Reversing the Ashley Treatment

In July 2004, a severely disabled girl known only as Ashley underwent a series of radical, surgical procedures including a hysterectomy and an appendectomy. She was only seven years old. The controversial set of medical procedures now referred to as the “Ashley Treatment” has received much scrutiny over the past few years and has led to the heavy criticism of Ashley’s parents, the operating physicians, and Seattle Children’s Hospital.

Ashley was born with encephalopathy, a severe brain impairment that prevents her from functioning on her own. She is suspected to live a normal lifespan, but despite being awake and breathing on her own, Ashley is completely incapacitated by her lack of mobility and 6-month-old mental capacity. Her parents must takecare of her every need.

When Ashley began showing signs of puberty, her parents sought out a radical treatment that would prevent their daughter from exhibiting secondary sexual characteristics. In addition to the surgical procedures, Ashley received growth-attenuating hormones, including a high-dose, estrogen therapy to halt sexual maturation. Her parents argued that these treatments would make everyones lives more comfortable, reducing the risk of bedsores, preventing pain from menstruation, alleviating the discomfort of breast development, and making Ashley’s mobility much more convenient.

Because of her parents' choices, Ashley will remain trapped in a 4 foot 5 inch, adolescent body for the remainder of her life. When does a parent's consent cross the line and become too invasive? Granted this decision must have been incredibly troublesome, but how can Ashley’s parents deny their daughter the right to experience an adult body and the feelings that go along with human maturation?

It is scary to think of the future impact this may have on the treatment of mentally disabled children. There are currently no growth-attenuating therapies being administered in the country, so why was this approved by Seattle Children's Hospital in 2004?

People will continue to debtate this medical issue, but because of the severe ethical dilemma, no definitive resolution is likely. Since 2004, the “AshleyTreatment” has been condemned by many medical professionals and ethicists alike, claiming it “is a violation of not only human dignity, but also of a physician’s oath to due no harm”(Burkholder). I simply wonder if this decision was made in the best interest of Ashley or her parents.

If there is an innovative, medical breakthrough sometime throughout Ashley's life that might advance her cognitive abilities, people will look back upon this radical treatment with even greater disdain. Her parents have been battling the critics and adamantly defending their decision over the past few years, claiming they were only doing what was right for their child. I agree that the most important thing is for Ashley not to suffer, but to what extent can we justify such radical medical procedures that prohibit basic human development?


posted by T. FitzGerald