According to the World Health Organization, over 465 million people worldwide are Deaf or Hard of Hearing; over 5% of the world’s population (World Health Organization, 2018). Since deafness is a spectrum, there are several medical definitions on what being Deaf really is. The Canadian Association of the Deaf uses the following medical definition:
“Anyone who cannot understand speech (with or without hearing aids or other devices) using sound alone (i.e. no visual cues such as lipreading) is deaf.” (Canadian Association of the Deaf, 2015).
There are many reasons why an individual could be Deaf, such as genetics, contraction of a virus such as meningitis, trauma and more. Knowing the medical definition of deafness is common knowledge to the average person, but there is one aspect that sparks debate: Is deafness a disease?
In a perfect world, answering this question would be easy: define deafness, define disease, and compare the two definitions to determine if deafness meets the criteria to be classified as a disease.
Step 1: Define deafness ✓
Step 2: Define disease
So why is this not straight-forward? The issue arises with the definition of disease. While the Merriam-Webster’s dictionary provides what seems like an adequate definition, I’ve learned over the past couple weeks that disease cannot be attributed to a single interpretation. Instead, the concept of disease can be viewed from different perspectives because it is really just a theory that exists to explain the components of a condition.
The perspectives of how to define a disease are rooted in two different foundations: the patient or the cause. The ontological and physiological perspectives are two competing concepts that fall under the cause-based theory. From a physiological perspective, a disease cannot exist outside of a patient because disease comes from within. There are several advantages to this theory, such that the disease can be treated on a patient-to-patient basis because it may affect everyone differently. However, since the disease comes from within the patient, it is possible that patients can be blamed for their own afflictions, which of course is not fair. From a physiological perspective, it makes sense why some people would classify deafness as a disease. You cannot catch deafness from another person, you cannot isolate deafness outside of a patient, and every Deaf person is affected differently because hearing loss is a spectrum. Contrastingly, there is the ontological perspective, which theorizes that diseases are separate from the patients they afflict. Here we see the first hole in the argument that deafness is a disease. You cannot catch deafness. Yes, it is possible sometimes individuals will catch a virus that can lead to deafness, but other individuals are born Deaf because of their genetic predisposition. So, under the ontological perspective, deafness does not appear to be a disease.
With such a contrast between the physiological and ontological perspectives, it is difficult to understand how anything can be classified as a disease. Therefore, there must be one defining characteristic that all diseases have in common. This is where the medical model comes into play. Also known as the organismic perspective, this model is the leading theory used in the classification of diseases. It does not focus on the source of the disease, but rather on how the disease impacts the patient. The organismic perspective highlights how diseases are a bad thing. Patients turn to medicine to alleviate the negative symptoms caused by the disease they are suffering from.
The question must then be posed: Do Deaf people wish they could hear?
Here is the Deaf perspective of that question:
There was one comment in the above video that I feel is really important to discuss, and that is the concept of Deaf culture and community. It raises the point that being Deaf is so much more than just an inability to hear. There are five sociological pillars necessary for defining something as a culture, and the Deaf community meets all of them: language, values, traditions, norms and identity (Canadian Hearing Society, 2013). I could write a whole essay on the importance of Deaf culture, its history and development through time, but that is not the assignment. The assignment is showing you how deafness is not a disease and Deaf culture is a crucial point in this discussion. Why? Because culture is positive.
This is the Hippocratic triangle of Disease, which is used to classify diseases based on three key elements: the observer, the illness, and the patient. With deafness, there are many observers. Not only can deafness be observed and diagnosed by a physician, but the hearing world is also a significant observer. It can be quite obvious that an individual is Deaf when an interpreter is needed during a lecture because there is a Deaf student in the class, or at a Starbucks when a non-oral Deaf person is placing their order. When it comes to identifying an observer, there is no doubt deafness meets that criteria. Then there is the illness component, which is slightly less clear depending on if you are using an ontological or physiological perspective. Overall, there is some structural dysfunction resulting in a loss of hearing. What really matters though is the third point on the triangle: the patient. I would like to argue that what seems like the most obvious component is actually the criterion that fails to declare deafness a disease. In accordance with the organismic perspective, patients are individuals who suffer from their diseases and they seek medical help to try and treat the disease. But if you look back on that video, none of those individuals are suffering, and none of them wanted to become a hearing person. Deaf people do not believe they need to be fixed and the majority truly love being deaf. A big portion of this has to do with the positives Deaf culture brings to the lives of Deaf individuals.
With the concept of no true patient in mind, I’d like to revisit the three disease perspectives discussed earlier in a new light. From an organismic perspective, while medicine has developed inventions like the cochlear implant, which can restore some hearing, many Deaf individuals choose to not receive an implant. This goes back to the concept that they do not feel they need to be fixed and that they are quite comfortable being deaf; there is no suffering that is characteristic of a patient who has a disease. Ontologically we already discussed the limitation of being unable to separate deafness from a person, but now we must also consider how Deaf culture shapes someone’s identity as well. So while you cannot isolate deafness because it is not a virus, you also cannot separate the individual and their identity that was developed through Deaf culture. This also relates to the physiological perspective. While deafness affects everyone differently, the Deaf culture is also a unifying factor that connects individuals together in many levels, not just a support system like most diseases. If you would like to read more about how Deaf culture is the defining factor when it comes to disease classification, check out this article.
Overall, deafness is not a disease. It is a culture, a community, and something to be embraced. Currently, deafness is medicalized, which means it is viewed as something abnormal rather than just a variation. Homosexuality was once medicalized because, in history, many people considered it wrong to be gay.
Today, the world is much more accepting, and we have realized that being LGBTQ+ is not abnormal, but simply a normal possibility of who a normal human could be. Deafness should be treated the same way and should be de-medicalized. To help end the stigma, I’ve joined the Queen’s American Sign Language (QASL) club. At QASL, all students, whether hearing, hard of hearing, or deaf, are welcome to learn sign language and more about the Deaf culture every week. Together we can help to change the historical perspective of deafness as a disease and instead embrace it as a diverse ability with a healthy, thriving culture.
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