A Growing Controversy

By Anastasia Toufexis

Short kids don't have it easy. They are pitied by playmates and picked on by bullies. More worrisome to some parents, short kids often grow up into short adults. Today many unhappy youngsters and their families have their hopes pinned on what is being touted as a medical fix to the problem: injections of a synthetic version of human growth hormone (HGH). But efforts to test the drug have exploded into a medical and ethical controversy. The chief issue: Can an experiment that gives healthy children a drug simply to change their looks be justified?

The debate flared anew last week when two organizations -- the Physicians Committee for Responsible Medicine and the Foundation on Economic Trends -- filed suit to halt a National Institutes of Health study that would give HGH to 80 boys and girls. The youngsters' pituitary glands produce typical amounts of HGH, and the children are within the normal height range for their ages of nine to 15, but they are shorter than average. The study had been suspended a year ago after the two groups accused the agency of violating federal regulations governing research with healthy children, but was resumed recently following a recommendation from an NIH advisory panel.

Federal rules require that research pose only a minimal potential risk to youngsters and glean important information about a medical condition. The study doesn't qualify, the groups charge. They claim that HGH therapy may increase the chance of developing cancer. Moreover, shortness is not a medical condition but a social problem. "There's no physical risk to being short," declares Dr. Neal Barnard of the Physicians Committee. Adds the foundation's Jeremy Rifkin: "NIH can't experiment on healthy kids if there's no medical problem."

NIH's independent advisory panel concluded otherwise. One reason offered for pressing forward with the study is that as many as 10,000 healthy youngsters have already been treated with HGH by physicians, despite lack of information about its long-term safety or efficacy. While the panel concedes that being short is not a medical disorder, it can make some things harder to do, like driving a car, and cause psychological problems. "There is heightism in our society," says panel member Dr. Melvin Grumbach of the University of California at San Francisco. NIH estimates that 100,000 U.S. children could receive HGH if it proves effective.

That possibility infuriates critics, who argue that the healthier approach would be to take the stigma out of being short. Instead, says Barnard, the NIH is legitimizing bias by implicitly "telling kids they're not adequate as they are."

With reporting by Ellen Germain/Washington and Alice Park/New York