There are two critical issues here, which most of the letter writers seem oblivious to. They are the ethics of the procedure itself and the ethics of how the decision was taken. Both are in doubt here.

An internal ethics board is subject to the pressures of any internal organization. There is to me, no clarity as to whether this hospital has an independent patient ombudsman, who would be free of those pressures. I also don't see any external organization which was able to review the procedure. Without external, independent review, this procedure should never have even been considered.

The parents seem thoughtful and to wish the best for their child, which is admirable. They also, in particular the mother, have considered some of their child's potential fears upon maturation. They are faced with the particular concern of a child who will not die before them, thus leaving them with the unknown of what happens after they die. It is instinct for them to protect their child, from the world, and perhaps from herself.

There is however, an incredibly troubling specter over the entire process. By justifying the complete removal of all sex organs as unnecessary, the doctors and parents have entered the realm of eugenics. They have called upon the worst lapses of medical ethics of the 20th century. Rosemary Kennedy comes to mind, robbed of the chance to perhaps develop, by parents both well-meaning and ashamed.

I doubt that there can ever be a satisfactory agreement on the ethics involved, and the Ashley Treatment will remain either a black mark on the hospital that performed the work or another footnote in an ongoing debate about our very contorted ethical debate. Had this happened in Germany, Salon readers would be on the barricades, screaming for blood.

Playing G-d is not something I aspire too. Yet life has put me and my wife into that position at times. Having a son with Down Syndrome has given us challenges directly related to those Ashley’s parents have had to deal with. Thank goodness our son is not severely disabled and nor as totally dependent as Ashley is. Despite being blessed with a relatively high-functioning son, there are still areas where his disability prevents him from having the ability to make responsible decisions about certain aspects of his life. Our job as his parents are to maximize his ability to be responsible for himself, to empower him as much as possible. But when we hit a wall that cannot be breached, it is also our responsibility to make the decision for him, in his best interests, as best we can.

If we are not willing to make those decisions on his behalf, who would? I guess family or friends would be our first choice. We certainly would not want it to be a social worker or outside agency. In making far-reaching decisions on his behalf, we can at least be sure that our love and caring for him are an important part of the process.

Do we always do right by our son? I hope so, but I can’t be sure. And while some parents are unsuited for the task, I do know that in our case, as in Ashley’s case, I would very much prefer to trust that a parent is looking out for their childs’ best interest, no matter how radical or different that decision may seem to be. Caring for a child with a disability is a huge, long-term and sometimes daunting task. As shocking as Ashley’s case, and the decisions her parents have made on her behalf, may seem upon first hearing of it, reading the article, her parents’ blog and thinking about the circumstances they made decisions within made me appreciate the thoughtfulness, thoroughness and, most importantly, the love they brought to the process as they tried to decide what was best for their daughters life.

...to have read such a truly intelligent & careful look at the Ashley treatment. When I read the headline, I was filled with trepidation. I've obsessed over close to a dozen articles about this (and posted simmering comments on at least two)-- however, not only did this piece echo many of my thoughts, it also raised a stirring & well-grounded challenge to consider nuances I previously hadn't.

Ashley could not ask for a better journalist to capture this issue. Thank you, Rebecca.

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Debating the concept of the "personhood" of anyone with the mind of a 3-month-old (not 3 years old, as some letterwriters have said), is a luxury of ivory tower dwellers, people who don't have to do the dirty work. It is said that nothing is impossible for the man who doesn't have to do it himself, and this sad situation is the perfect example.

It is disturbing, too, that so much emphasis is placed on the supposed cruelty of denying this person her sexual feelings. Much of what contributes to sexual feelings, such as soft touches, a feeling of being loved, even pleasant auditory and olfactory stimuli, can still be experienced. If she never climaxes, well, she's no worse off than most married women.

I hope that those who deplore the Ethics Committee's decision have the courage to vote for those who would put social needs over business needs in the next election.