updated 10/11/2007 1:55:27 PM ET 2007-10-11T17:55:27

The doctor at the center of a controversial procedure which stunted the growth of a severely disabled girl has committed suicide.

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Dr. Daniel F. Gunther died from toxic asphyxia from inhaling car exhaust, said Greg Hewett of the King County Medical Examiner's Office. His time of death was listed as 9:30 p.m. on Sept. 30. The 49-year-old was a pediatric endocrinologist at Children's Hospital and Regional Medical Center in Seattle and an associate professor of pediatrics at the University of Washington.

In 2004, Gunther and his colleague Dr. Douglas S. Diekema performed a hysterectomy, removed the breast tissue and started hormone treatment to permanently halt the growth of a 6-year-old disabled girl so her parents could continue to care for her at home. The doctors wrote about the procedure, which was performed at Children's Hospital, in the October 2006 issue of the Archives of Pediatrics & Adolescent Medicine.

News of the procedure last fall sparked debate about the ethics of the treatment both online and in the medical community. One poster on's message boards called the procedure "offensive if not perverse." Others supported the decision: "I feel like everything [the parents] are doing is intended to be in the best interest of their child."

Image: Ashley
Ashley's blog
A family photo on "Ashley's blog" shows the Seattle girl in 2003, a year before she completed hormone therapy intended to stunt her growth.
The girl, identified only as Ashley, had feeding problems shortly after birth and showed major developmental delays. Her doctors diagnosed her with severe brain damage and don't know what caused it. Her condition has left her in an infant state, unable to sit up, hold a toy or talk. Her mother called Ashley her "pillow angel" and said the procedure kept her a more manageable and portable size that would allow her family to continue to care for her at home.

In May, Children's Hospital admitted it broke state law by not having a court review the proposed treatment and allowing the surgery to proceed. The hospital blamed the lapse on "internal miscommunication." State law requires a court order before sterilizing a child.

The hospital has since promised to develop policies to require court orders for such procedures and appoint a disability-rights advocate to its ethics board.

Children's had no comment on Gunther's death, said hospital spokesperson Jennifer Seymour. The University of Washington Medical Center also would not comment.

'He cared deeply for his patients'
Gunther also served on the medical advisory board of the CARES Foundation, which provides support and education about Congenital Adrenal Hyperplasia, an endocrine disorder.

Kelly Leight, executive director of the New Jersey-based non-profit organization, remembers him as a "delightful, wonderful, kind, compassionate human being who went out of his way to help those in need. He cared deeply for his patients and went the extra mile to help them in a way that many doctors are unable to do in this current health care environment. ... I hope he knew how loved he was."

The King County Medical Examiner's office declined to say whether Gunther had left a note.

"You just can’t know what leads people to suicide,” said Art Caplan, director of the Center for Bioethics at the University of Pennsylvania bioethicist and columnist.

“But it’s certain that Ashley X’s case caused a seismic wave throughout pediatric medicine and the world of disability. It raised difficult and challenging questions about what’s in the best interest of children and young adolescents with disabilities. The controversy is going to continue to go on and I think that Dr. Gunther’s voice will be sorely missed.”

Ashley's family thanked Gunther profusely on their daughter's blog, last updated on March 25, 2007, saying, "Special thanks to Doctor Daniel F. Gunther, without whose courage, confidence, knowledge, open mindedness and unwavering support the treatment would not have been realized and the idea would have remained just an idea. We know that many endocrinologists would not have ventured into such new territory. It is our, and Ashley’s luck, that we knocked on the right door."

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