Monday, December 6, 2010

Disabled children: Is it Ethical to Restrict???


Should parents be able to restrict the growth of profoundly
disabled children to make them easier to care for at home? A
working group convened to discuss "growth attenuation" has given
the idea a cautious Yes in the Hastings Center Report.

Debate has raged since 2006, when the first case of the procedure
came to light. This involved Ashley, a 6-year-old girl with
profound developmental disabilities who underwent growth
attenuation in Seattle Children's Hospital at the request of her
parents. Doctors and ethicists argued that Ashley's parents could
more easily move her, dress her, and involve her in family

But the intervention drew strong criticisms, particularly from
disability rights and family support groups, who compared it to
involuntary sterilization and other horrific treatments inflicted
on disabled people throughout history, ostensibly for both
individual and social benefit.

The working group argued that growth attenuation could be "an
ethically acceptable decision" for profoundly disabled children who
have an IQ of less than 20 to 25. About 4,000 are born each year
every year in the US. They admitted that safeguards would be needed
so that the pool does not grow.

One concern was that "a request for growth attenuation might
actually reflect the parents' desire to ease their own burden
rather than support the child's interests." However, most of the
time parents have the best interests of their child in mind, the
working group argued. Growth attenuation is even intended to make
participating in family life easier. However, the committee also
observed that "the presumption that parents must always sacrifice
their own interests for the sake of the child is, practically
speaking, untenable and disrespectful of the parents".

Not everyone agreed.

One of these was Sue Swenson, who has a legally blind,
quadriplegic, nonverbal, autistic, profoundly intellectually
disabled, 6-foot-tall, 190-pound son. "Just to be clear: he has a
good life, friends, and interests. He is loved," said Ms Swenson.
"At 28, he is no longer a child." She commented that there is
continuous pressure to "fix" people with disabilities, instead of
accepting them. In her opinion, growth attenuation should never be
used unless it treats an underlying disorder. "The human rights of
the child as a person with disability should limit parental
rights," she said. ~ Eurekalert, Nov 30;, Nov 30;


  1. Even though I've never personally been in a situation where I have had to take care of someone with developmental disabilities who I was incapable of due to height and weight, I definitely don't support growth attenuation. I think it is ethically wrong to hinder someone's physical growth because the parent is unable to care for them. If someone is in a situation where they are unable to care for their children, they should seek outside resources for help instead. I understand that these parents go through many difficulties as it is but with the process of growth attenuation, it is as though they are further disabling them, in a physical way. As stated in the blog, I think this act is more in the interest of the parents rather than what is going to benefit the child the most.

  2. Taking care of severely disabled individuals is extremely difficult and takes a toll on those who are responsible for their care. However, despite the hardships that come along with the task, it is unethical to restrict the growth of a disabled individual via growth attenuation, whether it be argued to lessen the burden of care on the caretaker or for some other reason.

    By stunting the growth of an individual, without their given consent is violating their autonomy. Even though the individual may be disabled enough that they are unable to exercise their autonomy and voice out against the procedures, it isn't the care takers responsibility to control the growth of the individual.

    Additionally, one must take into account any possible harms or consequences of the procedure, and also ask if the benefits of the treatment are great enough to outweigh the harms. Given these circumstances, it is unethical for the treatment to occur.

  3. Although the parents of disabled children are the ones who are ultimately responsible for them and have to take care of them daily, it is unethical for parents to go through with growth attenuation for their disabled children because it is more of a convenience for the parents than a need for the child’s well being unless it would be optimal for their health. If the growth attenuation is not recommended by doctors, then it should not be considered because it is interfering with the natural growth of the child as a human being despite their disability. Also, it is not known if the child would want to go through this procedure, therefore, violating his/her human rights. As Ms. Swenson said, the child should be accepted for who they are and should not be “fixed” to be more socially accepted. Any parent who is willing to raise a child with a disability should know it will be a difficult journey, and it ought to be about fulfilling the child’s needs to their best ability. It should not be about how they can manipulate the child’s disability to suit the parents’ needs.

  4. This ethical dilemma is very tricky. While I do not personally agree with growth attenuation, I believe it is solely a personal choice. Some parents may choose to do this because they are thinking about their child's future, specifically when they are no longer alive. A mentally disabled person will be disabled for the rest of their life and will never ever grow out of it. They will be a child in an adult's body and if growth attenuation allows them to live an easier life as they grow up then it is personally right for them. However, growth attenuation is a violation of a disabled child's autonomy. This was not the option this child choose so why is it being forced upon them, to make the parent's life easier. This is also one side of the debate to also think about with the ethical dilemma. Which I ultimately believe leads to what is best for one person may not be the right thing to do for another person.

  5. I believe that growth attenuation treatment of mentally disabled children to keep them child-sized for the rest of their lives is unethical since it violates the autonomy of the patients. Although Ashley may not have been able to voice her own opinion on the subject of the treatment, she still had a right to autonomy. As her proxies, her parents should have kept HER best interests in mind. Instead of stunting the growth of their daughter, the parents should have considered what steps they could take to make sure they were best able to take care of her, no matter what her size. True, as Ashley matured, it would be more difficult to move and dress her, but her parents should have been willing to cope with these difficulties so that Ashley could have a fuller life and mature into an adult.

  6. While I understand that the care of profoundly mentally disabled children and adults is extremely difficult and demanding, growth attenuation is unethical and violates the child's autonomy. By taking away the child's ability to grow and develop into an adult, you are in a sense taking away part of their humanity. Profound mental disability does not make the child any less human or less deserving of a life of their choosing, whether or not they are able to articulate their wishes. While growth attenuation may eliminate the burden of taking care of a full grown adult, it serves the parents' interests, not that of the child whose body and life are being altered. As a mother quoted in the article points out, the rights of the child override the rights and wishes of the parents.

  7. The principle issue here is the autonomy of the parents and the rights of the child involved. While at first view it is almost appalling that one can even consider placing a limit to a child's growth, after much consideration, some ethical principles do come in favor of this decision.
    One must consider the anticipated benefits and risks to the child, and figure out if there are alternative options for including the child in family activities. If there arent, and if this is the only way that would facilitate integration into normal family life, then action should be taken.
    On the other hand, one can argue that this is an attack to rights of the child, since it is stopping a process that would normally occur and most importantly, it is preventing a process from occurring without a medical reason to do so. However, the argument that this is wrong because it is done without a medical need for begs new questions. There are many times in present day where medical intervention is done without the medical need for it. Then should those processes be prevented just as well?
    In conclusion, the debate rests between the right of the child to live a "normal life" (though by his/her mere handicap that is no longer possible) and the right of the parents to make conditions as favorable as possible in a difficult life situation.

  8. It seems Sue Swenson said it all in saying growth attenuation should never be used unless it treats an underlying disorder. If it is medically imperative, then by all means it is the correct moral action.

    However, society transmits a profound pressure for engineering aspects of our lives that it sees as “best.” Yet we do not know what is best on the topic of growth attenuation. Clearly it is a case by case issue, and should be fully examined with each individual. There is not a blanket answer for what is ethically correct; each case is unique – an aspect some might deem as a highlight of human nature.

    On that note, I further support Swenson and her opposition toward the desire to “fix” those with disabilities. There is no doubt that in most cases, parents who choose to use growth attenuation love and respect their child as well as his or her Autonomy. Since, based on the disabled person’s probable incapacity to decide for his or herself, the parents most likely do have the right. If it happens that the parents cannot handle their disabled offspring, there are services that can help. Perhaps the focus should not be on whether the parents have the right to choose, as it should be on the acceptance, dignity and beauty of human complexity.

  9. This case presents an interesting ethical dilemma. At first look, it appears very unethical to stunt the growth of a child with mental disabilities. It seems appalling that parents of these children would do such a thing considering their children already have enough problems and are often viewed differently by society. However, after further thought, I can see how this procedure may be justified. I know several parents with disabled children, and in many cases, their children do become difficult to care for. These disabled children often have erratic behavior, which can lead them to attack their parents. A 65-year-old woman I know, who still takes care of her disabled son, has been beaten and injured by her son on several occasions. She continues to love and care for her son, but she also scared of him. Thus, I see how restricting his growth would have been a positive thing for her. Since disabled children are often best cared for by their parents, I believe this treatment is justified so their parents can adequately take care of them. Ultimately, this treatment has the potential to help both the disabled and their caretakers.

  10. At first, I can see why it seems as though this parents are violating their child's autonomy by limiting her growth. But it should be considered how much autonomy the disability has left the child with if she is 6 years old and cannot dress herself. If she is going to require this type of care for the rest of her life, I don't think it should be assumed that the parents are putting their own interests above their child's.
    If growth attenuation will improve the quality of the care that the child will receive, then it is a justifiable treatment. If the parents have their child's best interest at heart, they will want to provide her with the best quality of life as possible. The fact that restricting the child's growth will make her parent's lives a little bit easier is just a positive side effect. It has to be a difficult decision for the parents to make, especially since their child is so young and so dependent. But if the benefits of better care for the child as a result of the treatment outweigh the harm that it will cause the child, then the parents are justified in making the decision to use the treatment.
    -Becca Adlman

  11. I think it is ethically unacceptable to restrict one's height because the parents would not be able to care for them. This is not only an injustice to the child, but it also is an act of maleficence, causing harm to others, as well as violating the child's autonomy, or right to make their own decision. If the parents are afraid that they will not be able to care for their child, they should consider other options such as finding help from someone who would be able to care for them. This may also be beneficial for the parents' sake because they would not feel as though their child is a burden if they had help. In the end, I strongly feel that the child's growth not be stunted for their parents' convenience.

  12. I am someone who has worked and cared for children with severe mental handicaps, including children who I have cared for as they have grown over the years. It is not easy to dress them, move them when they need help, or help calm them if they get violent (which happened frequently with one of my adolescent campers at a camp in Ohio).

    This being said- I think the idea of growth attenuation for these children is horrifying and ethically mind-boggling. As many have said on this thread, it certainly violates the child's autonomy as a patient- and even though the parent may take on the responsibility for the child, I don't believe this give them the right to make such life-altering decisions for them.

    If parents are able to afford something like growth attenuation surgery, perhaps they could allot this money for a care-giver to help out with the child's needs? I understand this can be very expensive, but it is ethically the right thing to do. Altering their physical characteristics so to take some of the burden off the parents is NOT ethical.

    In addition, think of the door this could be opening. What's next, completely sedating children because they are hyper-active, so that the parents can more easily deal with them? Oh wait...

    -Annie McCormack

  13. Although there is no denying the great difficulties a parent must encounter when caring for a child with extreme mental and physical disabilities, growth attenuation is not an acceptable means of lessening their burden. Growth attenuation administers high levels the hormone estrogen to cause the closure of the epiphyses of bones. This causes bones to stop growing and the individual to reach a shorter adult height than they would have reached naturally. Based on what is stated, there does not seem to be any medically necessary reason for this treatment. Although it may allow the parents to provide their child with better care it is a huge infringement on the child’s autonomy. It does not appear that, in this case, Ashley is capable of making an informed decision but that also does not give her parents the authority to make a decision that is so clearly for their own benefit. They claim that it is actually in Ashley’s best interest, but if given the choice I doubt she would choose remain the size of a six year old child for the rest of her life. It also appears, from what is stated, that growth attenuation acts as some sort of birth control. It is referred to as a way to prevent the pool of profoundly disabled children from growing. This statement implies that the profoundly disable people are less worthy of life than other people. As we have learned, all people have the right decide whether or not they wish to procreate and this clearly strips Ashley of this human right.

  14. Despite that fact that raising a developmentally disabled child may be hard, growth attenuation should not be the ultimate option parents take. Though it may seem like the best decision overall for the child and the parents, and may appear to create the most ideal environment for growth it does not change the fact that in doing so the child’s autonomy is imposed. The child has no voice in this decision and therefore the life would not be his own. The parents would not simply “improve” the child’s life but instead change it forever. There is no way to determine the course of a developmentally disabled child’s life. There is no way to guarantee that through growth attenuation a child’s quality of life would be improved or even that the quality of life of the family would be improved. So though the “Ashley Treatment” was viewed as ethical, it doesn’t take into account the “what if” factor. As the mother of the legally blind, quadriplegic, nonverbal, autistic man points out; who are we to judge the best course of action for a child’s life if we have no guarantees that it will be for the better. There shouldn’t be this pressure to “fix” people with disabilities but instead we should move to educate people and accommodate those that are less developmentally matured.

  15. *PART 1 (because i hit the character limit)

    Whew, this is a tough one… I do lean conservatively in most of my decisions, but I can respect both rationales in this case of growth attenuation for severely disabled children. I do concede this practice is disturbing until you take a deeper look at it. The repression of one’s growth by forcible means without consent is absolutely incendiary, but for these cases whether or not the child can ever, even with prolonged behavioral therapy, ever become slightly functional is the sticking point for me.

    Of course a child’s wellbeing is left to the hands of their parents due to them not being mentally able fend for themselves and make decisions by weighing realistic costs and benefits, and I am just referring to functioning children who will eventually be able to do so. Taking into consideration severely disabled children with IQ’ less than that of 25, a parent’s role has to become even more encompassing. There are parents’ who can mentally handle having and caring for a disabled child and foster their growth, but there are also parents who cannot due to the increased frustration and mental stress associated with raising a disabled child; and these are the parents who end up making the headlines as they kill their disabled child then proceed to commit suicide.

    I have a familial acquaintance that is a mentally disabled 42-year-old man who has become a functioning member of society. His successes in life are 100% a result of his parents’ investment in him and acceptability of his condition. Dealing with a full-grown man though has its obstacles at times when he does not want to cooperate, and his father admittedly says that dealing with his size and strength can be hard sometimes; and that it takes a certain type of person to be able to do it day in and day out. Considering the fact that he is disabled yet functioning, you can understand why a parent would want to attenuate the growth of a severely disabled child who realistically and empirically does not stand a chance at becoming functional. Functional most importantly including being able to follow simple directions.

  16. PART 2

    The benefits to the parents should be considered and allowing growth attenuation could possibly ease a lot of the burden of having to care for a physically, uncontrollable at times, disabled person who you cannot effectively communicate with because they cannot comprehend you. No one could effectively communicate and control Helen Keller before Anne Sullivan came along, but her problem was not mental, rather it was physical as she was not able to express herself. For these cases of the severely disabled, the problem is both a mental and physical one where the ceiling for intelligence remains low, and the ability to reach it remains nearly impossible not in a theoretical sense but in a practical one extant with physical barriers.

    So, while I can understand the argument against depriving a human being their inherent potential to develop unencumbered, the exigent circumstances of bearing the burden of a severely disabled child, severe being the key word, I think creates an exception to the ethical dilemma in question. Are there parents who see their disabled child as not a burden but a blessing, of course; but these feelings I believe to be of hindsight and coming to accept the situation them find themselves in. I cannot see how birthing a disabled child would be a rational desire of anyone given a choice, and people live with their problems in different ways; some accept them and choose to live with them to the best of their ability and others just simply cannot handle them. Understanding that not everyone has the personality and ability to effectively deal with a severely disabled child is important so as to not condemn them for something brought to them out of their control. If you find you cannot fully invest yourself in your severely disabled child, is giving them up for adoption an ethically better decision than attenuating their growth, definitely, but legally speaking as of right now the decision is still ultimately up to that parent despite the outside condemnation. It might sound dim, but it will probably take a case of a disabled child overpowering and accidently killing their parent until the rest of society could comprehensively understand where these parents are coming from and the issues they face day to day.

  17. Ryan Shea

    While this act may seem heartless at a first glance, growth attenuation may provide a increase in overall wellbeing for not only the parents, but the child as well.

    Growth attenuation has the ability to ease the daily stresses, which can positively impact the mental health and physical health of the parents. This act can also help the parents provide a better life for the child given the fact that the growth attenuation will help the parents provide for their children.

    Growth attenuation doesn't take the child's interests into account, however. These children have IQs of <25, making it highly probable that they aren't competent of understanding how it will impact their lives. Considering this point, it is easy to say that growth attenuation doesn't respect the autonomy of the child due to the parents never receiving consent from the child to go through with such a process.

    Overall, i believe that growth attenuation is unethical and shouldn't be allowed. This act does have the ability to ease the burdens of the parents, but it also has the potential to further disable the child. As stated in the excerpt from the blog, I think growth attenuation is more in the interest of the parents rather than what is going to benefit the child, and this conflict of interest makes the act unethical and improper.

  18. Even though taking care of a disabled child can be extremely difficult and burdensome on their care taker, it is unethical to use growth attenuation to lessen the burdens of these care takers. I agree with Sue Swenson in that growth attenuation should not be used unless it treats an underlying disorder. This unnecessary procedure would only be beneficial for the parents, in making care for their disabled children easier, and has no direct benefit for the child. In fact, growth attenuation is technically disabling them more by physically stunting and stopping their natural growth. This raises a huge issue on the rights of children and protecting them from the decisions made by their parents. Also, potential risks and harms must be considered in the procedures that are being used. Do the benefits, which are mainly gained by the parents, outweigh the risks for their child? The child should remain the focus of this debate since it is ultimately their life and their body that is being altered.

    Erica Jordan

  19. It is tough to say but I do think growth attenuation is unethical. I can certainly understand why parents would want to do this and I don't think it is selfish - they want to be able to take care of their children the best they can for the child's well-being. Say for example a parent wanted to restrain his or her son from self-inflicted injurious behavior, the parent has the best interest of the child in mind obviously and a very strong large child can pose a threat to himself and others. Also, one must keep in mind that these parents are choosing to still rear this child (for likely their lifetime). Whether they knew the child would be disabled or not, they did not abort or give the child up for adoption (or maybe they even adopted the child). I can't help but admire parents who devote their lives to taking care of a severely disabled child - of course it brings with it much happiness I'm sure but also much struggle and pain - not everyone can do it.
    That being said it is not the parents right to choose. It is a hard issue because no one who hasn't experienced taking care of a severely mentally disabled person really has any clue what that caregiver's life is like. I certainly don't. So it's hard for me to be certain saying this but it just doesn't seem right. With every medical treatment there are complexities and to unnecessarily give a child growth hormones is unethical because that child's autonomy is being breached (although he or she is in an arguable state of lack of competency). Additionally, small size might make other treatment such as surgery more difficult and dangerous.
    -Jess Safer

  20. Growth attenuation for severely disabled children is ethical only in extreme circumstances. Although it may initially seem to be an injustice to the right of the child to growth naturally, it may actually be in the best interest of the child. With a smaller stature, the parents may be better able to take care of the basic needs of the individual, which would allow for more equality in care. For instance, a 6'2" boy weighing 200lbs would be more difficult to care for than a 4'10" boy weighing 100lbs. As health care proxies, the parents of the child must have the best interests of the child in mind, and therefore by selecting this option as a last resort may indeed be ethical. As long as the height attenuation would not cause any other potential health risks, there would be no additional injustices suffered by the child.

    Due to the biomedical ethical principle of benevolence, the doctors ought only to perform this procedure in the best interests of the patient and therefore should only do this if it would benefit the child, not just the ease of care for the parents. According to nonmaleficence, the doctors ought not to do this procedure if it will harm the individual more than any typical procedure involving the disabilities.

    Height attenuation would allow equality in care for all children, as size limitations and restrictions would not factor into the care of these individuals. The patient's autonomy would not be overlooked, as it is the responsibility of her parents, her health care proxies, to garner this right for her.

    -Caitlin Giuggio

  21. To determine whether the use of growth attenuation is unethical one must analyze and understand the circumstances surrounding the case. Firstly, what types of side effects are associated with such a procedure, and how will these effects limit the life and happiness of the handicapped person? Parents are obligated by both the principles of beneficence and nonmaleficence to do what is in the best interest of their child, and to cause him and her no harm.
    In order for this procedure to be morally permissible one must take into account the intent/motive of the parents and the effects of the height alteration. If the height attenuation allows the child to participate in family events and helps his family assist him live a more "normal" and happy life, then the procedure may be deemed morally acceptable.
    However, if the motivation of the parents is selfish in nature and does not have the interests of the child at the fore front of their decision, then subjecting the child to height attenuation is unethical. In conclusion, the intent of the parents must be to provide their child with a happier and more manageable life, if not, it is hard see how this is an ethical procedure.

  22. When strictly regulated, growth attenuation for severely disabled children is ethical. The parents have the child's best interests at heart and this decision produces the greatest good for all the stakeholders. The family benefits because they will now be able to better care for their child which in turn benefits the child because of the care they will receive. This would affect the family on a daily basis and make ease their daily lives. Having said that, I believe this should be reserved for cases when it would otherwise become hard for the family to properly care for the child.
    In order to fully understand and answer this question I would also have to look further into what potential risks of this could be. If this were to effect the child's health then it would not be ethical because this harm would outweigh the reward of allowing the parents to better look after their child.

    Because the children in this case are severely disabled I believe that this is an ethical procedure. If the children were not severely disabled then it would clearly bring up many issues as to what the benefits and interests would be. Here the benefits are clearly laid out as it would make caring for their child on a daily basis easier for the family.

  23. However well-intentioned growth attenuation may be, I think it is wrong because it interferes with the true identity of the person who is disabled. Society and parents should accept people with disabilities as they are. We should not try to change them as in limiting growth, except in cases where treatment is being offered. I think in most cases of growth attenuation, the impetus for the procedure may not necessarily be the welfare of the individual who is disabled, but rather that the process makes it easier for parents to care for disabled children. Parents and doctors should not be moved into trying to "fix" people with disabilities; rather they ought to accept individuals with disability the way are and find ways that can make life as fulfilling as possible for these persons.

    Jill Grodman

  24. Despite an individuals disabilities, they are still a human being. They deserve the right to become a fully developed human insofar as their body will allow for. If we are to attenuate their growth as this case has described, it is limiting their full potential as a human and sidelining their own needs to the needs of their parents or caretakers. It is however important to weight he odds, but this is best done on a case by case basis. If an extremely developmentally disabled person ought to grow to a very large size and become an even greater burden on his parents, they may in turn suffer in the long run, and if he were to be attenuated it is hard to say how that will cause him to suffer. With a developmental disability an individual may or may not be aware of their growth attenuation, leaving us with the question of whether or not they realize what has been done to them. Although, if an individual who is disabled was attenuated, where they would have grown into a perfectly nomal adult this could be seen as a detriment to their own quality of life. It may impair them socially as well. It would appear to be more ethical to allow these individuals to develop to their fullest potential, rather than stunting or disabling their natural continuity for the benefit of someone other than themselves. It goes against their own individual autonomy, unless of course they themselves are in favor of this. It may be beneficial to attempt to get consent from anyone who is capable of doing so and knowing what is best for themselves as well.

  25. I don't believe that growth attenuation is unethical in consideration of severly diabled children. Firstly, in the case of children who will have an inability to decide for themeselves even after they reach legal decision making ages, it falls within the rights of their decision makers (the parents) to decide the best way to care for their children. As long as growth attenuation is not limiting of the child's right to the best possible quality of life, I don' think it is an unethical decision. I think it is very unlikely that stunted growth will limit the child's ability to live otherwise enjoyably with his/family. As a very short person myself (5' tall), I don't consider my height to be to my detriment. In some cases it may be inconvenient, but it in no way affects by health. Also, I think the lower weight presumably associated with growht attenuation is more healthy for a child who may have to live a sedentary lifestyle any way.

    -Farrah Belizaire

  26. The autonomy of the child is not being considered at all in these circumstances. If the child were capable of understanding the growth attentuation procedure, what would they want? If nothing else changed (their disability, cognitive functions, etc) except their understanding of what was happening, I'm sure they'd elect to help their parents helping them. However, they are not able to voice their opinions or give consent to the treatment, and to put them through such a treatment without their approval is unethical.

    On the other hand, the risks and benefits should be weighed out. In keeping the child to a smaller stature, the child benefits because the care received is better. The parents don't have to strain quite so much in moving, bathing, clothing, etc their children. Overall, both sides benefit. The article doesn't go into possible health issues in regards to the treatment, so without knowing and assessing the risks involved, the ethics of the treatment can't adequately be assessed.

  27. Questions of justice should be raised about whether Ashley and others with similar medical conditions who are severely cognitively impaired might be classified as vulnerable individuals and whether this type of experimental treatment is a form of exploitation. There is no doubt that Ashley and others with her condition are vulnerable individuals. They are incompetent and are at the mercy of their surrogate decision makers. Even though many argue that the treatment and surgery is in the best interest of Ashley, because her quality of life will be better in numerous ways, others will argue that in reality it is primarily in the best interest of the caregivers. There are viable options regarding treatment and care that will allow Ashley to be cared for without interfering with her natural developmental patterns. To perform this treatment and surgery on Ashley that is experimental and has potential risks and burdens when there are other viable options available that are less harmful can be viewed as a form of exploitation. It is unjust to place vulnerable individuals like Ashley in this position when other less invasive options give these individuals a comparable quality of life.

    Handi Wu

  28. I believe that the treatment of growth attenuation is unacceptable. It is the violation of the child’s autonomy to restrict the child’s growth regardless of her incapability. One must have the right to decide for her own action, even though, Ashley is disabled, it is not right to assume what is best for her. We don’t know if that is what she wants. On the other hand, this seems to be what the parents want. While giving her the treatment, we do not know what the true motives behind the parents’ decision is, whether it is for the child’s interest that Ashley will be able to live an easier live as she shows up or it is for the best interest of the parents who will have a more convenient way of lives having their child staffed.


  29. good interesting article!!

    Child Development

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