Growth attenuation is a treatment process that prevents one from growing in terms of body size. This is mostly done to children who have complex and multiple disabilities and are most likely never going to be able to participate in normal adult life activities such as securing a job, building a romantic relationship and starting a family. For instance, children with profound cognitive and neurologic impairment that has proven impossible to repair, are most likely to depend on their caregivers especially their parents for everything in their entire lives. Doctors, therefore, recommend attenuation treatment for such children so that they can be easier to move around and be more involved in life activities.
Some people may argue that the growth attenuation treatment only benefits the caregivers or the parents by making their work easier or by making it possible for them to stay with their child for a long time without needing to institutionalize them. However, this argument is meaningless when the procedure is undertaken to the right patient and in the right manner. Ethically appropriate attenuation is done after two major considerations. First, is the question of benefit to the child or patient and second is the question of harm of the procedure to the patient. The procedure is only conducted when there is expected improvement of the quality of life for a nonambulatory patient with profound disabilities of development (Gunther & Diekema, 2006). Secondly, the procedure is conducted if there is no risk of harming the well-being of the patient.
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Growth attenuation treatment is done through high dosage of estrogen that prevents growth and fast maturity advances of the epiphyseal growth plates. It results in permanent growth retardation in terms of height and general body size after only a short period of undergoing the treatment process. The procedure is conducted when the patient is still relatively small so that they remain easy to move around by the help of their caregivers. The treatment prevents the child from growing to adolescence as well as adulthood because it would have no meaning for them but only pose difficult to their caregiver. The patients who are ethically considered for this procedure are children whose minds are never likely to develop to enable them to think or act like adults. Their bodies may develop but their minds stay like those of a child. If there are bodies are prevented from growing, it gives them a better life since they can be easily moved from place to place.
The people who argue against this treatment are those who do not understand the kind of patients who are ethically undertaken through it. They think that the procedure takes away some life advantages from the patient. In normal people, things like tallness and normal body sizes give advantages like easy access to a wide variety of jobs, attractiveness in terms of romantic relationships, fitting in social groups such as teenagers' cliques, and defending oneself from bulling for example in school. However, the patients ethically selected for this procedure are those whose conditions will never allow them to enjoy all the normal life situations even if their bodies are left to develop. Most of them have body parts that are not fully developed and lack abilities such as sitting up, walking, talking or even any communication ability. They, therefore, depend on caregivers for every single activity in their lives such as feeding, bathing, nature calls and moving from place to place.
It is true to say that growth attenuation makes the work of a caregiver easier but one should not forget that it is meant for the benefit of the patient (Gunther & Diekema, 2006). If the caregiver does not find it too difficult to move the child around, or to change their clothes or sitting position, the caregiver is more likely to do it more regularly. The parent or caregiver can even regularly take the child with them when going for family outings, shopping, church or any other fun outdoor activities. On the contrary, when the child's body is left to grow and gain full height and weight, it becomes challenging for the caregiver to move them around. In such a case, the caregiver is likely to change the clothes or position of such a person fewer times. Such a person is also likely to be left in one place for the rest of the day or a better part of it. Such a person is also expected to stay home for the better part of their lives since it is tough to move with them around. Even pushing such a person in a wheelchair is weirder than when the person has a smaller body. So many people are likely to go staring making the situation feel uncomfortable.
Growth attenuation also makes it possible for one to stay with their family for a long time (Gunther & Diekema, 2006). When people with profound developmental disabilities are let to grow and develop into adulthood, in most cases, it becomes impossible for them to continue receiving the care they need at home, unless their families are wealthy and afford the specialized equipment required for their care. Most of these people are therefore forced to live in institutions with such equipment and with people who are specialized in handling them. Attenuation, however, makes it possible for the parents or home caregivers to continue easily handling such a person even for decades. Living around family members cannot be compared to spending the rest of one's life confined to a certain health facility. Attenuation will, therefore, help the patient to be able to spend time with their family members and stay in the comfort of their homes, which is a better way of living.
Other people argue that the procedure makes one be treated like a baby for the rest of their lives. This is not such a bad thing for a person living with profound developmental disabilities because they are not offended by it in the first place since their medical condition does not allow them to comprehend things like that. Otherwise, a person who has a mind enough to understand such life events cannot be ethically considered for the procedure. Most of this people only experience basic feelings like pain, and happiness just like a baby. It is therefore advantageous when they are treated like a baby instead of when they grow to adulthood, and people start to view them as aliens, or abnormal people.
Historically, people with mental retardation or those thought to have such are known to have been subjected to a lot of abuses. For instance, some were subjected to involuntary sterilization due to the belief that their condition was genetic and there was the risk that it could be passed to future generations (Gunther & Diekema, 2006). However, if a person is fit enough even to be involved in reproduction, they cannot be ethically considered for growth attenuation since their condition is good enough to let them enjoy such life activities like normal people. The ethics behind this procedure is that the process should not take away any possible life opportunities for the person. However, if the person is never likely to enjoy such opportunities even without the procedure, it is considered ethical to take them through the attenuation treatment for their benefit and the benefit of their beloved ones.
The only reasonable argument against the attenuation treatment, therefore, is whereby there is hope or possibility of the condition's improvement. Many people who are against the treatment are those who believe that maybe, sooner or later, scientists can discover a way to improve the condition of patients with profound developmental disabilities. If at all such a discovery is made when a child has already undergone the growth attenuation treatment, they lack the chance to try their luck of getting a normal life. This is because even if their ability improves, their growth has been permanently arrested and therefore they remain small in size for the rest of their lives. The irreversibility of the procedure is therefore clearly undesirable.
Reference
Gunther, F. D., Diekema, D. S. (2006). Attenuation Growth in Children With Profound Developmental Disability. American Medical Association, Vol 160, p. 1013-1017.
