Text Size: A A A
Article
Navigating Growth Attenuation in Children with Profound Disabilities: Children's Interests, Family Decision-Making, and Community Concerns

Our working group sought to engage the underlying ethical and policy considerations of growth attenuation—that is, administration of short-term, high-dose estrogen to close growth plates, thereby permanently limiting height. We hoped to move beyond staking out positions with divisive and polarizing rhetoric about growth attenuation in order to find common ground and better identify and understand the areas of deep disagreement. In this paper, we offer sympathetic accounts of differing views so that those who hold a particular view can better understand others’ concerns. We also reach for a middle ground—a moral compromise based on respect for sustained disagreement rather than on consensus. Most of our group agreed to the compromise that growth attenuation can be morally permissible under specific conditions and after thorough consideration.

Our working group sought to engage the underlying ethical and policy considerations of growth attenuation—that is, administration of short-term, high-dose estrogen to close growth plates, thereby permanently limiting height. We hoped to move beyond staking out positions with divisive and polarizing rhetoric about growth attenuation in order to find common ground and better identify and understand the areas of deep disagreement. In this paper, we offer sympathetic accounts of differing views so that those who hold a particular view can better understand others’ concerns. We also reach for a middle ground—a moral compromise based on respect for sustained disagreement rather than on consensus. Most of our group agreed to the compromise that growth attenuation can be morally permissible under specific conditions and after thorough consideration.

Benjamin S. Wilfond, Paul Steven Miller, Carolyn Korfiatis, Douglas S. Diekema, Denise M. Dudzinski, Sara Goering, and the Seattle Growth Attenuation and Ethics Working Group, "Navigating Growth Attenuation in Children with Profound Disabilities: Children's Interests, Family Decision-Making, and Community Concerns," Hastings Center Report 40, no. 6 (2010): 27-40.