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.


Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s