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I think it's entirely up to the mother. She's the one - nobody else - who will have to deal with this child in this state for a long, long time. Frankly, it's nobody else's dammed business, and if the UK government won't get out of her face about her decision then I'd take the daughter elsewhere to have it done. Whatever makes life simpler for both mother and daughter is at this stage of primary importance. I'm astonished that such a collectivist notion as precedence should take precedence over what's important to the individuals involved. They've got enough on their plate without having to take all future generations of celebral palsy sufferers and their families into account of their own private dilemma, which is theirs and theirs alone. Unless Simone wishes to be responsible for raising Katie Thorpe herself then she has no say in how the girl's mother wishes to do it.

I think a judge is the best person to make the decision at present. The mother is probably conscious of a change in her own legal position that will occur when Katie turns 16.

I think that the mother's heart is in the right place. She simply wants to do what's best for her daughter, and as the girl is only 15, legally it's up to her mom.

It's perfectly appropriate that the courts should be involved in this, for the protection of all involved, and to ensure that issues like this are handled on a case-by-case basis.

That being said, in this case it's very clear that the intentions and the intended effect of a hysterectomy are justified. A pregnancy in this poor lass would be a *disaster*, and menstruation likely distressing for all concerned. If we were talking about removal of a problematic skin tag, or fitting a feeding tube, or lengthening the Achilles tendon, there would not the the wailing & gnashing of teeth that we hear from some quarters.

This is not about the capacity to consent to treatment per se, but all about reproduction. Funny enough, some people feel that it's OK to cut bits off little boys' willies without their consent, for religious reasons, and for a presumed decrease in risk of HIV or penile cancer down the line. The only thing that is qualitatively different in this case is the issue of *reproduction*.

Perhaps some people need a dose of reality, and I would suggest that the hard knocks should not be undergone by Katie and her family.

I think it is important to consider whose rights need to be considered here, and what priority they take. Obviously Katie's rights should be the primary concern, closely followed by her mothers. And for a third party to decide what is in Katie's best interest does pose an interesting dilemma. To my mind the rights of that third party are way down the list.
Katie may be incapable of expressing her desires (for or against the operation) so in that instance Katie’s mother would be in the best place to know what is in her daughter’s best interest.
I think doctors and families should be able to talk through the issues and come to an acceptable ethical conclusion without involving the courts.

I'm glad to see we seem to be roughly in agreement. D Smyth #4, you might want to consider what you think is wrong with that sentence and why.

I think it's important to recognise that minors 'normally' cease to be minors when they reach a certain age and therefore in most cases it would be appropriate to wait a few years and see what happens when she is looking after herself, etc. But in this case Katie will always need as much care as she does at present, the upshot of which means that there are other rights permanently involved: her mother's.

Unless someone is seriously wishing to argue that Katie should someday be able to reproduce then I can't understand on what grounds they would have a problem with a hysterectomy which itself would prevent much needless hassle, a factor in her quality of life in general.

The mother is in no way morally subservient to the state in this case or any other relating to her child (though it's probably a good thing that the doctors want to ensure that they're on good legal ground to follow her wishes). In the case that the state disrupts or prevents the hysterectomy, she should take Katie to another state who won't stand in her way and have it done there.

_I'm glad to see we seem to be roughly in agreement. D Smyth #4, you might want to consider what you think is wrong with that sentence and why._

I don't necessarily disagree with your argument, however the term 'spastic' was abandoned the best part of 20 years ago by most right thinking individuals.

The only reasons given by Alison Thorpe for wanting her daughter to have a hysterectomy, are those presented in the OP, 'to prevent her from starting menstruation because she is concerned that Katie would be confused by periods and they would cause her indignity.'

I have not read anywhere that the intention is to ensure she doesn't conceive, though it would obviously have that effect too. It appears that the intention is to prevent menstruation which is presented for some reason as 'undignified'. Katie is incontinent and wears pads, so starting her periods will not have much practical effect. If she does happen to have period pain, pain killers or other medical solutions exist which are effective and less drastic painful and dangerous than a hysterectomy.

Look at the information on hysterectomies. The 'why is it necessary' section doesn't mention anything about 'preventing the indignity of menstruation'. The recovery time is said to be an average of 5 days in hospital, followed by 6-8 weeks at home.

I believe that parents must make decisions on behalf of their children as much as possible. But parents can be wrong, even when motivated by love for their child. The state has a duty to investigate and possibly take action if it appears that parents are neglecting or abusing their children. Likewise, the state must step in when a parent requests an unnecessary major surgical procedure, and ensure that the law is upheld, whether the child in question is disabled or not.

We do not know the full facts of this case, despite the many media appearances by Katie's mother. Doctors, ethicists, lawyers and Katie's parents must consider this together. It is not clear what efforts have been made to help Katie to communicate, not being able to talk isn't the same as not having anything to say. There are various strategies and devices to help even the most disabled people to communicate. It is important, that as far as possible, Katie herself can have a say too.

Sterilising people with a learning disability may have been in vogue in the last century, but thankfully is no longer practice..

Any medical procedure involving general anesthetic and invasive surgery is dangerous and must not be done without a patients consent without clear clinical need.

For all those out there who believe that "parents know best" take a look at the number of children abused every day in this country, go talk to many of the people with learning disabilities who have been kept at home by there aging parents being treated as the eternal child until their parents are too old or senile to care for them any longer.. or what of the young girls in many parts of the world who suffer circumcision as their parents feel its the right thing to do?

Growing up is a civil right and a biological fact for all people regardless of disability!

Having spoken to my wife who is a midwife she brought up something that I hadn't considered. There are alternatives to a hysterectomy - in particular having a coil fitted, which although it doesnt stop menstruation indefinitley is a less invasive option, and may make the situation more manageable.

D Smyth #7- You're just wrong. Spasticity is a medical term describing a condition of cerebral palsy. It was moronic children who watched Blue Peter and then went into the playground and used it as a term of abuse for disabled people in general, and I don't understand why that would be your point of reference. By the way, the 'abusive' connotations you ascribe to the term only exist like that in the UK. Here in the US the term is used as slang for "inept" and isn't regarded as offensive.

"You're just wrong. Spasticity is a medical term describing a condition of cerebral palsy. It was moronic children who watched Blue Peter and then went into the playground and used it as a term of abuse for disabled people in general, and I don't understand why that would be your point of reference. By the way, the 'abusive' connotations you ascribe to the term only exist like that in the UK. Here in the US the term is used as slang for "inept" and isn't regarded as offensive."

I'm perfectly aware that 'Spasticity' was originally a medical term, however it is a term which is now so laden with connotation as to make its use unnacceptable.

It may very well be an acceptable term in the U.S. but as this is a U.K. forum, dealing with an issue arising here in the U.K. it would be mannerly to observe U.K. standards regarding the use of a term which you demonstrate in your last post that you fully understand the history of.

D Smyth- Thank God I have you around to point out the infantile understanding of words that you're arguing take precedence over their original definitions; wouldn't want to get off-topic or anything. Maybe we should find a more appropriate word for 'penis' too while we're at it, since it's become abused in the playground.