Growth hormone in short children: beyond medicine?

The indications for growth hormone (GH) treatment in non-GH-deficient short children are in debate, with some arguing that this treatment does not bel ong solely in the medical domain. We describe three different approaches to the issue, and argue that neither a disease-oriented nor client-oriented a pproach is sufficient. Both lead to withdrawal of medical interventions or to an undesirable application. Conclusion: An approach focusing on suffering as an indication for treatmen t of short stature is the most appropriate. The challenge is to develop pro per tools by which to evaluate suffering and the efficacy of GH treatment i n these children in order to relieve or prevent suffering.