This release isn't on the web yet, but is making the rounds via email. There will be lots more info on Tuesday, May 8. For one thing, the full report mentioned below will be emailed to me - but it should also be available online sometime Tuesday.
Edit: I had to delete the press release as there has been some confusion about the status of its ability to be distributed (it's got an "embargo" date on it, telling the media not to report until the day of the press conference). I received two copies in email from third party sources, one with the embargo status and one without.
I contacted the national office and they were aware that the info had kind of flown out of control (it's to be expected when you send it via email to hundreds of people). At the time, they seemed to be adjusting to the fact that it's out there and didn't express concern about further distribution.
Now they are freaking so I am taking it off until Monday night when I'll post it again.
But summary of press release is as follows:
**Washington Protection & Advocacy, a private, nonprofit organization that protects the rights of people with disabilities, investigated the "Ashley Treatment."
**Investigation revealed that the hospital violated the state law and the child's constitutional rights by performing the sterilization without a court order.
**The hospital admits this, is very sorry, and has a plan to make sure it doesn't happen again.
There will be a press conference at Seattle Children's Hospital on Tuesday, May 8, with representatives of the hospital administration and the disability community.
I'll repost on Monday and issue the link to the full report when it becomes available.
I do wonder if this means that the parents (suing on their daughter's behalf) will now be able to go after the hospital for damages?
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quote:I do wonder if this means that the parents (suing on their daughter's behalf) will now be able to go after the hospital for damages?
Doubtful. Remember, they are the ones who wanted this "treatment."
Laws on nonvoluntary sterilization are meant to protect a person's rights, even from their own parents. If Washington is anything like Illinois, that court order would have involved a hearing and the appointment of a guardian ad litem for the child. The role of the guardian is to advocate for the child's interests and only the child's interests.
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I know what a guardian ad litem is. Diana, who posts here sometimes, is one.
And yeah, it is exactly BECAUSE they were the ones who requested the procedures that the possibility of them suing disturbs me so. It would not be the first such case. Not even close. If the (theoretical)money were awarded to her, even if it could only be used for her care, it would still be a net gain for them -- even if they had no direct control over the funds.
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OK, I didn't bother to update the press release section. Sorry about that.
But, as promised, here's the site you can go to for the full report in pdf(I'll post some links to news stories later): Washington Protection & Advocacy System
And as an added bonus, here's the executive summary for your reading pleasure. And it confirms my suspicions in terms of "groupthink.":
quote:WASHINGTON PROTECTION & ADVOCACY SYSTEM
The following is an excerpt from the Investigative Report Regarding the “Ashley Treatment”
Executive Summary
• The Washington Protection and Advocacy System (WPAS) is the federally mandated protection and advocacy (P&A) agency for the state of Washington. The P&As, which exist in every state and territory, are “watchdog” agencies with legal authority under federal statutes to investigate allegations of abuse and neglect of persons with disabilities and to advocate for their legal and human rights.
• Pursuant to its federal authority, WPAS initiated its investigation of what happened to Ashley in regards to her “Ashley Treatment” after publication of a medical journal article describing the medical interventions provided to a young child with developmental disabilities and suggesting it might be appropriate for others. WPAS also received numerous complaints after widespread media coverage of the situation.
• Ashley is a girl with developmental disabilities who was six years old at the time the interventions began. The intervention included surgical removal of her uterus and breast buds, as well as high-dosage hormone therapy to limit her growth and physical sexual development.
• The Washington Supreme Court has ruled that when a parent or anyone else seeks to sterilize an incompetent individual with a developmental disability, the individual must be afforded due process and a multi-factored test must be proven by clear and convincing evidence before a court can authorize the sterilization.
• The “Ashley Treatment” was conducted by physicians at Children’s Hospital, at the request of Ashley’s parents and after review by the Hospital’s Ethics Committee. There was, however, no court order sought or obtained before the sterilization portion of the “Ashley Treatment” was performed.
• FINDINGS: The sterilization portion of the “Ashley Treatment” was conducted in violation of Washington State law, resulting in violation of Ashley’s constitutional and common law rights.
o The Washington Supreme Court has held that a court order is required when parents seek to sterilize their minor or adult children with developmental disabilities, and that the individual must be zealously represented by a disinterested third party in an adversarial proceeding to determine whether the sterilization is in the individual’s best interests.
o Courts have also limited parental authority to consent to other types of medical interventions that are highly invasive and/or irreversible, particularly when the interest of the parent may not be identical to the interest of the child. Thus, the other aspects of the “Ashley Treatment” – surgical breast bud removal and hormone treatments – should also require independent court evaluation and sanction before being performed on any person with a developmental disability.
o The implementation of the “Ashley Treatment” also raises discrimination issues because, if not for the individual’s developmental disabilities, the interventions would not be sought. Such discrimination against individuals because of their disabilities is expressly forbidden by state and federal law.
• The violations appear to have occurred as a result of:
o a lack of policies at Children’s Hospital regarding the sterilization of minors with developmental disabilities;
o an opinion of Ashley’s parents’ counsel that no court order was required. This legal opinion was not supported by Washington law;
o reliance upon that opinion by doctors at Children’s Hospital and the mistaken belief that the opinion of Ashley’s parents’ counsel constituted a “court review;” and
o insufficient internal controls at Children’s Hospital to ensure that Ashley’s independent legal interests were protected.
• As a result of the WPAS investigation, Children’s Hospital has agreed to take the following corrective actions:
o Develop and implement a policy to prohibit sterilizations of persons with developmental disabilities without a court order. The policy will assure that all appeal periods and appeals, if any, are exhausted before any procedures are performed;
o Improve internal controls and oversight to insure that no sterilizations can take place without the necessary court order; and
o Give notice to WPAS of requested sterilization of persons with developmental disabilities so that it can continue to act as a watchdog on behalf of individuals with disabilities.
• Additionally, Children’s Hospital has also agreed to take the following additional steps to protect the rights of children with developmental disabilities for whom the “Ashley Treatment” or other growth-limiting interventions are sought:
o Develop and implement a policy to prohibit growth-limiting medical interventions on persons with developmental disabilities without a court order. The policy will ensure that all appeal periods and appeals, if any, are exhausted before any procedures are performed;
o Give notice to WPAS of requested “Ashley Treatment” and other growth-limiting interventions of persons with developmental disabilities so that it can continue to act as a watchdog on behalf of individuals with disabilities; and improve internal controls and oversight to assure that no such procedures can take place without the necessary court order. To the extent that it is medically viable, the policy will include provisions to monitor the prescriptions for high dosages of hormones that the Hospital’s pharmacy has been asked to fill; and
o Include a disability rights advocate on the Hospital’s Ethics Committee. The Committee will also bring in experts in particular relevant areas as it relates to medical care and interventions for individuals with developmental disabilities, as appropriate.
• NEXT STEPS: In order to continue advocating for the rights of people with developmental disabilities for whom sterilization or growth-limiting interventions may be contemplated, WPAS will:
o work with Children’s Hospital in ways identified in Section V of this Report and monitor the implementation of the Agreement between Children’s and WPAS;
o conduct outreach to courts and guardians ad litem to advise them of WPAS’s availability to provide technical assistance to guardians ad litem and/or representation for children with disabilities for whom a court order is being sought to perform a sterilization, the “Ashley Treatment,” or other growth-limiting medical interventions;
o provide technical assistance to other P&As and disability rights related organizations throughout the country who wish to address issues related to sterilization, the “Ashley Treatment,” or other growth-limiting interventions for children with disabilities, and conduct activities similar to those WPAS is doing in Washington State; o participate in opportunities to educate the public on legal and other issues related to sterilization, the “Ashley Treatment,” or other growth-limiting interventions for children with disabilities, from the perspective of the disability community;
o promote the availability of WPAS’s advocacy services to obtain assistive technology to facilitate mobility and ease of providing personal care where funding is required by law; and
o widely disseminate this report to various organizations and agencies in an attempt to draw attention to the need to take proactive measures to protect individuals with developmental disabilities. WPAS will also collaborate with our partners in the disability community to:
o identify and promote the best candidates who have a “disability perspective” for participation in hospital ethics committees around the state;
o conduct outreach to hospitals throughout the state to encourage them to adopt policies similar to the ones being developed for Children’s;
o develop a strategy for reaching and educating doctors who may be considering providing high doses of hormones for the purpose of growth attenuation of individuals with developmental disabilities on an outpatient basis in their offices and without the involvement of any hospital;
o create and disseminate educational materials and make presentations to train doctors, medical students, members of hospital ethics committees, judges, guardians ad litem, lawyers, law students, people with disabilities and parents of people with disabilities on legal and other issues related to sterilization, the “Ashley Treatment,” and other growth-limiting medical interventions for children with developmental disabilities from the perspective of members of the disability community;
o work with agencies involved in certification, accreditation, and licensing of hospitals and health care providers to assure that standards, criteria and requirements related to the provision of sterilization, the “Ashley Treatment,” and other growth-limiting medical interventions for children with disabilities are clear, consistent with the law, and communicated to those who need to know;
o work with health insurance companies operating in Washington State and around the country to assure that their policies for reimbursing costs of the “Ashley Treatment” and other growth-limiting medical interventions for individuals with developmental disabilities are clear, consistent with the law, and communicated to those who need to know;
o work with the disability community in Washington State and around the country to identify and advocate other ways to restrict the performance of the “Ashley Treatment” and related growth-limiting medical interventions for children with disabilities to the furthest extent possible;
o to the extent necessary, seek the means necessary to accomplish the above in a timely manner; and
o work with people on every side of the debate to join together to improve the services and supports for children with disabilities and their families.
To view the complete Investigative Report Regarding the “Ashley Treatment”, please see www.DisabilityRightsWA.org. To receive this document in an alternative format, please contact DRW Administrator Jessica McDaneld at 206-324-1521 or TTY 206-957-0728.
I changed the thread title so people would know there was new content, but since Kasie H already changed the thread title on the original thread, we could continue the discussion here.Posts: 4344 | Registered: Mar 2003
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quote:"We deeply regret that a court order was not obtained," Dr. David Fisher, medical director at Children's Hospital said in a statement. "The parents consulted an attorney and obtained a legal opinion that concluded the treatment was permissible under Washington state law without the need for a court order. This is where our system broke down. We take full responsibility."
This is a good illustration of why people/entities should obtain counsel from their OWN lawyer, not from the lawyer of someone who merely seems to have the same interests. The parents' interests were not the same as the hospital's interests, and risk-management at the hospital should have recognized this.
quote:"Sterilization is not the intent of the 'Ashley Treatment,' but a byproduct of it," [Ashley's parents] wrote, adding that while they support laws protecting against involuntary sterilization, they believe the law is "too broadly based" to "distinguish between people who are or can become capable of decision-making and those who have a grave and unchanging medical condition such as Ashley."
They have fundamentally missed the point. The violation of the law was not the sterilization, but the lack of a court order. The point of due process is to ensure that all relevant factors are analyzed before making a decision. One of the factors is what level of decision-making capability Ashley possesses.
Not requiring due process for certain people is like not requiring due process for terrorists - the process is needed to determine who the process is needed for.
quote:Doctors involved in the procedure said that Ashley is doing well in her family's care, which suggests to them it was the right thing to do.
This also fundamentally misses the point. Even IF the surgery was the right thing (and I don't think it was), the wrong thing was done by performing it without a court order.
quote:"A disabled child can be a big challenge for a family, and this was a family that clearly has devoted their lives to making life as good as possible for their daughter," he said.
A perfect illustration of why an independent advocate for Ashley was needed. The interests are very likely different.
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