March 10, 2010

Should We View Deafness With a Medical Model Viewpoint or a Cultural Model Viewpoint? Or Both?

I read a post on Deaf Read called Illinois Folks Speak Out for Hearing Aid Coverage. It is very informative and I suggest you take a look at the videos. These videos are of people talking about how hearing aids are a medical need, not cosmetic. Therefore, they should be covered by insurance.
I am all for it, of course.

It got me thinking about discussions people have of medical model vs.cultural model of deafness. The medical model focuses on how deafness is a disability and needs to be corrected and the cultural model focuses on deafness being a difference not a disability.

For me, I look at deafness with more of a medical model viewpoint. I view deafness as a disability for the most part (depending on the situation). I think about what degree of hearing loss someone has and also ways we can help the person function in the real world. I don't think it is just about "fixing" the hearing loss. It is also about ways of dealing with it so you can go out and communicate with people effectively, get a job, get around fine, etc. This could mean to learn sign language, learn how to lip read, get hearing aids, cochlear implants; whatever floats your boat.

Most hearing people have a medical model viewpoint, and this will probably always be the only way they will view deafness. They may look for "quick fixes" such as using cochlear implants. But, of course it is a lot more complicated than that. We can't just fix it. I think most people with the medical model perspective tend to be obsessed with the idea of fixing hearing loss. They would like to put a band aid on it and call it a day. But it is more than that. It is about learning to accept your hearing loss and finding ways to deal with it.

Many articles I found written by deaf people tend to favor the cultural model which they make obvious in their writing. I have a little bit of this viewpoint. I don't only think that deafness is a disability. There are times where my "disability" becomes an "ability." I think that I am lucky that I can choose not to hear at certain times (like when I need to sleep and it is noisy; I just sleep on my good ear and I am greeted by much needed quiet). I certainly don't think I am disabled at times like this.

I think it is important to consider both models. I keep both viewpoints in mind, but I still have more of a medical model viewpoint.

I can understand why many deaf people, particularly signing deaf people or anyone involved with Deaf culture would favor the cultural model. Because then the focus is off of their deafness, (why they are deaf, and how they can fix their hearing), onto themselves as people (what they can do, who are they, not just a person with deafness, deafness is not a disability, etc.).

However, after watching the videos from Hearing Aid 2008's blog, I realize how important it is to consider and accept the medical model of deafness.

Why is it important? Because if we are trying to get hearing aids covered by insurance what good is it to tell everyone that you do not have a disability? 

Deafness is not a disability? Really? What if I am in a classroom of small children and I have to mediate various spoken discussions they are having?  This would be a total nightmare for me. In this situation, I have a disability, especially if I do not wear hearing aids. I think a teacher with typical hearing would do a better job.

If you are deaf or have a hearing loss it makes sense to say that you have a disability. You are disabled if you are in situations where you need your hearing aid or when you rely on an interpreter. If you cannot function 100% on your own in certain situations because of your hearing loss, then yes it should be considered a disability.

If we focused more on the cultural model of deafness and expect others to not view deafness as a disability, then why should insurance companies take us seriously and consider hearing aids to be a medical need that should be covered by insurance?

Hearing aids are a medical necessity and they should be covered by insurance. Without my hearing aids I would struggle a great deal and would have to make a lot of changes in my life. 

Which model do you agree with more? Are hearing aids medical necessities that should be covered by insurance?



  1. I have a medical viewpoint but I am not obsess about curing my deafness. I just use CI and HA as a tool to cope in the world, also sign language when needed. Although hearing aids are not an issue over here, I believe they should be covered by insurance for those who want them because they are medical necessities, to enable people to hear and for people to communicate(especially those who have just become deaf and have no means of communicating other than spoken language)

    I do have a disability since I need equipment to enable me to hear, I need batteries and spare parts for the rest of my life, I need audiologists to make sure my CI and hearing aids are working correctly, I need interpreters when needed(since in the real world, a person is not going to stand still whilst talking or showing me something so I need an interpreter to fully understand everything) This is a great post!! Certainly made me think!

  2. I view Deaf as a cultural difference, much like being Hispanic.

    I see *lots* of accommodations for Spanish-speaking people. Some of these accommodations are written into law *and enforced*.

    Not so for Deaf. The Hearing expect all the responsibility for communication to be on the Deaf person. This lack of access strongly pushes Deaf toward use of HA and CI. If Hearing society is going to push HA on us, then Hearing society should bear at least a part of the cost. Perhaps health insurance is not the best way to do that, but it looks like the most open opportunity at the moment.


  3. Hearing aids are a definite medical necessity. The only time I appreciate being deaf in my left ear is when my husband snores and I sleep with my right ear to the pillow!

  4. As someone who was born HOH and raised in a deaf family and a part of the deaf culture, I view hearing loss as both medical and cultural. There's no avoiding one or the other except in cultural, it can be avoid for those who do not wish to be part of it.

    As I have said in the past, being deaf or hard of hearing, it is TECHNICALLY a disability.

    I don't go around with that stigma, however, it's a fact and not avoidable.

    Many deaf people get services under the disability provisions such as SSI or SSDI and you have to be considered disabled to get it, not culturally deaf. ;)

    Deaf people are culturally deaf based on language and other things but definitely not base on ethnicity and as such they should not compare themselves with other cultural ethnicity groups. JMO.

  5. Sharon Marie --

    Interesting about your both ears when you are sleeping. How can you tell when there is a noise in a bedroom during the night? I am very curious because you sleep the right ear onto the pillow and could not hear in the left ear.

    I have many hearing friends and they have told me that I was lucky not to hear snoring. They mostly prefer to have four bedrooms because most of the husbands go to the guest bedroom. Most of the married women does not want to deal with the snore.

    Accordingly to the Dateline or 20/20,(I don't remember when...) about the experiment between men and women during the sleep session. They found that there were more men than women from the tests.

    (e -- good blog. They should not have abused the "deafness."

    White Ghost

  6. I've been in the hearing health care industry for over 20 years so definitely the medical model for me. However, the type of hearing aids or even decisions to treat a medical condition such as a hearing loss is often based on social stigma. Thus the sizes and appearances of hearing aids have changed a great deal

  7. Geez-louise,

    I know for a fact that Jamie Burke has a CI. She has written in her Burke Outspoken blog about getting a CI. How does she juxtapose this use of hearing technology with her supposedly Deaf cultural view as you claim?

    I was born profoundly deaf yet raised oral and still use a hearing aid. There are some of us d/Deaf who cross this divide of the medical version of deafness and the culturally Deaf version several times over. I'm not as proficient in sign language as I am in the oral and written English, which is and always will be my first language, no matter how much I struggle with sign language, lol.

    There are some of us who are betwixt those two worlds and don't fit in either category. I suspect that Jamie would say the same. :)

  8. Ann_C - I said that Jamie Berke's article SEEMS to favor the cultural model. I never claimed that she only has this viewpoint. I know many deaf people who have hearing aids who strongly have or prefer to have a cultural model outlook. I have yet to meet one with a CI who prefers this model.

    Interesting, I had no idea that Jamie Berke was considering getting a CI. I have read in some of her articles that she does not like to wear hearing aids and has gone without them for a while. I am still learning a great deal about her.

    I think most of us are between worlds (just like how I am between being hearing and deaf). But I still look at deafness from more of a medical model viewpoint. However, there are times I view my deafness culturally. I don't think it should solely be one or the other.


  9. e)

    I just have to let you know that I've been enjoying reading your blog!

    Without any doubt, I definitely view deafness with a medical model viewpoint. I have bilateral cochlear implants. When I was growing up, I learned to hear and to speak utilizing the Auditory-Verbal approach. I've taken advantage of the ADA law as I had an IEP when I growing up, and I also used an assistive listening device in some classes.

    I agree with you that Jamie Berkke does seem to view deafness with a cultural model viewpoint.

  10. Most who are borderline deaf or are deafned/acquired/Hoh will see no issues in accepting both social AND medical models, some just accept the medical model. Perceptions mainly are based on individual experieinces and abiltities, it is nothing to do with culture. Loss defines disability aka the medial aspect. I'm not obsessed about cures either but that IS my bottom line, I am not a fan or preserving deafness ad infinitum, certainly NOT for future generations if a choice can exist. Hence I support CI's digital aids, BAHA's, and genetic research too. I think you have to live as a hearing person and then lose all that to know the realities of being deaf. I attach no credence to the view of those who have no other perspective, I am sure they are happy as they are, they know nothing else, but have no real reference point on the 'medical aspect'. We can only understand what we have lost, not so much whatever there is to be 'gained'.

  11. "Most who are borderline deaf or are deafened/acquired/HOH will see no issues in accepting both social and medical models, some just accept the medical model."

    That's what I was thinking of that statement. I agree. I strongly believe it's the "mother nature."

    White Ghost

  12. "I think you have to live as a hearing person and then lose all that to know the realities of being deaf. I attach no credence to the view of those who have no other perspective, I am sure they are happy as they are, they know nothing else, but have no real reference point on the 'medical aspect'. We can only understand what we have lost, not so much whatever there is to be 'gained'."

    Well said MM.

    I think I now understand where you were coming from when you commented on my post about "accepting your deafness" (Healing Deafness and Becoming "Normal").


  13. Someone asked me about sleeping with right ear in pillow to avoid hearing dh snoring. I am deaf in left ear but I am HOH in right ear so if I didn't sleep with right ear in pillow I would have problems with his snoring.

  14. cool blog friends!

  15. As I read your blog for research on my college paper "Cultural VS. Medical Model Deafness", I thought I had an opinion but realized I haven't heard enough from our friends in the Deaf thank you for your prospectives on this but I think we all need to do more research because MOST of us were at one time hearing and need to better understand never hearing a thing or never learning to speak.

  16. When I worked in Germany, I needed an interpreter at all times with me while on the job. When I got home, I didn't need one because everyone in my house spoke English. No, I was not fully able to "function on my own" while out shopping without the use of an English-German dictionary, or unless my interpreter was with me.

    Now supposing I was Deaf, I would need an interpreter at all times while on the job, but when at home I wouldn't need one. My family would Sign (in an ideal world, or if they were Deaf, too).

    Now I as a hearing person would not be able to function on my own at a place like certain parts of Washington DC, Michigan, or Austin, places with HUGE Deaf communities. Unless I had someone with me who could Sign.

    Given the former reasoning, I could make an argument that in certain situations, being an Anglophone is a disability. A medical problem to be overcome. And no matter what there are certain phonemes I'll NEVER be able to pronounce in German and sound like a native German speaker.

    My point: for MOST Deaf people, the ability to speak clearly enough for a hearing person to understand them, the ability to lip read, and the ability to hear anything beyond the loudest sounds will never happen.

    I'll never be "fixed" to be someone who was born into the English language, and for most Deaf people, there is nothing mutable about their Deafness.

    It's cultural.

    Hard of Hearing is a different story and depends on the individual, their individual perspective, and their amount of hearing loss, as well as when they became Hard of Hearing.

    It's cultural. Just my two cents.

  17. I'm just happening to see this post and I think your perspective is like mine. I am late deafened (progressive hearing loss that started 20 years ago)--it is moderately severe now. I think boomers now experiencing hearing loss tend to go very medical model, which in some ways seems like a dead end road--even with 16 different new technologies hanging off you, it's not gonna be normal hearing. Like you, I think acceptance is the key--but at the same time I would like to see boomers lend their voice to political action--like getting hearing aids covered. AARP seems worthless in this regard--all their posts are like-- ignore aging! ignore disability! Anyway--thanks for your great blog!


Keep it civil.