Ashley revisited

A response to the critics

Douglas S. Diekema, Norman Fost

Research output: Contribution to journalArticle

Abstract

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them.

Original languageEnglish (US)
Pages (from-to)30-44
Number of pages15
JournalAmerican Journal of Bioethics
Volume10
Issue number1
DOIs
StatePublished - Jan 2010
Externally publishedYes

Fingerprint

Clinical Ethics Committees
Developmental Disabilities
Hysterectomy
Estrogens
Breast
Parents
Physicians
Weights and Measures
Growth
Therapeutics

Keywords

  • Cognitive impairment
  • Developmental disability
  • Estrogen
  • Ethics
  • Growth
  • Handicapped
  • Puberty

ASJC Scopus subject areas

  • Health Policy
  • Issues, ethics and legal aspects

Cite this

Ashley revisited : A response to the critics. / Diekema, Douglas S.; Fost, Norman.

In: American Journal of Bioethics, Vol. 10, No. 1, 01.2010, p. 30-44.

Research output: Contribution to journalArticle

Diekema, Douglas S. ; Fost, Norman. / Ashley revisited : A response to the critics. In: American Journal of Bioethics. 2010 ; Vol. 10, No. 1. pp. 30-44.
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