Gal Kober

Since publication of the “Ashley Case” in 2006, few rigorous clinical or research reports have elucidated the benefits, risks, outcomes, and experiences of children with severe neurodevelopmental disorders treated with Growth Attenuation Therapy (GAT). GAT remains available, however, with at least one institution publicly discussing its ongoing program. This paper describes ethics consultations provided for two separate GAT requests (hormonal treatment only) at one institution, both from parents who independently learned of the treatment elsewhere. We detail these comprehensive consultations, and subsequent multistakeholder deliberations undertaken to determine whether formal consultations should be required for similar future cases. We offer insights regarding processes for future potential candidates, including for addressing questions such as: Should all clinically similar children be offered GAT proactively or only upon parental request? What are the implications for access/equity? We call for further peer-reviewed scholarship to reanimate this historically stigmatized and understudied treatment.

In the Ethics,1 Spinoza presents a rigorous naturalistic view of man and nature. Man is a part of nature, a subject of the same domain—not a domain separate from it, nor a domain within that of nature. Man cannot act against nature or in an unnatural way; in comparison with any other part or creature of nature, man is not special, more important or qualitatively different. All general laws of nature apply equally to animals, inanimate objects, humans, God, the mind, and the affects. Nature can be explicated based on necessary causes, and there are no extra-natural factors that affect it or anything in it: no supernatural power or metaphysical principles create or regulate it, and no separate methods of explanation ..