COMMENTARY

Vocal Cord Operation on Constantly Screaming Autistic Teen?

Arthur L. Caplan, PhD

Disclosures

November 04, 2013

But Was It Ethical?

Some people said, "Isn't this like debarking a dog?" Isn't it like having someone do surgery on a disabled person without permission? Cade does not have the ability to give consent to this, and even if he had said "no," it is not clear that his parents would have stopped, given the lack of other options.

The history of using surgical solutions to deal with cognitively impaired people is not glorious, whether it be sterilizing them or performing lobotomies. That history may have shaped some of the critics' responses. But I think the critics are wrong in this case. Twenty-first century surgery has given us an opportunity here to perform a reversible surgical procedure. If some day, for some reason, one wanted to put the vocal chords back together, it could be done.

I believe the surgical option is a benefit to Cade. It helps his family. It helps his brothers. It is a win, win, win all the way around. I know that it is difficult for many to accept a surgery that is imposed on someone, claiming it is in their best interest. In this case, however, I believe it is in Cade's best interest, so I find this surgical solution acceptable, particularly because it is reversible and it does good for the person who had it as well as the people around him. I do not accept the criticisms about this; I believe in this case, surgery may well be the best option.

I am Art Caplan at the NYU Langone Medical Center. Thanks for watching.

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