Below is an abstract from a paper that has just appeared at a prestigious pediatrics journal. It alludes to the Ashley X case in the first sentence, and advocates more widespread use of the high-dose estrogen treatment used there. Read CAREFULLY, and slowly:
Publication of an account of growth attenuation with high-doseestrogen in a child with profound physical and cognitive disabilitybrought widespread attention to a common and complex issue facedby families caring for all children, namely,the potentially negative effect of the increasing size of achild on the ability of his or her family to provide independentcare, which in turn makes it more difficult for parents to keepthe child in the home and involved in family activities. Inthis article we explore the scientific rationale for, effectivenessand safety of, and ethical considerations bearing on growth-attenuationtreatment of children without profound and permanent cognitivedisability. Informed responses to key clinically relevant questionsare proposed. Our analysis suggests that growth attenuationis an innovative and sufficiently safe therapy that offers thepossibility of an improved quality of life for ambulatorychildren without profound cognitive disability and their families.Pediatricians and other care providers should include discussionof these options as part of anticipatory guidance around theage of 3 years so that, if elected, potential clinically meaningfulbenefits of growth-attenuation therapy can be realized. Becauseof the publicity and debate surrounding the first reported case,ethics consultation is recommended.