largest medical device market: Utilization and awareness of cochlear implants in the United States. Cochlear Implants International, 14(Suppl 1), S4–S12.

    Google Scholar 

  • Sparrow, R. (2005). Defending deaf culture: The case of cochlear implants. The Journal of Political Philosophy, 13(2), 135–152.

    Article  Google Scholar 

  • Sparrow, R. (2010). Implants and ethnocide: Learning from the cochlear implant controversy. Disability & Society, 25(4), 455–466.

    Article  Google Scholar 

  • Sparrow, R. (2014). Egalitarianism and moral bioenhancement. The American Journal of Bioethics, 14(4), 20–28.

    Article  Google Scholar 

  • Temkin, L. S. (2013). What’s wrong with enhancements? Journal of Medical Ethics, 39(12), 729–731.

    Article  Google Scholar 

  • The Editors of the Lancet. (2010). Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 375, 445.

    Article  Google Scholar 

  • Tirosh-Samuelson, H., & Mossman, K. L. (2012). New perspectives on transhumanism. In H. Tirosh-Samuelson & K. L. Mossman (Eds.), Building better humans? Refocusing the debate on transhumanism (pp. 29–52). Frankfurt: Peter Lang.

    Chapter  Google Scholar 

  • Tucker, B. P. (1998). Deaf culture, cochlear implants, and elective disability. Hastings Center Report, 28(4), 6–14.

    Article  Google Scholar 

  • Valente, J. M., Bahan, B., & Bauman, H.-D. (2011). Sensory politics and the cochlear implant debates. In R. Paludneviciene & I. W. Leigh (Eds.), Cochlear implants: Evolving perspectives (pp. 245–258). Washington, DC: Gallaudet University Press.

    Google Scholar 

  • Van Hilvoorde, I., & Landeweerd, L. (2010). Enhancing disabilities: Transhumanism under the veil of inclusion? Disability and Rehabilitation, 32(26), 2222–2227.

    Article  Google Scholar 

  • Veditz, G. (1912). Proceedings of the ninth convention of the national association of the deaf and the third world’s congress of the deaf, Colorado Springs, Colo. August 6–13, 1910. Los Angeles, CA: The Philocophus Press.

  • Vermeulen, A. M., van Bon, W., Schreuder, R., Knoors, H., & Snik, A. (2007). Reading comprehension of deaf children with cochlear implants. Journal of Deaf Studies and Deaf Education, 12(3), 283–302.

    Article  Google Scholar 

  • Warwick, K., Gasson, M. N., & Spiers, A. J. (2007). Therapeutic potential of computer to cerebral cortex implantable devices. In D. E. Sakas & B. A. Simpson (Eds.), Operative neuromodulation volume 2: Neural networks surgery (pp. 529–535). New York: Springer.

    Chapter  Google Scholar 

  • Wolbring, G. (2013). Hearing beyond the normal enabled by therapeutic devices: The role of the recipient and the hearing profession. Neuroethics, 6(3), 607–616.

    Article  Google Scholar 

  • Wolpaw, J. R., Birbaumer, N., McFarland, D. J., Pfurtscheller, G., & Vaughan, T. M. (2002). Brain–computer interfaces for communication and control. Clinical Neurophysiology, 113, 767–791.

    Article  Google Scholar 

  • Woolf, N. J., Priel, A., & Tuszynski, J. A. (2009). Nanoneuroscience: Structural and functional roles of the neuronal cytoskeleton in health and disease. Heidelberg: Springer.

    Google Scholar 

  • Yokoi, H. (2009). Cyborg (brain–machine/computer interface). Advanced Robotics, 23(11), 1451–1454.

    Article  Google Scholar 

Download references

Acknowledgments

I would like to acknowledge the thoughtful comments, encouragement, and insightful suggestions of the editors and anonymous reviewers which assisted in the preparation of this manuscript.

Conflict of interest

None.

Ethical standard

There was no research involving human participants and/or animals conducted.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph Lee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, J. Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions. Sci Eng Ethics 22, 67–92 (2016). https://doi.org/10.1007/s11948-015-9640-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11948-015-9640-6

Keywords

Navigation