Document Detail

Ashley revisited: a response to the critics.
MedLine Citation:
PMID:  20077335     Owner:  NLM     Status:  MEDLINE    
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.
Douglas S Diekema; Norman Fost
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of bioethics : AJOB     Volume:  10     ISSN:  1536-0075     ISO Abbreviation:  Am J Bioeth     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-15     Completed Date:  2010-03-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100898738     Medline TA:  Am J Bioeth     Country:  England    
Other Details:
Languages:  eng     Pagination:  30-44     Citation Subset:  E; IM    
University of Washington School of Medicine, USA.
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MeSH Terms
Body Height* / drug effects
Child Advocacy
Choice Behavior / ethics
Decision Making / ethics*
Developmental Disabilities / complications*
Disabled Persons*
Estrogens / administration & dosage*
Ethics Committees*
Ethics, Clinical
Hospitals, Pediatric / ethics
Hysterectomy / ethics*
Mastectomy / ethics*
Mental Retardation / complications*
Personal Autonomy
Puberty, Precocious / complications,  drug therapy,  surgery,  therapy*
Quality of Life*
Sterilization, Involuntary / ethics
Wedge Argument*
Reg. No./Substance:
Comment In:
Am J Bioeth. 2010 Jan;10(1):46-8   [PMID:  20077337 ]
Am J Bioeth. 2010 Jan;10(1):52-4   [PMID:  20077340 ]
Am J Bioeth. 2010 Jan;10(1):W4-6   [PMID:  20077323 ]
Am J Bioeth. 2010 Jan;10(1):54-5   [PMID:  20077341 ]
Am J Bioeth. 2010 Jan;10(1):59-60   [PMID:  20077344 ]
Am J Bioeth. 2010 Jan;10(1):48-50   [PMID:  20077338 ]
Am J Bioeth. 2010 Jan;10(1):50-2   [PMID:  20077339 ]
Am J Bioeth. 2010 Jan;10(1):57-8   [PMID:  20077343 ]
Am J Bioeth. 2010 Jan;10(1):56   [PMID:  20077342 ]
Am J Bioeth. 2010 Jan;10(1):45-6   [PMID:  20077336 ]

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