Whoa!

[Oceanbreeze]

I find it odd that you would turn this around to be the responsibility of a confused mother, rather than on the unethical behavior of an audi.

Since there have been instances of others whom this audi has referred to this particualr ENT for CI evaluation, it can be safely assumed that is a part of the process. Likewise, it was reported that the audi, herself, admitted to this being standard practice for her.

Likewise, if this mother was as confused as you have described, then this is the exact point that the audi should have backed off and permitted this mother time to come to terms with and digest all of the inforamtion she had been given. The audi did just the opposite. She pushed this parent when the parent was most vulnerable.

Sorry, but all arrows point toward the audi.

That's the way I see it. I also think it's plausible to think that it's standard practice with some audis. I've come across doctors who were "tunnel visioned" with a particular treatment and wouldn't take no as an answer.

It happens.

 

[shel90]

Question

In my experience and from what many parents have told me...

When I first learned about what a CI was, it was back in 1995 or something like that. The audi showed me it and everything and I said no. The audi said "It can improve your life." All I could think was how bad I felt afterwards as a deaf person myself getting the implication that my life is so terrible. I really didnt appreciate that at all and yes, I felt a little pressured but luckily I followed my gut feeling knowing that I wasnt ready and maybe never will be.

Many of the parents have told me that the audis or drs say that it is up to them but better act fast before the window of opportunity is lost forever or before it is too late. The parents are vulnerable, confused, scared, and unsure so by saying these kinds of things can play on their emotions leading them into making rash decision which they may not be ready for. One parent told me she wasnt comfortable with the decision up to the day of her child's surgery but she was so afraid to "miss that window of opportunity" whenever that means. I felt bad for her.

Arent those kinds of wording used by the drs and audis indirectly pressuring the parents or patients?

My other question is, how is it ok for an audi/dr step out of the objective view into a more subjective view? Isnt that crossing the line of ethics?

 

[shel90]

You are absolutely correct. There is no reason that a parent cannot examine CI along with their other choices. However, it is the parent's decision to decide if and when that will occur, not the audi's.

Right...nothing wrong with examining the CI route along with all other routes. Let the parents be in control of the whole process instead of the audis or doctors.

 

[jillio]

In my experience and from what many parents have told me...

When I first learned about what a CI was, it was back in 1995 or something like that. The audi showed me it and everything and I said no. The audi said "It can improve your life." All I could think was how bad I felt afterwards as a deaf person myself getting the implication that my life is so terrible. I really didnt appreciate that at all and yes, I felt a little pressured but luckily I followed my gut feeling knowing that I wasnt ready and maybe never will be.

Many of the parents have told me that the audis or drs say that it is up to them but better act fast before the window of opportunity is lost forever or before it is too late. The parents are vulnerable, confused, scared, and unsure so by saying these kinds of things can play on their emotions leading them into making rash decision which they may not be ready for. One parent told me she wasnt comfortable with the decision up to the day of her child's surgery but she was so afraid to "miss that window of opportunity" whenever that means. I felt bad for her.

Arent those kinds of wording used by the drs and audis indirectly pressuring the parents or patients?

My other question is, how is it ok for an audi/dr step out of the objective view into a more subjective view? Isnt that crossing the line of ethics?

To answer your questions, "Yes, that is indirect pressure, better known as manipualtion. And they are using the parents' vulnerability to their advantage."

"It's not okay. And yes, it is an ethical violation."

 

[Liza]

I don't think it's acceptable nor ethical for an audiologist to pressure his or her clients about CI.

 

[jag]

I just found out about something that had happened very recently in my hometown. A mother very recently found out her two year old daughter is deaf. She's overwhelmed with all of the information about deafness, communication philosophies, etc. Her audiologist discussed getting a CI. The mother said she wanted to wait until she had time to sort through all of the information first (and to have time for her shock to sink in).

The audiologist went ahead and scheduled the surgery anyway. She insisted that if the mother puts off the CI, then it may be "too late" for the child. Now the mother feels pressured to proceed with the CI surgery.

What's wrong with this picture?

What's wrong seems to be a hugh misunderstanding somewhere maybe between the mother and audiologist or perhaps between when the mom discussed this with someone outside the audiologists and when the above statement reached you.
Why would I say that?

1. an audi cannot schedule surgery. the statement here is saying that an audiologist made an appointment, yes the audiologist could have made an appontment to an implant center for the parent to become more informed but unless the child has seen an ENT the parent probably needed to make an appointment to see an ent for purposes of aiding.

2. a good audi will refer to an ENT because for most children under the age of 18 in order to get HA's alot of states require a 'prescription' for HA's. in fact here in MN the first set of aides requires a prescription from 2 separate ENT's. subsequent aides only require running back to one ENT and getting the prescription. So this could be the appointment that was set up. (tho i suppose MN could be the only state that requires parents to jump through these type of hoops.....I still don't agree with having to see the ENT to replace aides since the hearing is not going to return.sigh)

3. the prescription required in 2. is required to insure that the child really does NEED HA's. The ENT can look in the ear and decide if the loss is caused by something that could be fixed, an audi cannot do that.

So for an audiologist to refer a parent to an ENT around here is quite normal. As many here have stated our understanding is the child does need to trial hearing aides to see if they will help. And as I've mentioned here a audiologist needs an ok to dispense them to a minor. And an audiologist cannot schedule surgery.

 

[rick48]

What's wrong seems to be a hugh misunderstanding somewhere maybe between the mother and audiologist or perhaps between when the mom discussed this with someone outside the audiologists and when the above statement reached you.
Why would I say that?

1. an audi cannot schedule surgery. the statement here is saying that an audiologist made an appointment, yes the audiologist could have made an appontment to an implant center for the parent to become more informed but unless the child has seen an ENT the parent probably needed to make an appointment to see an ent for purposes of aiding.

2. a good audi will refer to an ENT because for most children under the age of 18 in order to get HA's alot of states require a 'prescription' for HA's. in fact here in MN the first set of aides requires a prescription from 2 separate ENT's. subsequent aides only require running back to one ENT and getting the prescription. So this could be the appointment that was set up. (tho i suppose MN could be the only state that requires parents to jump through these type of hoops.....I still don't agree with having to see the ENT to replace aides since the hearing is not going to return.sigh)

3. the prescription required in 2. is required to insure that the child really does NEED HA's. The ENT can look in the ear and decide if the loss is caused by something that could be fixed, an audi cannot do that.

So for an audiologist to refer a parent to an ENT around here is quite normal. As many here have stated our understanding is the child does need to trial hearing aides to see if they will help. And as I've mentioned here a audiologist needs an ok to dispense them to a minor. And an audiologist cannot schedule surgery.

Jag,

Great post!
Rick

 

[rick48]

I've come across doctors who were "tunnel visioned" with a particular treatment and wouldn't take no as an answer.

And were you so "intimidated" by them that you agreed to subscribe to that particular treatment even though you did not agree with it?

 

[Pinky]

What's wrong seems to be a hugh misunderstanding somewhere maybe between the mother and audiologist or perhaps between when the mom discussed this with someone outside the audiologists and when the above statement reached you.
Why would I say that?

1. an audi cannot schedule surgery. the statement here is saying that an audiologist made an appointment, yes the audiologist could have made an appontment to an implant center for the parent to become more informed but unless the child has seen an ENT the parent probably needed to make an appointment to see an ent for purposes of aiding.

2. a good audi will refer to an ENT because for most children under the age of 18 in order to get HA's alot of states require a 'prescription' for HA's. in fact here in MN the first set of aides requires a prescription from 2 separate ENT's. subsequent aides only require running back to one ENT and getting the prescription. So this could be the appointment that was set up. (tho i suppose MN could be the only state that requires parents to jump through these type of hoops.....I still don't agree with having to see the ENT to replace aides since the hearing is not going to return.sigh)

3. the prescription required in 2. is required to insure that the child really does NEED HA's. The ENT can look in the ear and decide if the loss is caused by something that could be fixed, an audi cannot do that.

So for an audiologist to refer a parent to an ENT around here is quite normal. As many here have stated our understanding is the child does need to trial hearing aides to see if they will help. And as I've mentioned here a audiologist needs an ok to dispense them to a minor. And an audiologist cannot schedule surgery.

 

[deafbajagal]

What's wrong seems to be a hugh misunderstanding somewhere maybe between the mother and audiologist or perhaps between when the mom discussed this with someone outside the audiologists and when the above statement reached you.
Why would I say that?

1. an audi cannot schedule surgery. the statement here is saying that an audiologist made an appointment, yes the audiologist could have made an appontment to an implant center for the parent to become more informed but unless the child has seen an ENT the parent probably needed to make an appointment to see an ent for purposes of aiding.

2. a good audi will refer to an ENT because for most children under the age of 18 in order to get HA's alot of states require a 'prescription' for HA's. in fact here in MN the first set of aides requires a prescription from 2 separate ENT's. subsequent aides only require running back to one ENT and getting the prescription. So this could be the appointment that was set up. (tho i suppose MN could be the only state that requires parents to jump through these type of hoops.....I still don't agree with having to see the ENT to replace aides since the hearing is not going to return.sigh)

3. the prescription required in 2. is required to insure that the child really does NEED HA's. The ENT can look in the ear and decide if the loss is caused by something that could be fixed, an audi cannot do that.

So for an audiologist to refer a parent to an ENT around here is quite normal. As many here have stated our understanding is the child does need to trial hearing aides to see if they will help. And as I've mentioned here a audiologist needs an ok to dispense them to a minor. And an audiologist cannot schedule surgery.

1) I'm not sure what the appointment is for..the audiologist said "surgery" to the mother, who told me what was said. I'll find out soon.
2) She did not make a referral to an ENT.

 

[deafbajagal]

Oceanbreeze,

Its also just as easy to explain away a parent's actions by saying they are "intimidated" by doctors.

Do you honestly believe that most parents are "intimidated" by doctors to the point that they would allow a surgery to be performed on their child that they did not want to happen!

As a parent of a child who has a cochlear implant and having been around many, many other such parents for over twenty years, my experience is that these parents are overwhelmingly NOT intimidated by doctors. They take the cochlear implant decision seriously and the last thing they are going to do is to submit their child to a surgical procedure merely because some doctor or audiologist said to do so.

If your experience with cochlear implant parents is different then I would like to know exactly the depth and breadth of that experience.

Does anyone who has gone through the cochlear implant evaluation process or understands that process seriously believe that after this parent's initial meeting with an audiologist that the surgery was scheduled for their next appointment? Anyone who has gone through the evaluation process, knows what is involved before anyone is implanted and thus, from the get go I find the mother's version to be suspect. Either she did not understand what she was being told or more likely as deafbajagirl stated in one of her last posts, the mother could not "hear" anything after the word surgery was used. I suspect its a combination of both.

Are there audiologists who overstep their bounds and pressure parents, I am certain there are but they are few and far between. Are there parents who abdicate their responsibilities and obligations to their children by unquestioningly following the advice of doctors or Deaf professionals, again I am certain there are and again, they are few and far between.

Also, lets not lose sight of the fact that the cochlear implant process is one that takes time from start to surgery and there is absolutely no reason why a parent cannot begin the process while examining other options. It is not a case of choosing one or the other at that point. Finally, always remember that the parent controls the process and a concerned and involved parent will neither choose a cochlear implant or deny their child a cochlear implant without having done the necessary research to make a reasoned and informed decision.
Rick

Few and far in between. Thank God for that. Unfortunately, if what the mother is saying is indeed true, then this professional is one of the "few" bad apples in the barrel. If I find that she is doing this kind of thing as part of her practice, I am going to do everything in my power to put a stop to it.

 

[deafbajagal]

Report complaints to American Board of Audiology, so they will take a look at the complaint(s) on unethical practices.

Or mom will seek another audiologist with understanding. Unfortunately, there are not that many audiologists who are understanding at all. They want $$$.

I respectfully disagree. I have many friends who are audiologists themselves...and they really have the best intentions at heart. If the stories about this woman is indeed true, she is really giving audiologists such as my friends a bad rep.

 

[deafbajagal]

Wow! The lady must be very young and inexperienced.

The audiologist has been published in several articles, etc. and is regarded as one of the top leading audiologists in the state according to the publications. She's been with the field for more than twenty five years. She has a lot of political influences with several organizations and with the state government. She's on all kinds of boards. She is actually a CI audiologist (which I didn't know until today) as well as a speech language pathologist. I've spoken to her during this year regarding some of my students. She was always kind, respectful, and resourceful. I was shocked when my friend told me about this mother (who is now my friend) and how she was treated. I spoke with the mother...and you know the story. I'm anxious to get to the bottom of this and to see what is going on. The more I dig, the more I do not like what I see.

 

[overthepond]

Sorry must say i have to agree with momtodeafchild and jag,

I think there is some misunderstanding with communcation between the mom and Audiology

Deafbajagal - good luck (is it today?)

 

[R2D2]

I respectfully disagree. I have many friends who are audiologists themselves...and they really have the best intentions at heart. If the stories about this woman is indeed true, she is really giving audiologists such as my friends a bad rep.

Yes, there are always bad eggs in every group, who pull down the rest. If not this woman, then someone else. Good luck with your meeting and hope that it's not too difficult and ends on a more positive and constructive note.

 

[rick48]

1) I'm not sure what the appointment is for..the audiologist said "surgery" to the mother, who told me what was said. I'll find out soon.
2) She did not make a referral to an ENT.

How can you not be sure? Earlier you said you had spoken to the audiologist directly:

"I called the audiologist just a few moments ago because I wanted a straight answer. Apparently she does this (call for an appointment to meet with the surgeon and even will schedule the surgery because the surgeon and her are great friends) for a lot of parents to help them with the "transition process." This person is claimed to be one of the most successful audiologists (who is also a speech pathologist) in the state. She has a lot of recognition for her work...and is highly praised by the field. Oh, boy."


There seems to be a lot of miscommunication and backtracking going on.
Rick

 

[jillio]

How can you not be sure? Earlier you said you had spoken to the audiologist directly:

"I called the audiologist just a few moments ago because I wanted a straight answer. Apparently she does this (call for an appointment to meet with the surgeon and even will schedule the surgery because the surgeon and her are great friends) for a lot of parents to help them with the "transition process." This person is claimed to be one of the most successful audiologists (who is also a speech pathologist) in the state. She has a lot of recognition for her work...and is highly praised by the field. Oh, boy."


There seems to be a lot of miscommunication and backtracking going on.
Rick

Deafbajagal has not backtracked in the least. You are simply looking for a way to exonerate this audi from her unethical behavior. As has been stated prior, it doesn't matter if the appt was for consult or presurgical workup. This parent was not ready to proceed, and the audiologist has placed her in a position of committing to something which she has already stated she was not ready to do. Where are all your speeches about freedom of choice for parents of deaf children in their decision of how to raise their chidlren now? Is it okay for an audi to remove that choice from a parent just because it involves a work up for CI candidacy? It would appear all your noble claims regarding freedom of choice are nothing more than rhetoric, as they apply only to the decision to implant, and not the decision to postpone implantation, or not implant. Your agenda is glaring.

 

[Liza]

I think the point of this thread is to see if it is acceptable for any audiologist to do something like this. Right? :P
I'm sure there are wonderful audiologists out there with a few bad apples.

 

[jillio]

I think the point of this thread is to see if it is acceptable for any audiologist to do something like this. Right? :P
I'm sure there are wonderful audiologists out there with a few bad apples.

That is the whole point. Deafbajagirl never meant it as widespread criticsm of the whole profession. She was addressing this one particular audi's actions. And when kept in that context, this one audi is indeed out of line. Unfortunately, rather than commenting on this one situation as described, some people seem to think the way to address it is to discount what has been claimed. The point is, the mother has stated what happened from her perspective. If the mother walked away from her meeting with this audiologist feeling that she was being pressured, and having appointments set up for her child that she did not autorize, did this audi treat this client ethically and under the guideline of professional practice standards?

 

[MomToDeafChild]

That is the whole point. Deafbajagirl never meant it as widespread criticsm of the whole profession. She was addressing this one particular audi's actions. And when kept in that context, this one audi is indeed out of line. Unfortunately, rather than commenting on this one situation as described, some people seem to think the way to address it is to discount what has been claimed. The point is, the mother has stated what happened from her perspective. If the mother walked away from her meeting with this audiologist feeling that she was being pressured, and having appointments set up for her child that she did not autorize, did this audi treat this client ethically and under the guideline of professional practice standards?

What I don't understand is why the mom is going to the appointment with the ENT at ALL if she feels so strongly that she is being pushed into something she doesn't want to do? Why doesn't she just say, "Thanks, but no thanks", and find another audiologist who will better understand her needs? She doesn't have to do anything she doesn't want to do. This is why I can imagine it would be easy for the mom and the audi to have a miscommunication in the first place, since mom hasn't even taken charge to not go to an appointment she isn't comfortable with...