Ashley Revisited: A Response to the Critics

  title={Ashley Revisited: A Response to the Critics},
  author={Douglas Diekema and Norman Fost},
  journal={The American Journal of Bioethics},
  pages={30 - 44}
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… 
The case of Ashley X
This paper recounts the events surrounding the case of Ashley X, a severely disabled young girl whose parents opted for oestrogen therapy, a hysterectomy and breast removal – the so-called ‘Ashley
Parental reasoning about growth attenuation therapy: report of a single-case study
It is suggested in this paper that there is also merit in examining the parental decision-making process itself, and providing empirical data about the reasoning of one set of parents who ultimately chose part of this treatment for their child.
Forever Small: The Strange Case of Ashley X
I explore the ethics of altering the body of a child with severe cognitive disabilities in such a way that keeps the child “forever small.” The parents of Ashley, a girl of six with severe cognitive
Ashley, Two Born as One, and the Best Interests of a Child
  • G. Gillett
  • Philosophy, Psychology
    Cambridge Quarterly of Healthcare Ethics
  • 2016
It is argued that two principles that provide guidance in generating a conception of best interests for each individual child yield the right results in cases of growth attenuation treatments in children with severe neurological disorders causing extreme developmental delay.
Shaping the body of a child. Invasive medical procedures on incompetent patients – some ethical and medical remarks on Ashley’s case.
The case of Ashley X and the treatment she underwent as an example of invasive medical procedures performed on children has both its opponents and proponents is presented and some arguments important for ethical analysis of Ashley’s case are looked at.
Ashley's Interests Were Not Violated Because She Does Not Have the Necessary Interests
  • M. Spriggs
  • Philosophy
    The American journal of bioethics : AJOB
  • 2010
It is argued that the claim that the potential for harm is limited to complications with the procedures is credible because it is a comment about the capacities (or the lack thereof) of the therapy.
Growth Attenuation Therapy
  • N. Kerruish
  • Psychology
    Cambridge Quarterly of Healthcare Ethics
  • 2016
There is a need to redress this balance by analyzing published accounts both from parents of children who have received GAT and from parents who oppose treatment, and important points are illuminated regarding how parents characterize benefits and harms, and their responsibilities as surrogate decisionmakers.
Reasons to Amplify the Role of Parental Permission in Pediatric Treatment
It is suggested that an expansive role for parental permission may reveal facts and values relevant to their child's treatment, encourage resistance to suboptimal default practices, improve adherence to treatment, nurture children's autonomy, and promote the interests of other family members.
Putting Law in the Room
This paper argues that growth attenuation is unacceptable because Ashley is the same as most people and deserving to be accepted by and respected by and loved by her family for who she is and what she will become, with no modification required.
Scrutinizing Ashley X: Presumed Medical “Solutions” vs. Real Social Adaptation
It is believed that Diekema, Ashley X’s parents, and proponents of the Ashley Treatment, now referred to as growth attenuation, are disingenuous.


The Ashley Treatment: Best Interests, Convenience, and Parental Decision-Making
The story of Ashley, a nine-year-old from Seattle, has caused a good deal of controversy since it appeared in the Los Angeles Times on January 3, 2007. (1) Ashley was born with a condition called
Seattle syndrome: comments on the reaction to Ashley X.
  • R. Newsom
  • Medicine
    Nursing philosophy : an international journal for healthcare professionals
  • 2007
This brief comment summarizes many of the main objections to what was done to ‘the Ashley treatment’ (as it has become known), and suggests that they are unpersuasive.
The Ashley Treatment: An Ethical Analysis
The debate surrounding this treatment contrasts those who argue that the Ashley Treatment violates the child's human rights and is for the sake of convenience for the parents versus those who argues that this treatment is not only in the best interest of the child because it will provide a better quality of life but is also in the Best Interest of the parents and society as a whole.
Growth Attenuation, Parental Choice, and the Rights of Disabled Children: Lessons from the Ashley X Case
The case of Ashley X, a profoundly disabled child from Washington whose growth and sexual development were purposely stunted through medical and surgical treatments elected by her parents, raises
Disability and Slippery Slopes
I have wondered how Ashley’s case came to be framed as a “disability rights” issue, and whether “disabled” perhaps a misnomer in such cases.
Making someone child-sized forever? Ethical considerations in inhibiting the growth of a developmentally disabled child
In some rare instances, a developmentally disabled child may have only a minimal right against interference with her growth, and parents may be acting ethically if they use medical interventions to inhibit the growth of their child for the purposes of facilitating better care.
The Ashley treatment: two viewpoints.
Ashley has the developmental and cognitive capacity of a young infant and is able to vocalize but cannot talk, and is alert to her environment but it is not clear that she recognizes people, including her own family.
Growth attenuation: a diminutive solution to a daunting problem.
This work concludes that among the many extraordinary problems confronted by parents of children with profound cognitive and physical disabilities, figuring out how to provide care as the child grows into an adult is among the most difficult to solve and distressing to contemplate.
Attenuating growth in children with profound developmental disability: a new approach to an old dilemma.
It is suggested that after proper screening and informed consent, growth-attenuation therapy should be a therapeutic option available to children with severe, combined neurologic and cognitive impairment should their parents request it.
From the case files: reconstructing a history of involuntary sterilisation.
The case files of the Eugenics Board for the province of Alberta are analyzed to provide a richer understanding of the culture which sanctioned the practice of forcible sterilisation.