Managing ethically questionable parental requests: growth suppression and manipulation of puberty

David Isaacs, Bernadette Tobin, Julie Hamblin, Emma Slaytor, Kim C Donaghue, Craig Munns, Henry A Kilham

Journal of Paediatrics and Child Health
Journal of Paediatrics and Child Health

Abstract
Doctors sometimes struggle with ethically challenging requests for treatment from children’s parents. For instance, we have recently had two requests by parents of children, a girl and a boy, each with a severe developmental disability, for hormonal therapy to suppress growth and puberty: the girl’s parents requested, in addition, hysterectomy and mastectomy. We propose a reliable approach to assessing the ethical and legal aspects of these and other requests for ‘non-therapeutic’ treatment of a minor who lacks the capacity to give informed consent. We argue that a doctor should first assess whether the request is one that he or she can, in conscience, accede to, and then, if it is, seek the authorisation of a court. We outline considerations relevant to the doctor’s assessment of both the ethical issues and to the need for court authorisation.


Isaacs D, Tobin B, Hamblin J, Slaytor E, Donaghue KC, Munns C, Kilham HA. Managing ethically questionable parental requests: growth suppression and manipulation of puberty. J Paed Child Health. 2011 Sep 27;47(9):581-584.

(Correspondence) Abortion perils debated

Shauna C Hollingshead

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
. . . Regardless of one’s opinions about the abortion issue, educating patients about the benefits and risks of an intervention is integral to good medicine. Thus, physicians should be willing to inform their patients of the risks associated with abortion. Aside from the usual risks associated with a surgical procedure, these include increased risks of psychiatric illness, 1 future preterm birth2 and breast cancer.3,4 I commend CMAJ for refusing to allow politics to trump the scientific progress of women’s health care.


Hollingshead SC. (Correspondence) Abortion perils debated. Can Med Assoc J. 2003 Jul 22;169(2):101.