Forever young: the trouble with the 'Ashley Treatment'.

The "Ashley Treatment"--a series of medical procedures performed at Seattle Children's Hospital in 2004 on a profoundly mentally and physically disabled six-year-old girl in order to insure that she would remain small, portable, and prepubescent--has attracted criticism. Disability-rights advocates and others argue that deliberately stunting Ashley's growth, as well as removing her uterus and breast buds, violated her right to mature in the same manner as a normal child. Her parents and doctors respond that the procedures improved Ashley's quality of life by sparing her the difficulties of puberty and making it possible for them to care for her at home.

It's easy to dismiss Ashley's case as a sensational ethical dilemma with little bearing on most people's lives, but if we look more closely, we can see deep parallels between Ashley's situation and our own. In fact, we can see that Ashley's parents wanted for her something that most of us want for ourselves and for our loved ones: a close and harmonious correspondence between our "insides" and our "outsides," between our bodies and our minds.

Ashley's parents and doctors wanted to make her body correspond, at least roughly, to her mental state. As one of her physicians, Dr. Daniel Gunther, explained to Time: "Ashley will always have the mind of an infant, and she will be able to stay where she belongs--in the arms of the family that loves her." Ashley's family elaborates on its blog: "Ashley has all of a baby's needs, including being entertained and engaged, and she calms down at the sounds of family voices. Furthermore, given Ashley's mental age, a nine-and-a-half-year-old body is more appropriate and more dignified than a fully grown female body."

If we see Ashley's story as a dramatic attempt to make a person's body correspond with her mind and heart, it becomes more intelligible--though perhaps not ultimately defensible. After all, many people make changes to their bodies to make them reflect their psychic identity. Some cases, fairly common now, are nearly as dramatic as Ashley's. For example, transsexuals believe that their sexual organs do not accurately reflect the gender of their minds and hearts. Some transexuals not only take heavy doses of hormones, but undergo sex reassignment surgery in order to bring their bodies into line with their psyches. They seek liberation in what many people believe to be a horrible form of mutilation.

For most of us, though, the major dissonance between mind and body occurs as we age. Many people find themselves looking and feeling older physically, but not psychically. So they take steps, some of them quite invasive, to bridge the gap. Someone who has "normal" hips and knees for a seventy-year-old might obtain hip and knee replacements in order to continue activities they enjoyed when they were thirty. Someone who "feels young" on the inside might obtain a face lift, a tummy tuck, or liposuction to "look young."

How should Christians think about all this? The tradition provides an ethical framework for dealing with these questions, even if it doesn't provide answers for each and every hard case. Christian anthropology validates the quest for harmony of body and mind; it sees human beings as psychosomatic unities. At the same time, it provides a strong caution against trying to achieve perfect harmony anytime before the Second Coming. The tensions between body and soul, exemplified by suffering and death, will only be vanquished with the coming of God's kingdom. In the meantime, we need to be vigilant that our quest for harmony between body and soul doesn't lead us to harm, denigrate, or ignore those who don't currently possess it--a category of people that will include all of us as we age. We need to accept a certain amount of messiness in the relationship between body and soul.

We shouldn't try to neaten up everything according to contemporary standards of what's normal. Most important, we need to resist the temptation to narrow our concept of acceptable dependency. It's a big challenge: we live in a society that accepts, even welcomes, dependency in babies and small children--but not in adults. The sight of a completely dependent grownup with the mental age of a baby is disconcerting, if not frightening, to most people. In this context, it is entirely understandable that Ashley's parents tried to keep her a child--a "pillow angel." But as the years pass, she won't be a child, despite the Ashley Treatment. She will be a profoundly dependent teenager, adult, and finally, an old woman with the mind of a baby. We need to find a way to affirm the value of her life--and to provide her with necessary care--without requiring her to look like the baby we want her to be.