The Ashley Treatment has been considered as a controversial set of medical procedures that was first undergone by a Seattle child, Ashley. Ashley had a normal birth, but her mental and motor faculties failed to develop for reasons doctors could not determine. Ashley, called the “pillow angel,” by her parents, suffers from a developmental brain condition known as static encephalopathy (P Clark). Ashley’s parents decided to keep her small through some medical treatments which included high-does estrogen therapy to limit height and weight, hysterectomy to remove the uterus and prevent menstruation, breast bud removal to halt breast development, and an appendectomy (P Clark).
Argument 1:
I argue that the Ashley Treatment improve the patient who is similar to Ashley and her family’s quality of life that aligns with the Utilitarianism Theory. The surgical procedures will prevent potential discomfort from menstrual cramps and any possibility of pregnancy in the event of rape (P Clark). The treatment also avoids the discomfort of large breasts while lying down in the wheelchairs. By getting the treatment, the patient’s family could take care of the patient at home instead of spending all of their time in the hospital. The patient can enjoy the opportunity to be around by her family, the inclusion of family activities, and the comfort of her home, which fulfills the Beneficence Principle. The surgical procedures also revolve around Consequentialism Concept because the benefits of the treatment exceed the risks. The high-dose estrogen has no surprise side effects giving the fact that it is used to limit height in teenage girls (Pillow Angel). In addition, this treatment eliminates the chance of breast cancer.
Counter Argument 1 One doctor that I consulted with argued that the Ashley Treatment is against Natural Law Theory as it forces the patient to be a permanent child. The patient has the right to grow naturally. In addition, the removal of a patient’s uterus raises real ethical concern about sterilization (P Clark). The patient might suffer significant pain during the surgery of removing the uterus that violates the Non-maleficence Principle. Take the Short-term vs. Long-term Concept into account; I understand that it would make the parents’ life easier by shortening their child’s height and size. However, when the child grows up, she might peer pressures from others, and her feeling might be hurt. The Ashley Treatment can at first glance appear beneficial, but in the long run it might lead to harmful results.
Argument 2 Since patients who are in need for Ashley Treatment are more minors, their patients have the rights to make medical decisions for them. According to the Autonomy Principle, their parents can make a decision about their child’s life and body without coercion. Therefor, if the patient’s parents choose to perform Ashley Treatment on their child, we should respect the decision. Therefore, the Ashley Treatment allows the patient to receive care at home instead of staying at the hospital. In this way, the medical expense will be decreased, and the hospital can use the resource on other patients which correspond with the Utilitarianism Theory. Lastly, in the short run, the patient’s parents have the ability to take care and protect their child from potential harms. However, they worry about when they pass away; their child might suffer sexual abuse if the treatment is not performed. This is related to the Short-term vs. Long-term Concept.
Counter Argument 2 According to Peter Singer, the Ashley Treatment violates the human rights and dignity for the people with disability. “The treatment reduces disabled children to objects requiring the modifications for the convenience of their family members, rather than treating them as a human being with their own agency” (Singer). This behavior violates the Autonomy Principle. Similar to Singer another doctor I interviewed with claimed that the Ashley Treatment is performed more the convenience of the caregivers than for the benefit of the patient. The doctor stated that based on the Deontological Theory, it is morally wrong for caregivers to decide to perform the Ashley Treatment on a patient for their own benefits. In term of Justice vs. Mercy Concept, one might argue that it is not fair for disable people to reduce their size for convenience of caregivers. People with disabilities have suffered more than regular individuals, so we should have more mercy toward them.
Argument 3
I believe the Ashley Treatment is for the patient’s best interest. For instance, being a smaller child it will be easier for her caregivers to lift her and care for her general sanitation, which should reduce the risk of bedsores, pneumonia and bladder infection that plague patients like Ashley (Todohert). It relates to the Utilitarianism Theory and Beneficence Principle in term that the treatment minimizes the potential harms or risks and maximizes the possible benefits. When make a medical decision, it is important to examine the Consequentialism Concept and determine whether the benefits of the surgical exceed the risks. I believe the benefits of performing Ashley Treatment out weigh the burdens. The treatment provides a better quality of life for the patient and her family, eliminates any possibility of being traumatized by menstruation, prevent the possibility of appendicitis.
Counter Argument 3 The last doctor I spoke to argued that Ashley Treatment has potential risks and there are other treatments available that are less harmful can be viewed as a form of exploitation (Todohert). According to the Justice Principle, it is not fair to place vulnerable individual like Ashley in this position when other less invasive options give these people a comparable quality of life (Todohert). The doctor argued that this treatment violates the Utilitarianism Theory in term of setting a dangerous precedent for society as a whole, in particular for people with disability. For Individual vs. Community Concept, one might argue should we allocate funds to this kind of experimental treatment when the risks seem unreasonable and possibly harmful (Todohert). The amount of money spent on these surgeries could indeed be invested in new ways to help severely disabled individuals and their families live a better quality of life (Todohert).