Montreal Gazette 1/25/01

LYNN MOORE

The Gazette

Fed up with "bureaucratic" hurdles in Quebec and aided by private donations, a Laval man has arranged for his son to have cochlear-implant surgery at a Vermont hospital in March.

"I met with the surgeon (at Fletcher Memorial Hospital in Burlington) last Monday and he said that Ryan is a perfect candidate for the implant," Frank Duchoeny said.

Duchoeny's decision to take his 9-year-old son south of the [Canadian] border follows the refusal of the Régie de l'Assurance Maladie du Quebec to pay for the surgery, after the one Quebec hospital that performs the implants rejected Ryan as a candidate. Among the reasons cited for the refusal were Ryan's age and his ability to communicate in sign language. Specialists in New York and Ontario subsequently examined Ryan and determined that he was a suitable candidate for the inner-ear transplant [implant].

Duchoeny plans to appeal the health insurance board's decision, but said this week he is unwilling to wait until that process is completed because it could take more than a year.

Should the board decide to cover the $36,000 (U.S.) cost of the Vermont operation, Duchoeny said he will turn over the money to the Jewish Community Foundation, which is collecting funds to pay for the implant. The money will be designated to help another child in a similar position, Duchoeny said.

Invented in the 1970s, the cochlear implant is still hotly debated in the deaf community, certainly when it involves children. It has polarized the deaf, said James McDougall, a McGill University psychologist who lectures on the subject. "There were equal controversies about the hearing aid 20 years ago, and there still are today. But this is a far more expansive and intrusive (intervention)."

The latest cochlear implants look similar to hearing aids. An external microphone picks up sounds and transmits them to about 22 electrodes in various sites in the inner ear. Combined with intensive therapy, many severely deaf people can regain partial hearing as they learn to distinguish sounds, and some can gain spoken language skills. The best candidates for implants are adults who have gone deaf later in life, McDougall said, "because the brain has representation for language and knows what sound is."

There are no guarantees the implant will work, he said, and when it fails, blame is often wrongly assigned to faulty rehabilitation. "There are certainly no miracles (with the implant). It doesn't restore hearing, it just gives a sensation. For some kids, it does work well, for others, it doesn't."

Debaters should address whether implants are the best way to spend scarce resources for the deaf, McDougall said.

According to the Canadian Association of the Deaf, the implant surgery should not be performed on children. The implants are [generalized] as "bionic ears," which is misleading and raises false hopes among parents of children who are deaf, the association states in a position paper.

The group's director could not be reached for comment.

Should the child have the surgery, the damage it causes will leave him or her unable to benefit from future developments in the technology, the association says.

The Canadian Hard of Hearing Association supports the implant for children whose parents have informed themselves about the relevant issues, the association's executive director said yesterday. "Our group supports technology, anything that can integrate (a deaf person) into Canadian society," Janice McNamara said.

Her association has supported the Duchoeny family and has written to Quebec Health Minister Pauline Marois. The association said Quebec's decision to refuse Ryan the implant, apparently in part because he is able to use sign language, amounts to discrimination based on a physical disability and is contrary to the Quebec Charter of Human Rights.

McNamara's association does note that "there is no information on the ultimate social and psychological consequences" of implants for youngsters.

Duchoeny says neither he, nor Ryan, expects a miracle cure. "Ryan is fully aware that he may not be able to speak [completely clearly]. The fact of the matter is that if he puts his mind to it, he will succeed. When you give a person the input to hear, it translates into language."

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If you are in the United States, for more information about the Ryan Duchoeny implant fund, and to give Frank Duchoeny additional assistance, research results, and your own personal experiences and information if you are a CI user, send an email to Frank Duchoeny at frank@duchoeny.com.

*For more information about Ryan Duchoeny, please contact Frank Duchoeny at (514) 342-4636.

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