Forever Small

Abstract

This chapter analyzes the Ashley treatment (AT), named for a case where the parents of a six-year-old girl with severe cognitive impairment and global developmental deficits elected to have her undergo a procedure that involved growth attenuation (GA), along with removal of her breast buds, uterus and appendix. Acknowledging that AT is intended as care, Kittay argues that AT nevertheless fails to be ethical because it does not foster flourishing in critical ways. Kittay identifies four questionable presuppositions undergirding the arguments condoning AT: instrumentalization of the body; conflating apparent impairments with corresponding limitations to intellectual comprehension and emotional experience; positing severe cognitive disability and nonambulation as sufficient justification for these treatments even though they do nothing to cure or mitigate those conditions; and the notion that AT solves the problems of care of people with these conditions. Rather than pursue AT to handle the additional burden of care presented by nonabulating people with severe cognitive disability, we need social transformations that support the needs of severely disabled individuals and those who care for them.