The Seattle hospital where a profoundly disabled girl received the controversial "Ashley Treatment" broke the law, says group which conducted an official investigation into the procedure.

The Washington Protection and Advocacy System (WPAS), which represents people with disabilities, found that Seattle Children’s Hospital and Regional Medical Center violated the constitutional and common law rights of six-year-old Ashley by performing a hysterectomy without a court order.

The hospital has acknowledged its error, but blames the slip on flawed legal advice obtained by the parents. The case became known after the doctors involved published an article in a medical journal describing the procedure.

Ashley, or the "pillow angel", as her parents call her, has static encephalopathy, a severe brain impairment. She cannot walk, talk or swallow food. Her mental age is measured in months rather than years. To make it easier for her parents to care for her, the doctors at the hospital surgically removed her breast buds, her uterus and her appendix.

On a bioethics listserv, the bioethicist who consulted on the case, Dr Douglas S. Diekema, expressed his exasperation with the opinion of the WPAS. Its report, he says, only shows that the treatment may have been illegal, not unethical. In his opinion the notion that a court order should be sought for all medical procedures on developmentally disable children is absurd. By the same reasoning, he says, many similar operations on these children would require court intervention. "That’s starting to look like a lot of court orders and sends a message of incredible disrespect to the parents of these kids," he writes.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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