Ethical Use of Steroids and Surgery for Stunt Children - Essay Example

? Issue 10: Is It Ethical to Use Steroids and Surgery to Stunt Disabled Children’s Growth? Issue 10: Is It Ethical to Use Steroids and Surgery to Stunt Disabled Children’s Growth? This paper will provide an argument based on ISSUE 10 as stipulated in Taking Sides textbook. Thus, the paper shall first provide an outline of the chosen issue. With reference to the book, issue 10 provides a platform for an argument with regard to the ethics involved in the process of using steroids and surgery to stunt disabled children’s growth (Slife, 2012). While some people view this process as ethical, others totally disagree with the practice on moral and other ethical considerations. Therefore, this necessitates for an outline of both perspectives. Consequently, the paper will outline both arguments for and against the issue as stipulated in the book before providing a conclusion. Consequently, the paper will first outline the argument against the issue as stipulated by Teresa Savage. Next, it will outline the argument for the issue as stipulated by Sarah Shannon. Thus, both arguments will be outlined with regard to the Ashley Treatment. Therefore, this implies that Sarah’s argument will be in support of the Ashley Treatment whereas Teresa’s argument will be in opposition of the Ashley Treatment. In addition, the paper will also provide an assessment of the issue based on individual views and thoughts. Finally, the paper will conclude by asserting that the process of using steroids and surgery to stunt disabled children’s growth is not ethical and morally upright; thus, reinstating the thesis statement that use of steroids and surgery in stunting the growth of disabled children is not ethical. Issue Summary As mentioned earlier, there exist contrasting views with regard to whether or not it is ethical to use steroids and surgery in the stunting of disabled children’s growth. In support of the argument, Nurse Sarah Shannon believes that parents reserve the right and duty to make decisions on behalf of family members who may be unable to make those decisions. These decisions are based on the harsh social and economic realities that that surround severely disabled children care. Consequently, she believes that the proposed intervention is both ethically and legally right. On the contrast, Nurse Teresa Savage believes that severely disabled children should have independent advocates championing for them. These advocates should preferably be persons with disabilities. Thus, they offer a more critical judgment to the situation with respect to both the benefits and risks of the proposed interventions. Summary of the Ashley Treatment Ashley was born in 1997 with an extreme brain impairment referred to as encephalopathy. Consequently, this condition implies that Ashley can never develop beyond the level of an infant. Thus, Ashley was developing physically, but her mental ability was limited to that of an infant. Consequently, this situation posed a significant challenge to her parents in regards to her upbringing. Her parents felt that her physical growth would, at some point, become overwhelming, rendering them unable to effectively care for their child. Consequently, they sought for a medical intervention that would stunt her growth and prevent her from physically growing. This implied that Ashley would not have fully developed physical organs such as reproductive organs and breasts. It also meant that she would not undergo the menstrual process and that she would also be infertile. Consequently, this process involved the use of sex steroids in effecting stunted growth on Ashley; thus, resulting in crucial moral and ethical issues. In the analysis of the use of steroids and surgery to achieve the desired results, a few factors have to be considered: Ashley’s underlying medical condition Social context surrounding the issue Resources available for caring for severely disabled children Yes: In Support of the Ashley Treatment (Sarah Shannon) In her support of the Ashley Treatment Sarah outlines that such a sensitive issue involving a child whose mental development is severely impaired calls for critical thinking and reflection, as opposed to rushed decisions. Consequently, she goes ahead to outline the ramifications of Ashley’s condition. It is obvious that Ashley has the cognitive and mental capacity of an infant (Gunther and Diekema, 2006). This implies that she can not change her body position or sit upright without being supported. In addition, she is not able to talk; thus she can only make sounds and has to cry so as to express her discomfort or dissatisfaction. Moreover, she may not recognize people, including her family. Consequently, this forms the basis of Sarah’s argument. The fact that Ashley has the mental capacity of an infant renders the possibility of sex or parenthood impossible. This implies that Ashley can never develop to enjoy sex or conceive a child and become a parent. Thus, her parents were justified in the administration of sex steroids and surgery to intervene on her sexual life resulting in stunted growth. In addition, removal of the uterus would result in numerous health benefits for her. These benefits include the following: Facilitation of the administration of the sex steroids, thus, reducing the risk of side effects. Elimination of future use of steroids for the control of the menstrual process, thus, avoiding the discomfort that comes with the menstrual process especially if mobility is impaired which was the case with Ashley. Ashley’s treatment would also involve the removal of her breast buds. Consequently, this would prevent Ashley’s breasts from developing into fully grown breasts. Therefore, Sarah outlines that this process was not just a mere cosmetic endeavor. Due to her maternal lineage, Ashley was inclined to development of fibrocystic breasts. This represented an extremely painful condition. Therefore, just like the removal of her uterus, removal of her breast buds also had significant benefits for Ashley. Consequently, the removal of the breast buds would enable her to comfortably sit up strapped to a chair without exerting pressure on her breast tissue, thus avoiding discomfort resulting from skin breakdown. Sarah continues to outline that the biggest challenges in Ashley’s life would be discomfort and boredom. Therefore, there was a need for effective measures to be taken towards the minimization of these challenges. It was evident that Ashley would be prone to discomfort based on her condition. This was owed to her limitation in mobility. Moreover, this risk increased with factors such as increased body weight, large breasts and poor nutrition. However, the risk of discomfort would be reduced through practices such as frequent repositioning, hygiene and proper nutrition. Therefore, this implied that the treatment process would go a long way towards alleviating the discomfort in Ashley’s life. This is owed to the fact that having a small body size would minimize the chances of Ashley’s skin breakdown, which if not checked would result in discomfort. In addition, a small body size would result in increased mobility for Ashley, thus also reducing the risk for discomfort. Consequently, this would enable Ashley’s family to effectively provide her with the desired care. Consequently, Sarah concludes her support for Ashley’s treatment by painting two scenarios. The society can either modify Ashley so that she is fit for it, or undergo a massive transformation rendering it conducive for Ashley. Consequently, Sarah argues that the society does not have the resources necessary for conformation to Ashley’s condition. This implies that the process is too expensive to be undertaken by the current health care system (Hoffman, 2007). These health care systems are not even able to provide cover for Ashley’s condition. Moreover, the specialized pediatric-trained care givers for severely disabled and impaired children are short in supply. The specialized equipment necessary for this process is also limited. Therefore, in view of these harsh social and economic realities, growth attenuation treatment should be allowed for parents of severely developmentally developed children such as Ashley. No: In Opposition of the Ashley Treatment (Teresa Savage) Unlike Sarah, Teresa is vehemently opposed to the Ashley Treatment. She argues that severely developmentally disabled children such as Ashley should have specialized advocates (probably with disabilities) championing for them. Teresa believes that these advocates would be based suited to make the necessary decisions with regard to the disabled children in consideration of both the risks and benefits of the entire process. Consequently, Teresa outlines that the decision by Ashley’s parents to opt for attenuated treatment is based on numerous assumptions. Assumption 1 The first assumption is the notion that keeping Ashley small will improve her quality of life. Consequently, Teresa draws to her experience in caring for premature infants to refute this claim. She argues that even with the premature infants who happen to be the tiniest human beings, necessary practices must be embraced to keep them in perfect health. Failure to reposition or use appropriate bedding on the infants would result in a skin breakdown. In addition, lack of proper hygiene would result in pneumonia. Proper nutrition is also essential for their healthy development. Therefore, Teresa dismisses the fact that small size would add to Ashley’s quality of life. Whether small or enormous, Ashley still requires extensive care. Consequently, attention and care is the most crucial thing in Ashley’s life as opposed to her size. Ashley can receive care regardless of her size. Therefore, Ashley’s size should not just be taken away from her in the pretence of improving the quality of her life. Assumption 2 The second assumption was the fact that Ashley would never conceive children; thus, she did not need her uterus and that its removal would alleviate the effects of menstrual hygiene. Teresa countered this claim with the fact that hysterectomy still posed immense risks to Ashley’s health. Just like her menses, hysterectomy would also have a discomforting effect on her. Besides, any complications resulting for the effect of her menses such as skin problems could be subject to treatment through available methods such as hormonal therapy or conservative therapy. In extreme cases, hysterectomy would be applied but at an advanced stage. Thus, there existed no grounds for performing hysterectomy at age six. Assumption 3 The third assumption postulated that Ashley will develop large breasts, fibrocystic disease and breast cancer due to family history. In countering this assumption, Teresa likened the removal of Ashley’s breasts to the removal of the penis and scrotum of a boy with a similar condition. While both practices would ease the process of strapping the victim to the desired position, the latter case could be considered as mutilation. Therefore, Teresa argued that removal of Ashley’s breasts could not be justified. With respect to sexual molestation triggered by large breasts, Teresa argued that large breasts would have nothing to do with such an occurrence. In addition, she professed that no amount of surgery or hormonal therapy would prevent sexual molestation. Consequently, only close supervision and monitoring would protect her from her occurrences. Assumption 4 The fourth assumption was the fact that increased dosage of steroids would result in closure of the growth plates, hence, preventing linear growth and weight gain. Teresa dismissed these claims based on lack of empirical evidence. Consequently, she even speculated that the breast buds might have been removed to minimize the risk of breast cancer as a result of usage of high levels of steroids. Assumption 5 The last assumption was the notion that adults with the mental age of infants were undignified. Although adults with immature mentality could be subject to ridicule, Teresa maintained that the phenomenon did not warrant surgical and hormonal treatment of the victims. Consequently, Teresa outlined that the refusal of Teresa’s parents to accord her the opportunity to grow into an adult represented a different form of discrimination against the severely disabled in the society. Consequently, Teresa concluded by suggesting the championing for social changes with regard to persons with severe disabilities, as opposed to the employment of drastic interventions. Therefore, it would be deemed appropriate to get carried away by Sarah’s candid descriptions of Sarah’s condition. This is owed to the nature of Ashley’s condition. She appears to be in a desperate condition that requires the employment of drastic intervention measures. Therefore, arguing that the use of steroids and surgical treatments to reduce Ashley’s size would make her convenient for enhanced care is valid. This is because it would ease the process of carrying her around and providing care for her. This process would also shield her from other forms of discomforts associated with increased weight and height. However, with respect to the societal ethics, the implementation of attenuated growth could not be justified. Morality and ethics can not be based on logic and the convenience. They represented virtues that sanctify and uphold holistic human life at all times. Sarah’s argument does provide sufficient information as to why the process of growth attenuation can be considered ethical. The argument only provides logic grounds for the attenuation of the growth process. Moreover, some of the actions taken by Ashley’s parents and the medical team depict the negligence of societal responsibility and ethics. If Ashley’s parents possessed profound love for her, then the most ethical and morally upright endeavor to undertake would be to accept her and strive to protect and take care of her regardless of the cost involved. However, her parents resolve to modify her so as to fit effectively in their own biased society. This clearly represented a moral and ethical breach in the pretence of responsible and caring parenthood. Conclusion Both Sarah and Teresa profess various stands with respect to the use of steroids and surgery in the attenuation of growth of disabled children. Sarah’s argument provides solid, logical grounds for the employment of steroids and surgical measures in the attenuation of growth of severely developmental disabled children. However, Teresa’s argument seeks to test the morality and ethical conformity of this logic. Consequently, rather than addressing the moral and ethical issues, the logic concentrates on the employment of drastic, surgical, hormonal measures in averting what is deemed to be a social disgrace, thus validating the thesis statement. Therefore, the use of steroids and surgery in stunting the growth of disabled children is not ethical. References Gunther, D. F., & Diekema, D. S. (2006). Attenuating Growth in Children with Profound Developmental Disability: A New Approach to an Old Dilemma. Archives of Pediatric Adolescence Medicine, 160(10), 1013-1017. Hoffman, C. (2007). Simple Truths about America's Uninsured. AJN, American Journal of Nursing, 107(1), 40–47. Slife, B. D. (2012). Taking sides: Clashing views on psychological issues. New York:McGraw Hill. Read More