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Daniel F. Gunther, MD, MA; Douglas S. Diekema, MD, MPH

Arch Pediatr Adolesc Med. 2007;161(4):419-420.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In reply

We appreciate the thoughtful responses to our article on attenuating growth in children with profound developmental disability.¹ We fully expected our report to be controversial and hoped it would generate healthy debate, perhaps ultimately leading to a consensus regarding the appropriateness of providing this option to parents.

Dr Ross makes the interesting point that proactive measures to attenuate growth in a nonambulatory severely disabled child (commission) should be no more objectionable than a decision not to work up and treat a slow-growing child in the same situation (omission). We agree with her, and believe both options to be ethical when done for the benefit of the child at the parent's request.

Dr Grossberg cautions us against accepting a one-size-fits-all approach to the care of these profoundly disabled children. He appropriately reminds us that not all families will have . . . [Full Text of this Article]

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