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Deborah Rotenstein, MD
Medical College of Pennsylvania Pittsburgh

JAMA. 1989;262(1):30.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I read with interest the Special Communication by Lantos et al¹ regarding ethical issues in growth hormone therapy. Several concerns came to mind. The comment that there is "widespread agreement about the criteria for diagnosing classic growth hormone deficiency" may not be true. A majority (60% to 80%) of children with growth hormone deficiency, as defined in the classic sense, will have increased levels of circulating growth hormone after injection of growth hormone releasing factor.² This observation makes the term "classic growth hormone deficiency" an inexact label. The authors suggest that growth hormone treatment is ethical for those who have classically defined growth hormone deficiency. When the diagnosis of growth hormone deficiency depends on the choice of stimulus or secretagogue, ethical considerations concerning who is a candidate for treatment become even more complex.

In terms of cosmetic therapy, the authors state that for "most pediatricians, . . . [Full Text PDF of this Article]

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