Recently, a pediatric endocrinologist was at her wits' end, and so, she blew the whistle. The endocrinologist, who chose to remain anonymous, wrote to the radio show This American Life claiming she...
Recently, a pediatric endocrinologist was at her wits' end, and so, she blew the whistle. The endocrinologist, who chose to remain anonymous, wrote to the radio show This American Life claiming she was "inundated" with affluent parents seeking human growth hormone (HGH) for their short, but otherwise healthy, children. The requests now constitute roughly half of her caseload, she reported. Even parents of kids whose heights are in the 40th percentile – just barely below average – have been demanding HGH.
Other doctors have previously been taken aback by this trend, which, as University of Wisconsin pediatric endocrinologist David. B. Allen told This American Life, appears to be centered in wealthier areas of the United States.
It's easy to see why. HGH treatments generally last three to five years and cost upwards of $300,000. And they do work. Studies show the average boost to height is 3.5 to 7.5 centimeters (1.4 to 2.8 inches)
Legally speaking, there is nothing wrong with parents requesting these treatments for their children. HGH may be banned in Major League Baseball, but the FDA has allowed its use in kids with growth hormone deficiency since 1985. In 2003, the agency broadened HGH's availability to kids with "Idiopathic Short Stature" (ISS), in other words, kids who are short with no clear cause. Pharmaceutical company Eli Lilly and Company provided the only diagnostic criteria, saying the shortest 1.2% of men and women have ISS. This corresponds to under 160 cm (63 inches) for adult men and 150 cm (59 inches) for adult women. ISS does not have a regulated definition, however, so doctors can legally prescribe HGH to children whose heights are well above the cutoff.
Medically speaking, prescribing HGH seems to be safe, at least in the short term. Treatment is conducted before puberty, roughly between the ages of ten and sixteen, with minimal side effects during that time. Longer-term studies have watched for increased rates of various cancers and so far haven't found any. However, a decades-long study conducted in France that followed 7,000 people who had been given HGH when they were younger did find a slight increase in all-cause mortality compared to those who had not. The increase primarily stemmed from elevated rates of heart disease.
Giving HGH to short, but otherwise healthy, kids is controversial for a few reasons. For one, the long-term health effects are still relatively unknown. There also doesn't seem to be any boost to health-related quality of on average. Short kids who don't receive the treatment are generally just as happy and successful as those who do. Moreover, many pediatricians see this as an issue of fairness. One pediatrician This American Life interviewed called it "cosmetic endocrinology." The aforementioned anonymous doctor also complained to the radio show that the affluent parents she sees frequently manage to get their treatments covered by insurance and somehow get approved for patient assistance programs typically reserved for patients who can't afford treatments.
The present HGH conundrum may be just a taste of other rapidly approaching ethical debates. With the ascendance of genetic engineering, radical life extension, and human augmentation, some experts are concerned that wealthy individuals could biologically diverge from the rest of society. Does wealth entitle someone to additional intelligence, longer life, or boosted physical prowess? Are these qualities even desirable if attained through purchased enhancement? These difficult questions could loom larger in the near future.