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Ethical issues in screening for hearing impairment in newborns in developing countries
B O Olusanya1, L M Luxon, S L Wirz
1Academic Unit of Audiological Medicine, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK. b.olusanya@ich.ucl.ac.uk
Insights
Newborn hearing screening is vital for early intervention in speech development. Implementing universal newborn hearing screening in developing nations requires addressing support service limitations and healthcare challenges.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Newborn hearing screening is standard in developed countries, enabling early intervention for optimal speech and language development.
- Developing countries face challenges in implementing similar programs due to concerns about support services and healthcare infrastructure.
- The majority of children with hearing impairment worldwide live in developing countries.
Purpose of the Study:
- To examine the ethical justification for systematic newborn hearing screening programs in developing countries.
- To address limitations in current primary prevention and early detection strategies for hearing impairment.
- To explore incentives for building capacity for essential support services.
Main Methods:
- Ethical analysis of screening program implementation.
- Review of current prevention and detection strategies.
- Assessment of healthcare system capacity and support services.
Main Results:
- Ethical arguments support newborn hearing screening due to lack of alternatives and potential for capacity building.
- Early intervention is crucial for speech and language development in infants.
- Addressing healthcare challenges is key to successful program implementation.
Conclusions:
- Systematic newborn hearing screening is ethically justifiable in developing countries.
- Program success hinges on addressing infrastructure and support service limitations.
- Investing in capacity building is essential for effective early detection and intervention programs.
Abstract:
Screening of newborns for permanent congenital or early-onset hearing impairment has emerged as an essential component of neonatal care in developed countries, following favourable outcomes from early intervention in the critical period for optimal speech and language development. Progress towards a similar programme in developing countries, where most of the world's children with hearing impairment reside, may be impeded by reservations about the available level of support services and the possible effect of the prevailing healthcare challenges. Ethical justification for the systematic introduction of screening programmes for hearing in newborns based on the limitations in current primary prevention strategies, lack of credible alternative early-detection strategies and the incentives for capacity-building for the requisite support services is examined.
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