"It was merely a required legal procedure."

Detached ethics

Medical profession has a duty to care about critical rules

Editor, The Times:

I am appalled by ethicist Dr. Doug Diekema's statement that "Whether legally you needed a court order or not is a totally separate question from whether it was right or not" ["Children's Hospital says it should have gone to court in case of disabled 6-year-old," Times page one, May 8].

In the absence of compelling reasons for violating the law, such as saving a patient's life, it is unethical for any hospital to substitute its own internal ethics committee process for legal proceedings. There was no urgency to act quickly.

If the hospital believed it was acting in the child's best interest, it could have presented its case to the court. In all likelihood, the court would have ensured that both sides of the argument were presented, probably through the appointment of a guardian ad litem for the purposes of the proceedings.

Dr. Diekema authored a scholarly article presenting an ethical analysis that clearly was not a balanced presentation but rather an argument in favor of the procedures. He has every right to advocate in its favor, but he should not attempt to present himself as an impartial authority on its ethics at the same time.

— Dick Sobsey, director, John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Canada

Indifference disabled

The historical treatment of people with developmental disabilities is grim. Abuse, neglect, involuntary sterilization, isolation and death are among the grievances. Many of us thought these things were in the past, but perhaps not, as The Times' recent coverage of the Ashley Treatment would indicate.

The Arc of Washington State, as a long-time advocate for people with developmental disabilities and their families, applauds the Washington Protection and Advocacy System for its investigation, and Children's Hospital for acknowledging its mistake ["Child's hysterectomy illegal, hospital agrees," page one, May 9]. We appreciate the effort to ensure a disability advocate will be part of any future conversations.

Let's not forget our laws say disability is a natural part of the human experience. We believe people with disabilities are entitled to enjoy the same civil and human rights people without disabilities enjoy. As community advocates, we believe permanently altering an individual with a developmental disability (regardless of his or her mental capacity or communication abilities) is unacceptable and a violation of the individual's basic human rights.

We will continue to fight for the rights of people who cannot speak for themselves and remain committed to ensuring interventions like the Ashley Treatment are not promoted by our public policies.

— Sue Elliott, executive director, The Arc of Washington State

Politics unplugged

"The right decision for a 'Pillow Angel,' " [editorial, May 10] unknowingly defends hubris. Is it a new policy for the hospital to comply with state law?

Hysterectomy or other forms of permanent sterilization in minors require court order in California, Oregon, Idaho, Washington, British Columbia and most states — for the protection of minors and persons with disabilities.

A staff physician defends that they would be faced with "court order on half of what we do here" [Child's hysterectomy illegal, hospital agrees"]. Not so; there are very few situations in the practice of medicine for which court orders are required. In sterilization cases, court order is the family's responsibility.

It is true that law is not necessarily the same as ethics; despite quoted comments, there is no unanimity whatsoever on the ethics of the "Pillow Angel" case. But this was not, as suggested, court order interfering with physician and family decision, as occurred in the Terri Schiavo case. It was merely a required legal procedure.

The law is the law, and the physicians (despite ethics committee recommendation) simply didn't confirm that the family had followed and documented legal proceedings.

As the article states, physicians aren't lawyers, but hospital legal counsel was certainly immediately available.

New hospital policy? It will strengthen fairness and, yes, ethics, to now include input from advocates for persons with disabilities for consideration of new treatments. But with regard to required court orders, this "new" hospital policy, and your editorial, project the appearance of mere political spin.

— Mark Merkens, Lake Oswego, Ore.

Owls and the bureaucrat

Too long we have tarried

"Changes in plan to protect owl raise concerns about NW forests" [page one, April 27] sounded like another finger-pointing distraction strategy employed by Bush administrators to divert attention from what really is important.

To suggest that killing a few hundred barred owls is going to save the spotted owl is absurd. Contrary to some timber company studies that have been very limited and self-serving, the objective science has always been clear that contiguous, mature forest habitat is fundamental to the owls' survival.

The fragmented, old-growth stands and second- and third-growth forest alternatives have never been proven to be anything other than marginally supportive of spotted owls. Barred owls, however, do very well there. Back in 1944, the last documented and undisputed sighting of an ivory-billed woodpecker was made in Louisiana by my friend, the field naturalist and artist Don Eckelberry. Sixty-plus years later, we're still holding onto this icon of Southern forests primeval with diminishing belief that it survives.

The spotted owl occupies a similar place in our consciousness. Its survival is symbolic of the contiguous ancient forests it must occupy and these forests are a fundamental part of our natural heritage and well-being.

I would hope that in the middle of this century, we'll not be documenting a last sighting of the spotted owl, for if we do, its demise will be our fault, not that of another species, and our impoverishment will be great indeed.

— Tony Angell, naturalist/artist , Seattle

Fighting in-country

Surrender at Fort Dix

I understand that Senate Majority Leader Harry Reid, D-Nev., and House Speaker Nancy Pelosi, D-Calif., upon hearing that six Islamic jihadist types were caught planning an attack on soldiers stationed at Fort Dix, N.J. ["6 Islamists charged with plotting Fort Dix attack," page one, May 8], demanded an immediate withdrawal of all U.S. military personnel stationed at Fort Dix.

— Scott St. Clair, Kirkland

D.C. reverts to union

Thanks to the Constitution, a timetable for getting George Bush and Vice President Dick Cheney out Washington, D.C., is guaranteed.

— Gordy Green, Seattle