It's a battle between the lesser of two evils or the better of two goods, in the case of Ashley. Ashley, known to the world by just one name, is a severely disabled nine -year old- girl. In addition to extreme physical disability, mental disability as well renders her mind akin to a three-month-old baby.
Ashley's parents who have remained anonymous till now have outlined their treatment and care of their daughter, whom they refer to as the 'pillow angel', on an online website.
Yet ever since they published accounts of an operation; a hysterectomy, performed on Ashley, which they granted approval to believing it to be in the best interests of their daughter, they as well as the hospital that performed the operation have been under fire.
The suit against Children's Hospital & Regional Medical Center, Seattle, was filed by the patient-rights group, the Washington Protection and Advocacy System (WPAS). According to them, performing the operation on a minor like Ashley without prior permission from a court was a violation of Ashley's constitutional and common-law rights.
Incidentally, the operation has halted the physical and sexual development of Ashley, as well as her ability to become pregnant.
In response, the hospital admitting a 'communication breakdown', agreed that it was acting outside the law when its doctors performed the controversial hysterectomy even when her parents and doctors had concluded the operation was in Ashley's best interests. Hospital officials now acknowledge they should first have sought court approval for the 2004 surgery on the girl.
Ashley's parents have explained why they took the extreme step of stunting their child's growth- by series of interventions like the hysterectomy, high doses of hormones to stop her bones from growing and surgery to stop her breasts from developing.
They say that it was in the best interests of their daughter, as the operations would make Ashley more comfortable and less susceptible to health problems associated with being bedridden. Her body would be "more appropriate and provide her more dignity and integrity than a fully grown female body."
They reasoned that a smaller child would be easier to include in family life and to decrease the chances of medical problems if she became too large for them to move.
They say the hysterectomy was performed to prevent bleeding during her treatment and eliminate the risk of uterine cancers and menstrual discomfort. Her breast buds were removed to prevent her breasts from growing to protect her from possible sexual abuse and to eliminate the risk of a breast disease, of which her family has a history.
Ashley was diagnosed with static encephalopathy, or severe brain damage, after she had feeding problems and developmental delays shortly after birth. The now 9-year-old girl's hysterectomy was part of a series of treatments sought when she was referred in 2004 to Dr. Daniel Gunther at Children's when she showed signs of early puberty.
Assistant state Attorney General Edward Dee who reviewed the case after an unidentified person complained about the treatment, said that though Washington has no specific law forbidding the procedures performed on Ashley, state courts have ruled that sterilization of a developmentally disabled person for birth-control purposes requires court approval.