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  • Writer's pictureSociety of Bioethics and Medicine

Navigating Gene Therapy for Congenital Deafness

Written by Devika Baddhan

Edited by Samantha Cavusoglu

In the realm of medical innovation, few breakthroughs hold as much transformative potential as gene therapy1. Recent strides in this field have illuminated a path toward restoring hearing in individuals with congenital deafness, offering a profound opportunity for those who have long lived in a world of silence. Among these advancements are clinical trials spearheaded by companies like Akouos and Decibel Therapeutics that focus on gene therapy as a treatment for congenital deafness resulting from mutations in genes such as OTOF. 

Animal studies have demonstrated the technical feasibility of delivering functional copies of genes to the inner ear and restoring hearing in experimental settings. While gene therapy has shown promising results in animal models of congenital deafness, the translation of these findings to humans presents several challenges. The anatomical and physiological differences between animal models and humans, particularly in the inner ear structure and gene expression patterns, can hinder the direct application of findings to human patients. Additionally, factors such as immune responses, genetic variability, and the complexity of human hearing present unique hurdles that must be addressed to ensure the safety and efficacy of gene therapy in clinical settings. Therefore, while animal models provide valuable insights into the potential of gene therapy, further research and clinical trials in human subjects are essential to validate its effectiveness and safety for treating congenital deafness.

One remarkable success story emerged from the Children’s Hospital of Philadelphia, where 11-year-old Aissam Dam, born deaf and raised in Morocco, became the first person in the United States to undergo gene therapy for congenital deafness. Aissam's journey, marked by a transition from a life of profound silence to the discovery of sound, exemplifies the power of gene therapy in restoring hearing function.

What Remains Uncertain

Ongoing clinical trials are expanding to include younger children and to explore the efficacy of gene therapy in both ears. These studies aim to gather comprehensive data on safety, efficacy, and long-term outcomes. Current advances in gene delivery techniques and understanding of inner ear biology are driving progress in the field, offering hope for improved treatment outcomes and expanded therapeutic options. 

While initial results are promising, the long-term efficacy and durability of gene therapy for congenital deafness remain unknown. Continued monitoring of trial participants is crucial to assess the persistence of hearing restoration over time. Gene therapy introduces genetic material into the body, raising concerns about potential adverse effects, including immune reactions or unintended/off-target genetic changes. Ensuring the safety of these treatments is paramount. Therefore, questions still linger regarding the optimal timing and dosage of gene therapy, particularly in younger children. Determining the ideal parameters for treatment delivery requires further research and careful consideration.

Additionally, ethical dilemmas surrounding equitable access and autonomy further underscore the need for thoughtful and inclusive approaches to gene therapy implementation. Dr. Jaipreet Virdi, a disability historian and bioethicist, highlights that the promise of gene therapy is accompanied by various ethical considerations. He has raised concerns about the potential for gene therapy to undermine Deaf culture and identity, further questioning the societal perception of deafness within the broader Deaf community. 

They argue that implanting Deaf children before they have a chance to acquire language denies them autonomy and access to Deaf culture. “Erasure before choice is presented—to an individual, not their parents—is problematic,” Virdi says. (Mullin, 2023)

He emphasizes the importance of preserving linguistic diversity and supporting cultural autonomy. Gene therapy also raises complex ethical questions surrounding autonomy, consent, and access to treatment. Decisions about who receives gene therapy, particularly in the case of children, must navigate issues of informed consent and societal values. Ensuring informed consent from trial participants, particularly minors, and their guardians is essential, given the experimental nature of gene therapy and the potential risks involved. Moreover, issues of health equity and accessibility must be addressed to ensure that gene therapy benefits reach all individuals affected by congenital deafness, regardless of socioeconomic status or geographic location. Maintaining equitable access to gene therapy remains a critical ethical consideration, as disparities in healthcare access and affordability could exacerbate existing inequities. As stakeholders navigate these complexities, it is imperative to uphold ethical standards.

Nevertheless, ongoing research endeavors offer hope for expanded therapeutic options and improved treatment outcomes. The benefits of gene therapy for congenital deafness are undeniable, with the prospect of restored hearing and personalized treatments tailored to individuals' genetic profiles that build on precision medicine.

Do the Benefits Outweigh the Critics? 

In conclusion, gene therapy holds immense promise as a potential treatment for congenital deafness, offering hope for individuals who have long lived in silence. However, navigating the complexities of gene therapy requires careful consideration of scientific evidence, ethical principles, and societal values. As research progresses, stakeholders remain vigilant in addressing safety concerns, promoting equitable access, and upholding principles of autonomy and informed consent. Only through a comprehensive and ethically informed approach can gene therapy fulfill its transformative potential while safeguarding the well-being of those it aims to serve.


Amariutei, Ana E., et al. "Recent Advances and Future Challenges in Gene Therapy for Hearing Loss." Royal Society Open Science, vol. 10, no. 6, 2023, pp. 230644, 

Institut Pasteur. "Audiogene, the First Clinical Trial in France for a Gene Therapy to Treat Hearing Loss in Children." Institut Pasteur, 23 Jan. 2024.

Kolata, Gina. "Gene Therapy Allows an 11-Year-Old Boy to Hear for the First Time." The New York Times, 23 Jan. 2024. 

Mullin, Emily. "New Trials Aim to Restore Hearing in Deaf Children—With Gene Therapy." Wired,  October 20, 2023.

National Institute for Health and Care Research (NIHR). "World-first Trial of Gene Therapy to Cure Children with Rare Type of Genetic Deafness Begins." NIHR, Oct 26, 2023. 

Powell, Alvin. "Experimental Gene Therapy Enables Hearing in Five Children Born Deaf." Harvard Gazette, Harvard Medical School, 25 Jan. 2024.


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