The right decision for a "Pillow Angel"

A change of policy at Children's Hospital & Regional Medical Center to require court orders for certain treatments for disabled patients is the right thing to do.

Doctors who performed a hysterectomy on Ashley, a girl with severe disabilities, admitted they missed an important legal step in not obtaining a court order. Nonetheless, the procedure was an important part of treatment intended to improve Ashley's quality of life.

Here are the facts: Ashley has the mental and physical capacity of a 3-month-old. She cannot move on her own. Her small size allows her parents to carry her, cuddle her and turn her in bed to prevent bedsores.

Ashley is expected to have a normal life span and her parents understandably became worried that as the girl grew to adult size, her care would grow more difficult, perhaps even impossible. They worried about sexual abuse from ill-intentioned caregivers. Who burdened with the responsibility to care for a disabled loved one has not had the same fears?

Doctors and Ashley's parents decided three years ago to stunt the girl's physical development with high doses of hormones, a hysterectomy, and surgery to prevent her breasts from developing. The choice made them the target of critics who included disability-rights advocates.

The admittedly radical choice of treatment for Ashley wasn't decided lightly. Doctors gained approval from the hospital's 40-member ethics committee. This was a carefully vetted decision, not a reckless one.

Among the medical pluses: Ashley is more comfortable when strapped across the chest in her wheelchair; she can be picked up for a spontaneous hug or included in events with her siblings; she will not face menstrual discomfort; she has a less likely chance of getting the breast cancer that runs in her family.

The girl, nicknamed the "Pillow Angel," suffers less and enjoys life more. This treatment may not be right for most people, but it ought to remain an option.

The new policy at Children's adds a layer of legal accountability. The role of the courts will be to ensure that medical decisions for patients with disabilities are made by the appropriate people for the right reasons — in short, exactly what happened in Ashley's case.