Is it Ethical to Treat Healthy Short Children with Growth Hormone?

Underwood, Louis E.; Rieser, Patricia

doi:10.1111/j.1651-2227.1989.tb11302.x

Cited by 31 publications

(7 citation statements)

References 17 publications

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“…Along the same lines, it has also been noted that ''a focus on adult height attainment ignores the important psychological components of being short, the concerns about possible harm that may arise from such invasive intervention, and the role that parents must assume in their child's development. The motivation for GH therapy may say much more about parental hopes than any aspirations expressed by the child" [53,54]. It was also emphasized that ''we must not impose our goals on them, either in thought or in action, .…”

Section: How Can Ethical Principles Be Safeguarded In the Management mentioning

confidence: 97%

Idiopathic short stature: Management and growth hormone treatment

Wit

Reiter

Ross

et al. 2008

Growth Hormone & IGF Research

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Section: How Can Ethical Principles Be Safeguarded In the Management mentioning

confidence: 97%

Idiopathic short stature: Management and growth hormone treatment

Wit

Reiter

Ross

et al. 2008

Growth Hormone & IGF Research

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“…Care must be taken to reassure them that they are indeed healthy and normal. There is a danger that demands for treatment may be motivated less by concern for the children than by the aspirations of their parents who may wish to give their children a perceived advantage in life (62). They should bear in mind, however, that where the SS is familial, treatment will not prevent SS from recurring in subsequent generations.…”

Section: Ethical Considerationsmentioning

confidence: 99%

The psychological burden of short stature: evidence against

Voss

Sandberg

2004

European Journal of Endocrinology

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Short stature, per se, is clearly not a disease, but is commonly perceived to be associated with social and psychological disadvantage. The assumption, widely held by pediatricians that short children are likely to be significantly affected by their stature, has been founded largely on older, poorly designed clinic-based studies and laboratory investigations of beliefs about the association between stature and individual characteristics. In contrast, data from more recent and better designed clinic-and community-based studies show that, in terms of psychosocial functioning, individuals with short stature are largely indistinguishable from their peers, whether in childhood, adolescence or adulthood. Parents and children alike should be reassured by these findings. In the absence of clear pathology, physical or psychological, GH therapy for the short but otherwise normal child raises ethical concerns about so-called 'cosmetic endocrinology'. European Journal of Endocrinology 151 S29-S33

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“…In fact, GH treatment has been used even when specific etiologies are unknown [9]. Important questions have been raised about the financial, ethical and psychosocial impact of GH therapy for short children who are otherwise ‘normal’ [7,10,11,12,13]. Given the cost of GH, the financial implications of treating such children (whether at the bottom 5, 3, 1, or 0.1%) are considerable.…”

Section: Treatment Of Iss With Growth Hormonementioning

confidence: 99%

Hormonal Treatment of Idiopathic Short Stature

Reiter¹

2007

Horm Res Paediatr

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Background and Objective: The classification idiopathic short stature (ISS) represents a heterogeneous group of children who, as a group, are similar in height to patients with growth hormone (GH) deficiency, Turner syndrome, and short stature as a consequence of being born small for gestational age. GH therapy has been an effective treatment for enhancing height in children with ISS. Methods: A large body of literature – including data from KIGS (Pfizer International Growth Study Database) and the National Cooperative Growth Study database – shows that non-placebo-controlled GH treatment programs generally, though not uniformly, are associated with substantial increments in height gain. Placebo-controlled trials conducted in several countries report significant gains of 5 to 8 cm in final height. Conclusions: Long-term data are needed to assess the behavioral consequences, if any, of GH treatment for children with ISS. As the pool of children with ISS is potentially large, it would be highly desirable if clinical trials enabled accurate prediction of likely height gain and could result in greater individualization of treatment. The use of aromatase inhibitors to slow estrogen-mediated skeletal maturation is a new treatment modality, but it has only been minimally tested. The lower cost and ease of oral administration are attractive considerations, but long-term safety data are needed.

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Is it Ethical to Treat Healthy Short Children with Growth Hormone?

Cited by 31 publications

References 17 publications

Idiopathic short stature: Management and growth hormone treatment

Idiopathic short stature: Management and growth hormone treatment

The psychological burden of short stature: evidence against

Hormonal Treatment of Idiopathic Short Stature

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