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Nothing about Ashley is, or ever will be, fully realized.
Not her size, which has been medically “attenuated”
to keep her small and easy to care for. Not her body,
which has been stripped of its undeveloped breasts so
that they won’t grow large enough to cause discomfort,
harvest cancer or invite sexual assault.
Not her uterus and ovaries, which were removed to
prevent menstruation, potential cancer sites, as well
as pregnancy. Not her voice, which has already been
shrunk to fit her body and IQ.
Ashley is 9-years-old, but she is not and never will
be her own person.
She’s a “pillow angel” whose anonymous
parents were tragically misinformed and misguided into
believing that keeping her pocket-sized and minimized
was in her best interest.
Her case made headlines last month. Born with a developmental
disability called static encephalopathy, she showed
signs of puberty at 6-years-old. It drove her parents
to seek drastic interventions. Medical professionals
embraced the call for help with compassionate and willing
arms. In 2004, Ashley was operated upon.
After an investigation by Disability Rights Washington
(the recently-renamed Washington Protection and Advocacy
System), Children’s Hospital admitted it was wrong
to perform a hysterectomy without a court order. Not
wrong to perform the surgery on a 6-year-old, just wrong
to do it without going through the appropriate legal
channels. Other than that, no problem.
In a case of grabbing hold of the right stick at the
wrong end, the eye of the media storm has fixed itself
on the parents’ choice to stunt the body and potential
of their daughter.
The great brains of modern medicine and ethics should
not, however, be focused solely on the decisions made
by Ashley’s parents. They should be thinking long
and hard about the dangers of a society that makes such
decisions possible.
“She gone,” says Jim McNamara, president
of Self Advocates of Washington, an organization run
by and for individuals with developmental disabilities.
“She’s not Ashley,” he says. “She’s
ashes.”
McNamara expresses the grief of individuals whose
bodies and IQs have been measured, assessed and routinely
invalidated. Ironically, but not surprisingly, they
have yet to be respectfully consulted on the ethics
of medical modifications.
Consider Ken C. Now 71-years-old, he talks about having
had a lifetime of decisions made in his best interest.
“They said I didn’t know how to read or
write and I didn’t know anything about money,
so they put me in Rainier School for the rest of my
life,” he says. “I tried to commit suicide
because I thought I’d never get to see the outside.”
While he did move out of the institution eventually,
he faced another kind of institutionalization: sterilization.
His mother said it was the only way he could get married.
“They said they didn’t want any kids to
look like me,” says Ken.
He thinks surgery is more risky than pregnancy. It’s
one reason he, and not his wife, chose sterilization.
“They didn’t think she could make it,”
he says. What a choice, especially for someone considered
incapable of making major decisions.
Asked what he thought about Ashley’s hysterectomy,
he says, “Her parents need to hire good helpers
that treat her right.”
In Ken’s view, the answer is to strive for the
best, not prepare for the worst. Rather than accept
abuse and a life of discomfort as Ashley’s fate,
he poses a much more revolutionary idea: fix the problem,
not the person.
Emily Rogers, self-advocacy coordinator for The Arc
(Advocates for the Rights of Citizens with Developmental
Disabilities) of Washington State, agrees. “I
really believe that there’s no amount of modification
to a person that can happen so that they are not at
risk,” she says.
Like Ken, Rogers promotes the idea that other options
are available and that new ones can be developed to
prevent future Ashley-style treatments from occurring.
“She was six years old at the time this happened,
but that doesn’t mean that over the span of her
lifetime that’s the extent of who she’ll
be.”
As far as Ashley’s treatment is concerned, Ken
suggests a fitting end to the debate that many professionals,
parents and pundits have yet to embrace: “Treat
her like a human being.”
Grier Jewell serves as host of
Olympia Insider, a video podcast devoted toward disseminating
news and information on developmental disabilities.
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