Agnes Fletcher: 'This is a medical solution to a social problem'

From a basic point of medical ethics, people not in a position to give their consent should only receive treatment of direct medical benefit to them - treatment to enhance their health or treat a condition. That does not seem to be the case for Ashley.

It seems to me that what has happened to her is an attempt to find a medical solution for a social problem; that is, the lack of care and support for her and her family as she grows and her needs increase.

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People choose to have all sorts of treatments that aren't directly of benefit to their health - cosmetic surgery for example - but in such cases consent is given. Those choosing to have treatments understand the pain and distress caused by the procedure and are aware of the dangers. In Ashley's case some of the reasons given for having these procedures do seem quite extraordinary. For example, her parent say that having her breasts removed would reduce the risk of sexual assault. That seems pretty outrageous to me.

Consent is the key issue. Women with a high risk of breast cancer can choose surgery, but there is no indication in this case of any increased risk, and that seems to be treading beyond the line.

The main point from the perspective of the Disability Rights Commission is that the situation facing families with disabled children, both here and in the US, is that they are under enormous strain because of the inadequacies of care services and lack of funding.

That's the real scandal in this situation.

Agnes Fletcher is assistant director of the Disability Rights Commission