Sources of Medical Technology: Universities and Industry by Committee on Technological Innovation in Medicine

Author:Committee on Technological Innovation in Medicine
Language: eng
Format: epub
Tags: Health and Medicine : Medical Technologies and Treatments
Publisher: NATIONAL ACADEMY PRESS
Published: 1995-01-01T00:00:00+00:00

The "Clinicians," The "Experimentalists," And The Establishing Of Clinical Feasibility

Among those otologists working on cochlear implantation William House is generally acknowledged as the "founding father." His place of honor at international conferences and the frequent demand for his recollections of the "early years" are witness to his status among his colleagues. Why should this be, given the previous history of work on electrophonic effects, and given the enormous criticism which his work received? The answer has to be sought in House’s contribution to the stabilization of a clinical context for work on electrical stimulation. It was House’s work, more than that of Simmons or Michelson and Merzenich, that attracted the attention of European otologists. It was House, and then in the same sort of way Chouard in France, who tried rapidly to establish a means of providing "the deaf" with an auditory prosthesis. The strategy adopted had a number of elements.

First, the claims of basic scientists that "it would not work given current knowledge" had to be countered. This was done by showing that it simply did, by "letting the patients speak." Patients were "made to speak" in various ways. One way, traditional in pathological approaches to the deaf, was simply to present live patients to an audience. A successful performance by a oralized individual is a traditional form of persuasion. Ballantyne et al. (1978) visiting House’s institute, describe such a performance:

Five implanted subjects were demonstrated to an audience which, in addition to ourselves, included visitors from Germany and the United States. They came in one at a time and sat on a platform, where they were interviewed by … a teacher of the deaf who is Director of Rehabilitation at the Center.

Similarly, Chouard wrote of his patients "performing" on television, while House devoted a large part of his first major article on implantation to the "testimony" of a patient. The latter’s account of his successful social functioning bore witness to what had been—and thus could be—achieved. For a lay public, and indeed for many clinicians, such performances are far more convincing than any statistical analysis of word-recognition tests. Moreover, such individual experiences—with their references to the rediscovered delights of music or bird song—are far more newsworthy than are dry statistics and complex batteries of audiological tests.

Second, the claims of medical colleagues that, given limited knowledge both of benefits and of possible damage, this kind of "human experimentation" was wrong had also to be countered. This could be done by arguing that it was not correct to view what was being done as "experimentation." Under attack by Kiang in 1973, as discussed earlier, House used this argument:

I am trying to do everything I can to improve the patient’s situation. That is basically different from an animal experiment in which I am required for scientific reasons to sacrifice the life of the animal. … If I put an electrode in a patient’s ear, will it cause some serious harm to the patient? If not, and if there is some chance of

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