>The article which follows, published yesterday by Reuter's and available
>at the MSNBC website cited at the end, has been the subject of much
>discussion on another list in which I participate. You can read this
>discussion on our archives at: List-Archive:
><http://listserv.nodak.edu/cgi-bin/wa.exe?LIST=PSYCH-DD>
>
>I would be interested in your viewpoints, especially since most of the
>PsychDD members are Americans -- and the majority are psychologists.
>-----------------------------------------------
> Should severely disabled kids be kept small?
>
>6-year-old given hormones to stunt growth so parents can care for her
>Reuters
>
>Updated: 6:23 p.m. ET Nov 1, 2006
>
>NEW YORK - In a report published in a medical journal this month, two
>doctors describe a 6-year-old girl with profound, irreversible developmental
>disability who was given high doses of estrogen to permanently halt her
>growth so that her parents could continue to care for her at home.
>
>The controversial growth-attenuation treatment, which included hysterectomy,
>was requested by the child's parents and initiated after careful
>consultation and review by an ethics committee.
>
>In their report in the Archives of Pediatrics and Adolescent Medicine, Drs.
>Daniel F. Gunther and Douglas S. Diekema, both at the University of
>Washington in Seattle, explain the reasoning behind what they hope will
>generate a healthy debate. Gunther is at the Division of Pediatric
>Endocrinology, and Diekema is at the Center for Pediatric Bioethics.
>
>Caring for children with profound developmental disabilities can be
>difficult and demanding, they note. For children with severe combined
>neurologic and cognitive impairment who are unable to move without
>assistance, all the necessities of life - dressing, bathing, transporting -
>must be provided by caregivers, usually parents, and these tasks become
>increasing difficult, if not impossible, as the child increases in size.
>
>"Achieving permanent growth attenuation while the child is still young and
>of manageable size would remove one of the major obstacles to family care
>and might extend the time that parents with the ability, resources, and
>inclination to care for their child at home might be able to do so," Gunther
>and Diekema write.
>
>The parents of the 6-year-old, both of whom were college-educated
>professionals, indicated a strong desire to continue caring for their
>daughter. Despite having the neurologic development no greater than that of
>an infant, the 6-year-old responds to her parents and two healthy siblings -
>vocalizing and smiling in response to care and affection - and "clearly is
>an integral, and much loved, member of the family," the authors note.
>
>After extensive evaluation, the combined opinion of a team of specialists is
>that the child will have no significant neurologic or cognitive
>improvements.
>
>The onset of puberty and continued growth caused concern in the parents
>about how they would care for their daughter long-term, which they clearly
>wanted to do. They were concerned about having to turn over care to
>"strangers" and also about the complications that would arise when the child
>started menstruating.
>
>The child is now a little more than a year into growth-attenuating therapy
>and approaching the end of her growth, Gunther and Diekema report. "As of
>yet, there have been no treatment complications."
>
>The authors feel that growth arresting therapy can be "both ethical and
>feasible and should be an option available to parents."
>
>The authors of a commentary applaud Gunther and Diekema for publishing this
>case report, although they believe that attempts to attenuate growth are
>"ill advised."
>
>Nonetheless, Dr. Jeffrey P. Brosco from the University of Miami and Dr.
>Chris Feudtner from the University of Pennsylvania, Philadelphia, say that
>by beginning the debate, this paper helps to "advance our ethical dialogue
>as we struggle to define our core values in words, laws, and deeds. Only
>with further research and public discussion will we learn whether attempts
>to attenuate growth run with or against our fundamental values in caring for
>children with profound developmental disabilities."
>
>(c) Reuters 2006. All rights reserved. Republication or redistribution of
>Reuters content, including by caching, framing or similar means, is
>expressly prohibited without the prior written consent of Reuters. Reuters
>and the Reuters sphere logo are registered trademarks and trademarks of the
>Reuters group of companies around the world.
>
>URL: http://www.msnbc.msn.com/id/15517226/
________________End of message______________________
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