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The Pediatric Forum |

Only Half the Story

Carole L. Marcus, MBBCh
Arch Pediatr Adolesc Med. 2007;161(6):616. doi:10.1001/archpedi.161.6.616-a.
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The authors of the article “Attenuating Growth in Children With Profound Developmental Disability: A New Approach to an Old Dilemma”1 discuss the ethics of inducing intentional growth stunting to facilitate the care of a child with developmental disabilities. However, according to TIME magazine,2 these authors are telling only half the story. In their article in the Archives, they discuss administrating high-dose estrogen to fuse the child's epiphyses and limit growth. However, the TIME article also states that the child's breast buds were surgically removed to decrease the chance of her developing fibrocystic disease or being uncomfortable with her rehabilitative equipment. She also underwent a hysterectomy to prevent problems in the future related to menses. Thus, it appears as if the child's family did not merely wish to limit her size to facilitate taking care of her; they also wanted to infantilize her and remove any evidence of puberty and maturation. In this they were aided and abetted by their physicians. The argument that menses would be messy or that she required a prophylactic mastectomy for fibrocystic disease cannot seriously be considered as medical indications for her surgery. If so, why not also do a colostomy and urinary diversion to facilitate nursing care? Why not do a prophylactic appendectomy to prevent potential episodes of appendicitis?

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June 1, 2007
Daniel F. Gunther, MD, MA; Douglas S. Diekema, MD, MPH
Arch Pediatr Adolesc Med. 2007;161(6):616. doi:10.1001/archpedi.161.6.616-b.
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