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}}</ref> It is not clear that Cole, who had recently had heart surgery, was stable and healthy. It also is not clear that [[informed consent]] was received by the parents, Tim and Gabrielle Groth, who apparently granted surrogate consent for a non-therapeutic surgical [[amputation ]] and [[genital mutilation]] in violation of [[Medical_ethics#Medical_ethics_and_circumcision| standards of medical ethics]].<ref>{{REFweb