Monday, October 08, 2007

Mother seeks girl's hysterectomy

BBC NEWS | Health | Mother seeks girl's hysterectomy

Katie is a 15 year old girl who has cerebal palsy, and she cannot speak for herself. Katie's mother has asked permission to allow her daughter to undergo a hysterectomy because she does not want her daughter to begin menstruation. This is a request that needs to be handled with extreme sensitivity.

Katie's mother has reasoned that her daughter would not understand the process of menstruation and that Katie would feel undignified by the monthly process. Her reasoning on the issue is as follows:

Mrs Thorpe said: "All we are trying to do is keep and improve Katie's quality of life.

"By stopping menstruation it's allowing Katie to enjoy life to the full without the problems of menstruation...the mood swings, the tears, the stomach cramps, the pain, the discomfort, the embarrassment."

Mrs Thorpe said her daughter would not be able to ask for help or even let people know what she was feeling.

She said the decision had not been made lightly, but was something she had thought through for many years and finally decided upon when Katie turned 13.

According to the Sunday Times, Phil Robarts, a consultant gynaecologist at Mrs Thorpe's local hospital, supports her decision.

Mrs Thorpe said: "She's not going to get married and she's not going to have children...Katie is not going to become a normal adult.

"I absolutely understand that it's not for everyone, and I'm not saying it should be either.

"I'm not advocating this should be a blanket policy for all disabled children, absolute horror at that."

But she said she was "utterly" convinced it was the right decision for her daughter.

"It's not about us, it's about Katie," she said.

However, representatives from Scope, advocates for the disabled have another opinion on the issue, pointing out that if the operation was given approval, then there are disturbing implications for other disabled children.  Andy Rickell, the executive director of Scope stated:

He said: "It is very difficult to see how this kind of invasive surgery, which is not medically necessary and which will be very painful and traumatic, can be in Katie's best interests.

"This case raises fundamental ethical issues about the way our society treats disabled people and the respect we have for disabled people's human and reproductive rights.

"Scope is concerned that doctors are supporting parents in this case. If this enforced sterilisation is approved it will have disturbing implications for young disabled girls across Britain."

He said that it was for society to adapt to the needs of disabled people, not the other way round.

Mr Rickell said the government should do more to help people who care for severely disabled people, and to put in place extra legal safeguards to protect the rights of disabled people themselves.

He said: "We want to see a clear framework put in place for dealing with ethical decisions of this complexity, which places the rights, and best interests, of disabled children at the heart of any decision."

Simone Aspis from the UK's Disabled People's Council also spoke against giving approval for the operation:

She said: "It is very clear to us that no operation should be undertaken if there is absolutely no clinical benefit to the person concerned.

"The operation should not be carried out under these circumstances. We are very aware there are other methods of medical intervention that can be done to help control Katie's pain.

"There's lots of non-disabled women who also experience discomfort in their periods.

"Doctors wouldn't even anticipate in recommending to a parent that their child should have their womb removed. Why should it be the case for this person simply because she is disabled?

"As far as we're concerned that is totally and utterly unacceptable."

I see the issue as one that is extremely sensitive because I do not really believe that parents should have the right to ask for this operation for their child. It is simplistic to think that this will prevent Katie from having menstruation without thinking through the implication of surgically induced menopause. I am concerned about the effects on Katie on her production of estrogen and prostaglandin which are hormones that are normally produced by the body and are needed for strong bones in order to prevent osteoporosis. This is not an operation that should be undertaken lightly by any woman if it is not strictly necessary, and that includes when a woman has fibroids in her womb. Why put this child through something like hot flushes?

I hope that permission is refused for the operation, and that all necessary assistance is given to the mother of Katie to help her help Katie through the process of menstruation, which is a natural thing for any female. It does not have to be painful.

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