Ashley事件から生命倫理を考える（ミラー）

In order to ensure that a court order is obtained before a sterilization or growth-limiting growth-limiting medical intervention is preformed on an individual with a developmental disability, Children’s Hospital has entered into an agreement with WPAS to take the following steps:

A.Implementation of Policy and Procedure on Growth-Limiting Medical Interventions

Children’s will develop, adopt, and implement a policy prohibiting growth-limiting medical intervention for individuals with developmental disabilities unless Children’s has received a valid order from a court of competent jurisdiction, not subject to appeal, authorizing such intervention in a given specific case. In the event Children’s does receive such an order providing legal authorization for one or more growth-limiting medical interventions for an individual with a developmental disability, Children’s will in addition forward to its Ethics Committee for consideration any proposed use of such interventions. The Ethics Committee will review the proposed use and issue a report setting forth its recommendations regarding such interventions.

For purposes of this policy prohibiting growth-limiting medical interventions for individuals with developmental disabilities without a court order, the term “developmental disability” will have the definition set forth in federal law, 42 U.S. C. §15002(8)(A). A “growth-limiting medical intervention” means any medical intervention, including surgery or drug therapy, that alters or is intended to alter a patient’s potential for normed physical maturation. The policy will apply whenever a growth-limiting medical intervention for an individual with a developmental disability is sought by a parent, guardian, or other third party.

Investigative Report Regarding the “Ashley Treatment”
May 8, 2007, Washington Protection & Advocacy System, P.25

We are working to introduce new safeguards so that something like this never happens again. These safeguards include:

・Children's will require a court order for growth attenuation through hormon treatment, and for breast bud removal and/or hysterectomy when it involves a child with a developmental disability.

・Children's will not schedule procedures either to attenuate growth or perform hysterectomy or breast bud removal in children with developmental disabilities without review and approval from Children's legal counsel, who will assure a court order is obtained before allowing a procedure to be scheduled.

・Children's will appoint someone with a disability rights perspective as a full member of the Hospital's Ethics Committee, and will require committee review and guidance when a court order has been obtained by parents.

裁判所の命令なしに発達障害のある人に成長抑制を行わない。裁判所の命令があった場合、子ども病院はさらに倫理委員会で検討を行う。方針と手順についてはWPASと密に相談し、２００７年９月１日までに策定する。　さらに、それら手続きなしに治療が行われたり薬が処方されることがないよう、病院のコンピュータ・システムにセーフガードを儲ける。また成長抑制療法に裁判所の許可が下りた場合は、プライバシー法の範囲で、子ども病院はWPASに通知する。