Ashley's case also makes waves in the USA. The decision of a team of doctors in the American city of Seattle to inhibit the growth of a handicapped child with a combination therapy and to prevent puberty has led to heated discussions about the ethical aspects of the intervention. The girl is to be kept in a state of "permanent infancy" in accordance with her parents' wishes for easier care. The case of the child, known only by her first name, Ashley, has made headlines in the U.S. media since the weekend and prompted reactions in numerous Internet forums.
A newspaper report had pointed to the website of Ashley's parents, in which they describe the fate of their daughter and justify the therapy undertaken. In medical circles, the case has been known since October. At the time, the specialist in glandular diseases responsible for Ashley's treatment, Daniel F. Gunther, and medical ethicist Douglas S. Diekema presented the "Ashley Treatment" in a professional journal. It had not been easy to comply with the parents' wishes. Ethics committee has approved decision A committee of 40 equal numbers of female and male scientists and bioethicists in Seattle, Washington State, examined the various ethical and legal aspects of the project. Special attention has been paid to sterilization, which is part of the "Ashley treatment". Attorneys consulted took the position that an American law prohibiting forced sterilization in women did not apply to Ashley. The regulation applies to mild disabilities. However, Ashley, now nine years old, is considered severely disabled.She suffers from a rare condition called static encephalopathy. According to parents and doctors, it has resulted in the girl remaining mentally at the level of a three-month-old baby. Based on this, a combination therapy was performed on Ashley in the summer of 2004, consisting of three segments. Uterus was surgically removed to prevent menstruation and sexual development.The removal of breast tie was also aimed at this. This procedure was also justified on the basis of her family history, which included numerous cases of breast cancer. The danger that Ashley would also fall ill from this was to be prevented.Eventually, high-dose estrogen therapy was administered in an attempt to limit Ashley's growth. Parents emphasize that caring for Ashley would be easier if she stayed small. U.S. media has since christened the child "Pillow Angel". According to media reports, the therapy has limited Ashley's height to about 135 centimeters; the nine-year-old weighs about 30 kilograms. Parents argue that the measures can prevent complications such as ulcers, bladder infections or pneumonia in the bedridden child. US experts are cautious While the public reacts with harsh criticism or else understanding for Ashley's parents, experts express more restraint. Pediatricians Jeffrey Brosco and Chris Feudtner of the University of Miami raised doubts about the effectiveness of growth inhibition by estrogen. But they praised colleagues in Seattle for raising this critical ie for public discussion. Scientific American magazine highlights the devoted care and affection of Ashley's parents. They know best what is good for their daughter: "They take care of their child, while other parents would have given her to an institution long ago."Bioethicist Art Caplan of the University of Pennsylvania, on the other hand, called the case "a slippery slope" and doubted that growth inhibition was a solution for similar patients.