To the Editor: I concur with Eva Kittay's disagreement with the group's "compromise" for exactly the reasons she articulates. The glaring flaw in the Seattle Growth Attenuation and Ethics Working Group's recommendation is the disconnect between the indication for growth attenuation and the criterion for who is eligible for it. The indication for growth attenuation is extensive immobility, such that growing to typical adult size will prevent the patient from taking part in as wide a range of activities as would be possible if she stayed smaller and lighter. But the decision of the working group is not that growth attenuation should be offered to all children who experience extensive immobility, although all children who are immobile face the same restriction of activity as they grow larger and heavier. Rather, the working group decided that only those children who are immobile and profoundly intellectually impaired should be offered growth attenuation.
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