Professional Decisions in Healthcare Report (Assessment)

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Were the alterations to Ashley’s body in her best interest?

When doctors decided to remove Ashley’s breast buds and uterus at 6 years of age with the approval of her parents, these alterations were not in her best interest. Instead, her parents decided to authorize the alterations to Ashley’s body based on their emotional interests. They are her parents and nobody can dispute that and as such, they would want what is best in their opinion for their daughter. For example, they would not want her secondary sexual characteristics to develop beyond their current levels on the chance that she might be raped and get pregnant. For this reason, they saw it best to have her uterus removed.

Besides, her family has a history of large breasts and they would not want that for Ashley given her current condition, which is why her breast buds were removed. Normally, such alterations cannot be carried out on a normal child but in this case, Ashley is not a normal child. Therefore, it is the responsibility of her parents to ensure that her future is practical and better and for this, we cannot blame them. However, they did not seek a second opinion on the intended alterations to their daughter’s body. According to the Washington state law under whose jurisdiction Ashley falls, it is illegal to undertake involuntary sterilization before a court of law has been approved. It is important to note that Ashley’s parents did not seek the approval of the court regarding this matter. Ashley may not be in a position to make rational choices but she has rights regardless of her condition. In this case, the court of law would have acted as a custodian of her rights and probably made a ruling that would have been in her best interest.

What is/ are the core issue/s of the situation?

Ashley was born with static encephalopathy, a rare brain condition. Although Ashley is now 9 years old, her mental age is the same as that of a 3-month-old child, owing to her condition. This means that she cannot talk, walk, change her position in bed, or even hold a toy. Doctors have said that Ashley will have a normal lifespan, although her current mental condition can never improve. With the approval of her parents, doctors at the Seattle Children’s Hospital have performed a hysterectomy a controversial procedure that involved removing Ashley’s breast buds and a hormone therapy procedure entailing estrogen treatment aimed at inhibiting growth. These hormones will hinder normal development so that even as an adult, Ashley will have the body of a child. Her parents authorized her breast buds to be removed so that her breasts may not develop normally because the family has a history of enlarged breasts. This would be a burden to those taking care of Ashley given her condition and small statute.

On the other hand, the removal of her uterus was intended to arrest the development of her secondary sexual characteristics to avoid complications associated with menstruation. It is also intended to avoid her getting pregnant in case she is raped by say, a pedophile. However, in giving their approval, Ashley’s parents put their emotional interests ahead of her best interests. They also do not seek the approval of a court of law.

Would this situation create a problem for you as a professional?

The situation would create a problem for a profession because according to the Washington state law, one should not undertake involuntary sterilization without the approval of the court. Therefore, a health care professional would be faced with problems in case they counted such a treatment because they have violated the law. Besides, human rights activists can also use these professionals on grounds that they have violated human rights by conducting such a heinous and barbaric act on the child.

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