Making someone child-sized forever? Ethical considerations in inhibiting the growth of a developmentally disabled child

Abstract

In a recent case, parents of a profoundly developmentally disabled child asked physicians to use high-dose oestrogen to inhibit the growth of their child in the interests of allowing better care of her as she ages. The physicians asked whether such an intervention would be ethically acceptable. Such an intervention would seem to violate the rights of the child to bodily integrity and to normal growth, making the intervention ethically objectionable. But in this paper, I argue that in some rare instances, a developmentally disabled child may have only a minimal right against interference with her growth. In those instances, parents may be acting ethically if they use medical interventions to inhibit the growth of their child for the purposes of facilitating better care. But they may so intervene only when the child's disabilities are so profound that the child has no personal interest in developing an adult size and when the intervention is the least intrusive means available for facilitating the care of the child.