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The Ethics of Elective Growth Hormone Therapy in Children with Idiopathic Short Stature

Kevin Leslie Kecskemeti1, Samuel Reis-Dennis2

  • 1MD Candidate 2024, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. klkecskemeti@mun.ca.

The Journal of Clinical Ethics
|September 22, 2021
PubMed

Insights

Growth hormone (GH) therapy for idiopathic short stature (ISS) in children is ethically questionable. Research suggests potential risks outweigh benefits, making it unjustifiable for most cases.

Area of Science:

  • Pediatric Endocrinology
  • Medical Ethics
  • Child Health Policy

Background:

  • Idiopathic short stature (ISS) affects children without identifiable underlying medical conditions.
  • Growth hormone (GH) therapy is a treatment option for ISS, raising ethical considerations.
  • Assessing the risk-benefit profile of elective GH therapy is crucial.

Purpose of the Study:

  • To critically analyze the ethical justification of elective growth hormone therapy in children with ISS.
  • To review current clinical evidence on GH therapy's efficacy, side-effects, and risks.
  • To determine the ethical permissibility of GH therapy for ISS.

Main Methods:

  • Systematic review of recent clinical research on GH therapy for ISS.
  • Ethical analysis framework applied to treatment efficacy and safety data.
  • Evaluation of long-term outcomes and potential adverse effects.

Main Results:

  • Clinical evidence shows variable efficacy of GH therapy in increasing height for children with ISS.
  • Potential side-effects and risks associated with long-term GH administration are significant.
  • The benefits of GH therapy do not consistently outweigh the identified risks for most children with ISS.

Conclusions:

  • Elective growth hormone therapy for idiopathic short stature is ethically challenging.
  • The current evidence suggests that GH therapy is not ethically justifiable for the majority of children with ISS.
  • Further research and ethical deliberation are needed to guide clinical practice.

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