Cochlear implantation has evolved from its experimental state into a safe and effective therapy for the treatment of profound deafness. Although not applicable to all patients, it offers an alternative to a life in silence. In particular, in early detected and treated deafness in childhood inner ear prostheses have enabled affected persons to be integrated into the world of sound. In addition to the significant impact that therapy has on the life of the individual, there is a social and cultural consequence for society. This is epitomized in the criticism by the deaf community that has resulted in the total rejection of cochlear implants. A critical analysis reveals different personal images prevailing in the deaf community. Knowledge of these differences and their relevance is important for all clinicians involved in counselling a cochlear implant candidate.