Ashley Revisited: A Response to the Critics

@article{Diekema2010AshleyRA,
  title={Ashley Revisited: A Response to the Critics},
  author={Douglas Diekema and Norman Fost},
  journal={The American Journal of Bioethics},
  year={2010},
  volume={10},
  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
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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
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Ashley, Two Born as One, and the Best Interests of a Child
  • G. Gillett
  • Philosophy, Psychology
    Cambridge Quarterly of Healthcare Ethics
  • 2016
TLDR
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.
TLDR
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
TLDR
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
TLDR
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
TLDR
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
TLDR
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
TLDR
It is believed that Diekema, Ashley X’s parents, and proponents of the Ashley Treatment, now referred to as growth attenuation, are disingenuous.
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References

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