Ethical Dilemmas

I've just had a prescription for a ten-year-old boy. The prescription is for Prostap SR
Prostap Sr is licensed for the followed indications:-

(i) Treatment of advanced prostatic cancer.
(ii) Management of endometriosis, including pain relief and reduction of endometriotic lesions.
(iii) Endometrial preparation prior to intrauterine surgical procedures including endometrial ablation or resection.
(iv) Preoperative management of uterine fibroids to reduce their size and associated bleeding.

None of those seem very likely in a prepubescent male.

So, do I:-

A.Dispense the prescription normally after bringing up my concerns with the parent and carry on with my day? (and possibly destroy the patient's faith in the doctor)

B.Speak to the GP and after repeating my concerns explain that I'm not prepared to dispense the prescription (Which would strictly be a breach of the pharmacy's NHS contract)

C.Lie to the patient's parent and pretend I cannot get Prostap from my wholesaler at the moment. Thereby absolving myself of any responsibility. "Try Boots, they might be able to help!"

It's a tricky situation. Presumably my medical colleague has decided to give a ten-year-old child this painful injection every month for a valid reason. He isn't a very pleasant child, so maybe the GP just wants to make him squeal? Maybe the GP is planning a crack choir containing 12 chemically-castrated boy sopranos?

A quick Medline search and what pops up but this? The conclusion is:

“This study provides the first clinical evidence for the benefit that combined anti-androgen and anti-heavy metal therapy may have on some children with ASDs. Additional studies should examine androgen and heavy metal mechanisms of action in ASDs, and future ASD treatment protocols should consider androgens and heavy metals.”

That's the conclusion of a small, non-randomised, uncontrolled trial. My patient's medical history suggests he may suffer from Autistic/Autistic spectrum disorder too. It's hardly a sufficient base of evidence to warrant antiandrogen therapy in a child, is it? It looks horribly like something along the lines of "vaccines/mercury in vaccines makes your child autistic". That looks like a Daily Mail headline, oh dear.

I've contacted the company that make Prostap to see if they are aware of any other trials. I suspect they will not be. (They returned my mail-they have no data, even anecdotal, of Prostap being used in children.)