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

Research paper by David D Isaacs, Bernadette B Tobin, Julie J Hamblin, Emma E Slaytor, Kim C KC Donaghue, Craig C Munns, Henry A HA Kilham

Indexed on: 29 Sep '11Published on: 29 Sep '11Published in: Journal of Paediatrics and Child Health


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.