The principle of respect for autonomy in clinical ethics is frequently linked to bioethics’ neglect of community-level ethical considerations. I argue that the latter is not an inevitable consequence of the former; rather, that neglect results from a common interpretation of respect for autonomy in solely synchronic and individual terms. A relational understanding of autonomy reveals the way in which respect inescapably involves diachronic and social dimensions. When these are acknowledged, the association between respect for autonomy and liberal individualism is (...) weakened. Such respect has more in common with communitarian approaches, and it need not conflict with the incorporation of collective-level values into ethical deliberation. (shrink)

ABSTRACT In this paper, I discuss several arguments against non‐therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of ‘aberration’ that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of (...) duties to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations. (shrink)

In this paper, I discuss several arguments against non‐therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of ‘aberration’ that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of duties (...) to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations. (shrink)

Through illustrating the similarities between embodied practices rooted in different cultural contexts (such as `African' female genital cutting and `Western' cosmetic surgery), feminist theorists seek to reveal the instability of essentialist binaries which distinguish various groups as culturally, ethnically and morally `different'. They also aim to query how the term `culture' is employed differentially on the basis of embodied axes such as race and nation. However, in emphasizing overarching commonalities between practices, feminist cross-cultural comparisons risk collapsing into economies of sameness (...) that elide the complex relations of power through which such practices have been constituted. They can also fix the imagined subjects of these practices in troubling ways. Using the ubiquitous `African' female genital cutting and `Western' cosmetic surgery binary as an example, this article explores the difference it might make to address culturally essentialist constructions of embodied practice with a focus on relationality rather than commonality. As a means to reorient feminist cross-cultural approaches which depend on assertions of similarity or sameness, it argues for the theoretical and pedagogical utility of thinking through relational webs. (shrink)

Making links between different embodied cultural practices has become increasingly common within the feminist literature on multiculturalism and cultural difference as a means to counter racism and cultural essentialism. The cross-cultural comparison most commonly made in this context is that between ‘African’ practices of female genital cutting (FGC) and ‘western’ body modifications. In this article, I analyse some of the ways in which FGC and other body-altering procedures (such as cosmetic surgery, intersex operations and 19th century American clitoridectomies) are compared (...) within this feminist literature. I identify two main strategies of linking such practices, which I have termed the ‘continuum’ and ‘analogue’ approaches. The continuum approach is employed to imagine FGC alongside other body-altering procedures within a single ‘continuum’, ‘spectrum’ or ‘range’ of cross-cultural body modifications. The analogue approach is used to set up FGC and other body-altering practices as analogous through highlighting cross-cultural similarities, but does not explicitly conceive of them as forming a single continuum. Two key critiques of the continuum and analogue approaches are presented. First, because these models privilege gender and sexuality, they tend to efface the operation of other axes of embodied differentiation, namely race, cultural difference and nation. As such, the continuum and analogue approaches often reproduce problematic relationships between race and gender while failing to address the implicit and problematic role which race, cultural difference and nation continue to play in such models. This erasure of these axes, I contend, is linked to the construction of a ‘western’ empathetic gaze, which is my second key critique. The desire on the part of theorists working in the West to establish cross-cultural ‘empathy’ through models that stress similarity and solidarity conceals the continuing operation of geo-political relations of power and privilege. (shrink)

Psychiatric patients may try (or express a desire) to injure themselves in hospital in order to cope with overwhelming emotional pain. Some health care practitioners and patients propose allowing a controlled amount of self-injury to occur in inpatient facilities, so as to prevent escalation of distress. Is this approach an example of professional assistance with harm? Or, is the approach more likely to minimise harm, by ensuring safer self-injury? In this article, I argue that health care practitioners who use harm-minimisation (...) can be considered to be helping physical injury to occur, although they do not encourage the act. I consider why there are compelling reasons to believe that a patient who self-injures is not maximally autonomous in relation to that choice. However, I then move onto argue that allowing a degree of self-injury may enable engagement with psychotherapy (enhancing autonomy) and behavioural change. In these circumstances, allowing injury (with precautions) may not be harm, all things considered. (shrink)

Despite global and local attempts to end female genital mutilation , the practice persists in some parts of the world and has spread to non-traditional countries through immigration. FGM is of varying degrees of invasiveness, but all forms raise health-related concerns that can be of considerable physical or psychological severity. FGM is becoming increasingly prohibited by law, both in countries where it is traditionally practised and in countries of immigration. Medical practice prohibits FGM. The Italian parliament passed a law prohibiting (...) FGM, which has put in place a set of measures to prevent, to oppose and to suppress the practice of FGM as a violation of a person’s fundamental rights to physical and mental integrity and to the health of women and girls. The Italian law not only treats new offences but also wants to deal with the problem in its entirety, providing important intervention in all the sectors. Different kinds of interventions are considered, starting with the development of informative campaigns, training of health workers, institution of a tollfree number, international cooperation programmes and the responsibility of the institution where the crime is committed. Particularly, the law recognises that doctors have a role in eliminating FGM by educating patients and communities. (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in the context of measures (...) to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)