Ashley is a girl living in the United States who has a disability that prevents her from developing beyond the mental capacity of about a three month old. In order to keep her small and mobile, help her remain in home care, and protect her from sexual predators as she ages, Ashley’s parents had her breast buds removed, gave her a hysterectomy, and put her on high doses of estrogen to prevent her from growing. This collection of surgeries has been labeled the “Ashley treatment.” Since then, there has been a debate about the medical ethics of this treatment. Some people support this treatment, while others are appalled by it.
The condition that prevents Ashley from developing mentally is called static encephalopathy. A person with this condition may develop normally physically, but may not develop beyond the mental capacity of a baby. In Ashley’s case, at nine years old, she couldn’t swallow, feed herself, or lift her head. The Ashley treatment is given to children in order to help keep them more mobile and to help ease discomfort going into puberty can cause.
One part of the Ashley treatment is removing a female patient’s breast buds. When a child is young, the breasts are only the size of almonds. By removing them, the discomfort caused by lying down with larger breasts is removed. It also prevents the risk of breast surgery later on in life. Removing the breasts may also help deter any sexual temptation a male caregiver may experience should one be called for in the future.
A hysterectomy — the surgical removal of a woman’s uterus — is also a part of the Ashley treatment. The removal of the uterus will prevent a woman from menstruating and, as such, will prevent the cramps, bleeding, and discomfort a period can bring. It also eliminated the possibility of pregnancy. In addition to the hysterectomy, growth attenuation is given as part of the Ashley treatment. By introducing high amounts of estrogen into the body, a person’s growth can be stunted, making it easier for caregivers to carry her around.
Proponents of the Ashley treatment say these surgeries and treatments help to increase the quality of life for the disabled person. It makes it easier for her to be carried around and interact with other members of the family. Others think that it is dehumanizing and constitutes illegal sterilization. In fact, Disability Rights Washington, a group that seeks to protect the rights of the disabled, found that performing a hysterectomy on Ashley without a court order was illegal sterilization. It is likely that both sides will continue to debate about the medical ethics of this treatment, with both sides continuing to have strong opinions about the validity and legality of the issue.