Parental reasoning about growth attenuation therapy: report of a single-case study.
In 2006 a case report was published about a 6-year-old girl, Ashley, who has profound developmental disabilities and was treated with oestrogen patches to limit her final height, along with a hysterectomy and the removal of her breast buds. Ashley's parents claimed that attenuating her growth would make it possible for them to lift and move her more easily, facilitating greater involvement in family activities and making routine care more straightforward. The 'Ashley treatment' provoked public comment and academic debate and remains ethically controversial. As more children are being referred for such treatment, there is an urgent need to clarify how clinicians and ethics committees should respond to such requests. The controversy surrounding the Ashley treatment exists, at least in part, because of gaps in the literature, including a lack of empirical data about the outcomes for children who do and do not receive such treatment. However, we suggest in this paper that there is also merit in examining the parental decision-making process itself, and provide empirical data about the reasoning of one set of parents who ultimately chose part of this treatment for their child. Using the interview data, we illuminate some important points regarding how these parents characterise benefits and harms and their responsibilities as surrogate decision-makers. This analysis could inform decision-making about future requests for growth attenuation and might also have wider relevance to healthcare decision-making for children with profound cognitive impairment.
['Kerruish|Nicola|N|', 'McMillan|John R|JR|']
D000328:Adult D002648:Child D002675:Child, Preschool D003657:Decision Making D002658:Developmental Disabilities D019988:Disabled Children D026689:Ethical Analysis D017041:Ethics Committees D004992:Ethics, Medical D005260:Female D006128:Growth D006728:Hormones D006801:Humans D007044:Hysterectomy D008607:Intellectual Disability D008297:Male D008408:Mastectomy D016487:Parenting D010290:Parents D011788:Quality of Life
Disability Decision-making Minors/Parental Consent