Ashley Revisited: A Response to the Critics

This is the official announcement of a new Target Article that has been accepted for publication in a forthcoming issue of AJOB.

Ashley Revisited: A Response to the Critics
Douglas S. Diekema


Open Peer Commentaries are now invited on this Target Article. Open Peer Commentary articles are typically between 500-1500 words and contain no more than 10 references. A guide to writing an Open Peer Commentary is available under the Resources section “Instructions and Forms” at

We ask that by Wednesday, October 7th, you submit a short summary of your proposed Open Peer Commentary (no more than 2-4 sentences). Please submit your proposal online via the AJOB Editorial site, following the instructions provided there. We ask that you do not prepare a full commentary yet. Once we have evaluated your proposal, we will contact you via email to let you know whether or not we were able to include you on the final list of those to be asked to submit an Open Peer Commentary.

You will then have until Wednesday, October 21st, to submit your full Open Peer Commentary. Please keep in mind that, except for rare exceptions, authors are limited to one Open Peer Commentary per journal issue.

To help you decide whether or not you will be an appropriate commentator for the forthcoming Target Article, you may consult the abstracts below and access the complete article as a PDF file by going to the URL above. If you do not have Adobe Acrobat and are unable to read PDF files, you may download free Adobe Acrobat Reader software for any computer platform, at .

AJOB and Taylor & Francis also assist Open Peer Commentators with disabilities by providing the Target Article in other formats on request.

We ask that you not reproduce or cite the Target Articles or Open Peer Commentaries on the Editorial web site, as they have not yet been edited for publication. Please cite only published materials from AJOB (as indexed at the Journal’s website, ).

Ashley Revisited: A Response to the Critics
Douglas S. Diekema
ABSTRACT: 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.


Nationalized Child Care in Canada?

In the last two federal elections in Canada, there was a fair bit of umming and aahhing about improving national daycare standards. And with all the hooplah about socialized medicine from our good neighbour south of the border, this promotional video is surely timely:

h/t to Fiona Cowie

Ventilator rationing guideline

A guideline is being prepared by US health care officials to decide whose ventilators will be disconnected in case of swine flu pandemic. It is based on what is called the New York protocol, which “calls for hospitals to withhold ventilators from patients with serious chronic conditions such as kidney failure, cancers that have spread and have a poor prognosis, or ‘severe, irreversible neurological’ conditions that are likely to be deadly.”

Dr. Carl Schultz at the University of California at Irvine says, “The problem with lowering the standard of care is where do you stop? How low do you go? If you don’t want to put any more resources in disaster response, you keep lowering the standard.”

Read the ProPublica story below for details.


The Disability Studies Program at the University of Washington presents:


A one-day public symposium examining the history and significance of eugenics in Washington, which in 1909 became the second state to enact a forced sterilization law. This event will provide a forum for dialogue about the eugenic past and its current implications.

Friday, October 9, 2009
9 a.m. – 3 p.m.
UW Tower Auditorium, 4333 Brooklyn Ave. NE, Seattle, Washington 98195

Registration is required. This event is free and open to the public.
Lunch will be provided at no cost to registered attendees.

To register and for further information, go to:
Or contact Tammi Olson, (email), 425-774-4446 (voice), 425-774-9303 (fax), 425-771-7438 (TTY).

For information about symposium content, email Joanne Woiak, UW Disability Studies Program,

To view the live and archived web broadcast of the symposium, go to

The symposium will feature panel presentations by national and local scholars and advocates, addressing “Disability in the History of Eugenics” and “Perspectives on the Relevance of Eugenics Today.” The roundtable format will include ample time for audience discussion. The intended audience includes academics, community advocates, individuals with disabilities, clinicians, service providers, policy makers, and interested members of the general public.

Co-sponsors: UW Office of the Provost, UW Center for Genomics and Healthcare Equality, Seattle Children’s Treuman Katz Center for Pediatric Bioethics, DBTAC Northwest ADA Information Center.

Eugenics, Health Care, and the Government

As debate has raged over nationalized health care in the US–i.e., the kind of health care that the rest of the wealthy part of the world enjoys–there have been more than a few smart, savvy, and evocative interventions in the webosphere. Here’s one, linking the history of eugenics in North Carolina, about which we have blogged here, with “government health care”

Make no mistake about it: stories like the one told in the video are sadly common, though neither commonly told nor known. Eugenic sterilization continued until the 1970s and even 1980s in a number of North American jurisdictions. Although the particular groups of people disproportionally sterilized (relative to their numbers in the population) varied from place to place, there were two commonalities: Continue reading

Human Kinds–The Categories of Sexual Orientation in Law, Science, and Society–Part 3

The wrap-up of Ed Stein’s talk at the Human Kinds symposium.  Here Ed talks a little about whether there are natural human kinds, whether male and female, or gay and straight, might be such kinds, and the relationship between such questions and  issues of gay rights.