Kafer presents the Treatment that Ashley’s parents and doctors (Gunther and Diekema) prescribed for her without consent, as a potentially harmful and degrading experience for disabled bodies and lives. The Treatment has stripped away, as it strips away Ashley’s potential “pleasure” she might experience from what the mastectomy took away from her; violates her choices in the future (as who knows when her ability to interact and communicate with the world will suddenly change?); and because the Treatment argues for the flaw in privatizing Ashley’s case and treatment to a “mother knows best” logic. And honestly, the argument has its strengths. The arguments that Ashley’s parents and her doctors put out to gain supporters and potentially collect more “pillow angels” for the treatment in the near future is flawed, and is definitely skewed towards benefitting the interests of Ashley’s parents.
However, this does not mean that Kafer’s arguments are not flawed at all, and is a perfect argument against this idea of “the Treatment”. In fact, I found the arguments presented in the article quite hypocritical and offensive. Throughout the article, Ashley’s parents are criticized for dealing with the imagined future of Ashley in pain, Ashley sexualized, and Ashley imagined “grotesquely” in an adult body. This puts to question the “what if” arguments that are posed by the doctors and the parents. Instead of questioning this appropriately with logic, Kafer throws in another set of “what if’s”. What if the Treatment hasn’t improved Ashley’s quality of life? What if Ashley felt more pain getting her breasts removed than if she were to have kept them? What if Ashley’s breasts might have presented a range of potential sites and sources of pleasure? Concluding her own sets of “what if’s”, Kafer concludes that the Treatment-supportive discourses being presented as self-evident facts is wrong.
This becomes more a problem with philosophy at this point. We cannot constantly be haunted by the chances of a better outcome that might have been in the future. We cannot constantly be hopeful for a miracle to bestow upon us in the future (the miracle here being Ashley in the near future being able to suddenly to form thoughts, judgments, and interactions with the decision for the Treatment). The present is the present, and there is a need to make a swift and informed decision. It is definitely not right for Ashley’s parents to present the Treatment as fact that it has improved Ashley’s “quality” of life. However, it is even more wrong to question and condemn the informed decision-makers, who would’ve had to make this difficult decision to proceed with these medical interventions. Even if the decision might have been to not proceed with this invasive treatment, Ashley’s parents definitely would have been criticized being “too soft”, idealistic, and unintelligent in not proceeding with the Treatment.
Furthermore, Kafer criticizes the parents for assuming that familial care is the best form of care possible for Ashley’s case. Kafer argues that this is disrespecting and demonizing towards caregiving and paid attendants. She argues that privatizing Ashley’s case is a pathologizing excuse, and that you cannot just ward off everyone from debating, except for those closely involved in the case. However, I found this to be a somewhat flawed argument. I do definitely see where Kafer is coming from (there is definitely a need for debate and communication, both for the ethics committee, disabled community, and medical community), and “privatizing” Ashley’s case is not the right thing to do. However, the fact that Ashley’s parents were willing enough to present their child’s treatments and story as open to the public shows how prepared to talk about this with the public. Kafer wouldn’t have ever had the luxury of getting to learn about Ashley and her story, and for her to demonize the parents for privatizing their decision-making is hypocritical. Not every decision has to be made after consulting the entire public for a consensual, democratic decision. Of course there is a need for making a swift, “private” decision. Not every choice that the parents make need to be consulted and debated with the public. This is nowhere near disrespecting the trained caregivers of our society. Rather, it is reinforcing the role of family in making medical decisions for their child. No child, whether or not they are abled or disabled in differing severities, would want to consent to an invasive treatment that is potentially going to hurt them in the near future. But this does not mean we wait patiently around for newborn children to be “intelligent” enough to make a decision that yes, they would like to undergo bronchial thermoplasty. And if Kafer argues that this is because we “know” enough that medically, without surgery, the baby would have died, I would like to pose the same question to her: “who knows if they were going to die?”
Ashley’s parents arguments, philosophies, and “pillow angels” movement is flawed, yes. It could also be potentially harmful for the future generation of disabled children. And yes, it is right for us to find a way to argue against the parents’ logic that this is the cure-all best treatment for disabled children: turning them all into pillow angels. However, approaching this from an angle of more what if’s is never going to get us anywhere. The world is filled with what if’s. Try again, Kafer.