In article published last fall in the Archives of Pediatrics & Adolescent Medicine continues to stir up controversy. The article described a medical case involving a 9-year-old bedridden girl, referred to as "Ashley," who underwent a surgery that stunted her growth. Supporters and critics alike are emotionally roused by the story.

Ashley was diagnosed with static encephalopathy, or severe brain damage, shortly after her birth. The condition has left her in an infant state, unable to sit up, roll over, hold a toy, or walk or talk. In a surgery performed at a Seattle hospital in July 2004, physicians removed her uterus and breast tissue, and gave her large doses of hormones to halt her growth.

Her parents claimed that the surgery and hormone treatment will benefit their daughter and allow them to continue to care for her at home. "Ashley's smaller and lighter size makes it more possible to include her in the typical family life and activities that provide her with needed comfort, closeness, security and love, mealtime, car trips, touch, snuggles, etc," her parents wrote on their blog.¹ Ashley is now about 13 inches shorter and 50 pounds lighter than she would be as an adult.²

Ashley goes to school for disabled children, but her parents care for her at home and say they have been unable to find suitable outside help. Ashley's parents say keeping her small will help reduce risks for bedsores and other conditions that can afflict bedridden patients.

Critics want an official condemnation from the American Medical Association (AMA), which owns the medical journal in which the case appeared. Approximately 25 protesters—some in wheelchairs—demonstrated outside the AMA's headquarters in Chicago. One protester carried a sign saying, "Let Disabled Children Grow."³

As you can see, the issue is fraught with emotional complications. I am not going to make a case of whether the surgery was ethical or not. As PTs, you see the challenges of caregivers whose lives revolve around their loved ones with disabilities, and you also see the internal motivation of patients who want to desperately return to optimal levels of function given their conditions. This is obviously a sensitive topic, and there can be many statements made to justify both points of view.

What inspired me to write about Ashley's case in our debut issue of Physical Therapy Products' Product Guide, is that after reading her story, I became even more passionate about the products in this dynamic field that are helping to improve the lives of people with disabilities. Kudos to the manufacturers who are passionate about developing better technologies that help to test and treat patients. And, with admiration, I especially want to praise PTs who use these tools to help enhance their patients' lives. I hope you find this resource useful. Let me know how we can make it work better for you in the future. Be sure to visit our Web site for convenient access to all of the product information featured in this issue.

Arati Murti

References

1. The "Ashley Treatment." Available at: http://ashleytreatment.spaces.live.com/. Accessed March 29, 2007.
2. Surgery to stunt girl's growth sparks debate. Available at: http://www.msnbc.msn.com/id/16473471/. Accessed March 25, 2007.
3. Activists condemn surgery to stunt girl's growth. Available at: http://cbs2chicago.com/health/local_story_011164627.html. Accessed March 25, 2007.