History of the Cochlear Implant and Historical Controversies

“A Socio-cognitive Model of Technology Evolution: The Case of Cochlear Implants”
Authors: Raghu Garud and Michael A. Rappa
Publication: Organization Science
Date: August 3, 1994

This was the most interesting article I encountered in my search for information on cochlear implantation because it approaches the issue from an entirely different angle. The journal Organization Science seems to include articles that analyze greater trends in science. In the case of this article, information on cochlear implants is simply being used to illustrate “A Socio-Cognitive Model of Technology Evolution” which is an analysis of the way in which the attitudes of the scientific community affect the way the development of technology. Although the case of cochlear implants is only a case study, this paper seems to be the most inclusive collection of information on cochlear implants up to the article's publication date in 1994. According to the article, the authors sat in on meetings of cochlear implant manufacturing and development companies, attended conferences on the topic, and did thorough research of articles published on the topic. The authors of the study claim to have amassed a database of 1,329 articles, all of which were then thoroughly analyzed for their content, rated, and placed in a chronological and social context. The authors of this paper were willing to perform such rigorous research because they considered cochlear implants to be “‘sociopsychological’ products because several different interpretations of their safety and effectiveness have been possible.” This ststus for cochlear implants provided a fertile field for the authors' analysis of scientific bias and technology.

The scientific and business bias that plays a major part in the early implementation of cochlear implant technology was between single- and multi-channel cochlear implants, but even before this became an issue, the idea of implants themselves had to be dealt with. Before 1973, the National Institutes of Health would not support any technology that involved implantation because of a belief that implantation technology was “morally and scientifically unacceptable.” This changed, of course, but this background shows that the early researchers in cochlear implantation were dealing with several great unknowns. The most important of these unknowns was the possibility of neuro-physiological damage due to the insertion of electrodes into the cochlea.

The early supporters of the single-channel (single electrode) cochlear implant used this unknown to their business advantage, promoting the single-channel with shallow insertion into the cochlea as the least likely to cause damage. The company that produced the single-channel implant, and that was therefore its largest supporter, was the 3M Corporation. The article also mentions that 3M originally promoted the single-channel device, and the crude sound recognition it provided, as what the deaf community was looking for. In retrospect, and in the face of the mounting opposition of the deaf community to cochlear implants, this may be in fact true. However research in cochlear implants has recently been exclusively geared towards providing normal hearing to otherwise profoundly deaf individuals.

Despite concerns over neuro-physiological damage, many researchers and companies went along with research on multiple-channel implants. This research was driven by the Nucleus Corporation and by Graem Clark, a researcher at the University of Melbourne. The multi-channel devices were developed in the interest of providing deaf patients with the ability to recognize speech patterns and to distinguish between voices.

A bitter rivalry ensued between the 3M and Nucleus corporations, in which the support and approval of the FDA was contested, and each side accused the other of poor research practices. In the end, and when faced with evidence to the contrary, the supporters of multi-channel devices apologized for accusing that single-channel devices did not allow for speech pattern recognition, although for most of the debate neither side actually conducted that research. Multi-channel devices, which do provide a significantly higher level of speech recognition than do single-channel devices, eventually won favor and a three-day conference between the FDA and the NIH in 1988 produced a consensus that multi-channel implants were preferable.

In the article, the controversy over cochlear implants and the blindness experienced by each side in response to data which did not favor their product was analyzed according to three organizational principles. These are: evaluation routines (the process of evaluating a new technology, which may be suitable for the old technology and be unsuitable for application to a new technology), beliefs, and artifacts (the physical manifestations of a new technology, such as the cochlear implants themselves). Not only does the paper analyze the information on cochlear implants in an entirely new way, a “socio-cognitive model of technology evolution,” it also provided detailed information on a historical debate on cochlear implants which is entirely different from the current controversy. This historical controversy has been completey disguised by the current controversy about cochlear implants. In a sense, the historical controversy shaped the contemporary controversy: if single-channel implants had won out, cochlear implants would have been limited to providing a very basic sense of the sounds in the world, and would not be threatening the existence of a community based on sign language, the Deaf World.