It is sometimes argued that the non-therapeutic, non-consensual alteration of children‘s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed 'female genital mutilation' or FGM), and one for boys (in which such alterations should be termed 'male circumcision‘). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children - whether female, male, or indeed intersex - should be (...) free from having parts of their genitals removed unless there is a pressing medical indication. (shrink)

A survey of Nigerian women who have undergone female circumcision (female genital mutilation) revealed a majority in favour of the practice. Are Western feminist bioethicists entitled to condemn it?

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural (...) pride. Circumcision is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants. Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision, which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one (...) form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda. (shrink)

This paper has attempted to steer a middle course between two opposing views. Although the examination tilts in favour of the conservationist, by proposing legal regulation of the practice, it also seeks to contain the fear of the abolitionist. The proposed regulation will make it illegal for minors to undergo female circumcision, and only those adults who wish to have it done will be permitted under the strict scrutiny of the law.Female circumcision has returned to mainstream debate again (...) and one hopes that this time a compromise acceptable to the abolitionists and the conservationists will be forged. The latter group should be given the opportunity of expressing its view without fear of being regarded with contempt. Such a cordial approach will foster a fair debate between the various interest groups that is long overdue. (shrink)

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing female (...) genital mutilation with all our power. (shrink)

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural (...) pride. Circumcision is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants (TBAs). Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation (FGM) is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

The contentious topic of female circumcision brings together medical science, women’s health activism, media, and national and international policy-making in pursuit of the common goal of eradicating such practices. Referring to these diverse and heterogeneous practices as ‘female genital mutilation’ (FGM), eradicators have then condemned them as ‘barbaric’ and medically harmful to female bodies and sexuality. In presuming that bodies can be separated from their cultural contexts, the anti-FGM discourse not only replicates a nature/culture dualism that has (...) been roundly questioned by feminists in science studies and cultural studies, but has also perpetuated a colonialist assumption by universalizing a particular western image of a ‘normal’ body and sexuality in its quest to liberate women and girls. I use my own story as a circumcised woman to highlight the entanglements of body and culture as presented in these feminist theories of female bodies. (shrink)

Tolerance is at the heart of Western liberalism, permitting mutually exclusive ideas and practices to coexist peacefully with one another, without the proponents of the differing ideas and practices killing one another. Yet, nothing challenges tolerance like the practice of sunna, female circumcision, clitorectomy, or genital mutilation. In this essay, I critique the Western critics of the practices, not in order to defend these practices, but rather to show that Western liberalism itself does not offer transcultural and transtemporal principles, (...) for these principles only cohere within the tradition of liberalism. The Western critique of sunna often maps onto the bodies of African women Western symbolic notions of sexual and political freedom, as symbolized in the clitoris. The practices of sunna cohere within the web of beliefs, the tradition, of those who practice them and, thus, are rationally justified within those traditions. I offer Alasdair MacIntyre's notion of moral inquiry as a guide through the complex world of cultural and moral dialogue between differing traditions. (shrink)

Purpose: The sensitization which this discussion engenders, has the objective of instituting an ever more formidable resilience in the advocacy against female genital mutilation (FGM) around the globe. Methodology: Besides the expository, analytic and evaluative character of this work, a particular effort is made to unveil the political and epistemological trappings that undergird the condemnable, but on-going practice of female genital mutilation in different parts of the world, especially in the continent of Africa. Findings: Some people point out (...) that the word "cutting" is less judgmental and relates better to terms used in many local languages. However, many women's health and human rights organizations use the word "mutilation," not only to describe the practice, but also to point out the violation of women's human rights. Unique Contribution to theory, practice and policy (recommendation): Ritual circumcision of young males and females is a practice seen in many cultures across the world, including sub-Saharan and North Africa, the Muslim Middle East, the Jewish diaspora, Aboriginal Australia, the Pacific Islands, Southeast Asia, etc. This work discuses female circumcision as “female genital mutilation” and rejects the view proposed by some that its practice is culturally and ethically relative. All three terms, female genital cutting (FGC), female circumcision, or female genital mutilation (FGM) describe the procedure that cuts away part or all of the external female genitalia and are used to describe the same thing, that is, mutilation. Some people fear that parents may resent the implication that they are "mutilating" their daughters by participating in this largely cultural event, and so reject the term FGM in favour of FGC. (shrink)

This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we distinguish (1) between a person-oriented and a body-oriented approach and (2) between four levels of interpretation, i.e. bodily integrity conceived of as a biological wholeness, an experiential wholeness, an intact wholeness, (...) and as an inviolable wholeness. We argue that bodily integrity is a prima facie principle in its own right, closely connected with, but still fundamentally different from, the principle of personal autonomy, that is, autonomy over the body. (shrink)

Scenes of violence and incisions into the flesh informeethe demand for law. The scene of little girls being held down in practices of female circumcision has been a defining and definitive image that demands the attention of human rights, and the intervention of law. But the investment in protecting women and little girls from such a cut is not all that it seems.eeLaw's Cuteeon theeeBody of Human Rights: Female Circumcision, TortureeeandeeSacred Flesheeconsiders how such imageseecome to inform laweeand the (...) investment of advocates of law in an imagination of this scene. Drawing on psychoanalytic andeepostcolonialeetheory, and accompanying ideas in political theology, Juliet Rogers examines the language, imagery and excitement that accompanies recenteeinitiatives to legislate against what is called 'female genital mutilation'. The author compliments this examination witheea consideration of the scene of torture exposed in images from Abu Ghraib and Guantanamo Bay.eeRogers argues that the modes ofeefascination and excitement that accompanyeesceneseeof torture and female circumcisioneebetray the fantasy of aeepolitical conditioneeagainst which the subject of liberal law is imagined; this is subjectivityeein aeestate of non-mutilation, non-prohibition or, in a psychoanalytic idiom, non-castration.eeTo support the fantasy of this subject,eethe mutilated subject, the authors suggests, is rendered as flesh cut from the democratic nation state, deserving of only selective human rights, or none at all. (shrink)

This article discusses the problems that a liberal, multicultural democracy has in dealing with cultural practices, such as female circumcision, which themselves suppress the liberal values of autonomy and pluralism. In this context I have chosen the justification of female circumcision as my issue for three reasons. First, with increasing immigration, in Western multicultural and pluralistic societies this practice has recently been given a good deal of public attention; second, I believe that it is time to put this (...) cruel and discriminatory tradition finally in the past; and third, the paradox that the victims of this practice are also often its strongest proponents well demonstrates the problems that liberal democracies have in dealing with the question of autonomy and tolerance in real‐life situations. My main argument is that, without giving up tolerance, we can show that there can be no moral justification for such a tradition as female circumcision, even within a multicultural and pluralist society. I shall first show why neither female circumcision nor any other tradition that oppresses and harms individuals and is maintained by coercion can be satisfactorily defended by liberal arguments. Then I shall discuss why ‘communitarian’counter‐arguments which appeal to the significance of communal values and traditions or to cultural rights also fail to give any plausible support to the maintenance of this tradition. Finally, I shall consider in more detail how the value of autonomy should be normatively understood in a modern pluralist society [1]. (shrink)

ABSTRACT The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system. We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation. From the unique structure of patient‐medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian (...) argument that finds hospital‐based circumcision safer than non‐medicalized alternatives. The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation. (shrink)

Television pictures of starvation and depredation are not the only way that famine and political instability in the horn of Africa have affected the United States. Many people from that region of the world are seeking political or economic refuge here, and they are exposing us to a culture that is in some ways — most notably, in the practice of female circumcision – so radically different from the prevailing American cultures that we have been stunned. They are also (...) forcing hospital ethics committees to face issues that cannot be resolved by the facile application of the settled principles that have guided those institutions for the past several years. Autonomy and multiculturalism, long the foundations of most ethics committee decision making, have started to give way to a list of formally articulated rights and wrongs – perhaps to a restatement and adoption of rules said to be based in natural law. Female circumcision, argues one newspaper letter writer, “is just a sickening display of male power disguised as legitimate dogma. (shrink)

J S Mill used the term ‘dead dogma’ to describe a belief that has gone unquestioned for so long and to such a degree that people have little idea why they accept it or why they continue to believe it. When wives and children were considered chattel, it made sense for the head of a household to have a ‘sovereignal right’ to do as he wished with his property. Now that women and children are considered to have the full complement (...) of human rights and slavery has been abolished, it is no longer acceptable for someone to have a ‘right’ to completely control the life of another human being. Revealingly, parental rights tend to be invoked only when parents want to do something that is arguably not in their child's best interest. Infant male circumcision is a case in point. Instead of parental rights, I claim that parents have an obligation to protect their children's rights as well as to preserve the future options of those children so far as possible. In this essay, it is argued that the notion that parents have a right to make decisions concerning their children's bodies and minds—irrespective of the child's best interests—is a dead dogma. The ramifications of this argument for the circumcision debate are then spelled out and discussed. (shrink)

Male circumcision—partial or total removal of the penile prepuce—has been proposed as a public health measure in Sub-Saharan Africa, based on the results of three randomized control trials showing a relative risk reduction of approximately 60 per cent for voluntary, adult male circumcision against female-to-male human immunodeficiency virus transmission in that context. More recently, long-time advocates of infant male circumcision have argued that these findings justify involuntary circumcision of babies and children in dissimilar public health environments, such as the (...) USA, Australasia and Europe. In this article, we take a close look at the necessary ethical and empirical steps that would be needed to bridge the gap between the African RCTs and responsible public health policy in developed countries. In the course of doing so, we discuss some of the main disagreements about the moral permissibility of performing a nontherapeutic surgery on a child to benefit potential future sexual partners of his. In this context, we raise concerns not only about weaknesses in the available evidence concerning such claims of benefit, but also about a child’s moral interest in future autonomy and the preservation of his bodily integrity. We conclude that circumcision of minors in developed countries on public health grounds is much harder to justify than proponents of the surgery suggest. (shrink)

The decision of the German regional court in Cologne on 26 June 2012 to prohibit the circumcision of minors is important insofar as it recognises the qualitative similarities between the practice and other prohibited invasive rites, such as female genital cutting. However, recognition of similarity poses serious questions with regard to liberal public policy, specifically with regard to the exceptionalist treatment demanded by certain circumcising groups. In this paper, I seek to advance egalitarian means of dealing with invasive rites (...) which take seriously cultural diversity, minimise harm and place responsibility for the burdens and consequences of beliefs upon those who promote practices. (shrink)

Despite global and local attempts to end genital mutilation, in their various forms, whether of males or females, the practice has persisted throughout human history in most parts of the world. Various medical, scientific, hygienic, aesthetic, religious, and cultural reasons have been used to justify it. In this symposium on circumcision, against the background of the other articles by Hutson, Short, and Viens, the practice is set by the author within a wider, global context by discussing a range of rationalisations (...) used to support different types of genital mutilation throughout time and across the globe. It is argued that in most cases the rationalisations invented to provide support for continuing the practice of genital mutilation—whether male or female—within various cultural and religious settings have very little to do with finding a critical and reflective moral justification for these practices. In order to question the ethical acceptability of the practice in its non-therapeutic forms, we need to focus on child rights protection. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Circumcision and Regrets from the Mother of Three SonsMaría Viola SánchezI am a psychologist and a radio talk show host for 25+ years. Both of my parents spoke English as their second language. I was raised by immigrants who demanded that "we speak English because we are Americans." I have four adult children, three sons, and a daughter.I gave birth to my children in the mid-80s. They are very (...) close in age and remain dear friends to this day. While I was a professional with a career when my children were born, I took a leave to work part-time and largely, to be a stay-at-home mother for nearly ten years. I was very involved with all their academic and extracurricular activities. I became a single mother when they were 2, 4, 6, and 7 years old, which served to redouble my parenting efforts to compensate for the absence of their father.My dirty secret is that I circumcised my three sons. I did so out of sheer ignorance. I am ashamed and deeply saddened by my decision at the time of their births. This is a burden that I will live with for the rest of my life. Something that I took away from them and that I can never repair.Here's the justification for my ill-informed decision. My father was circumcised, my two brothers were circumcised, and my then-husband was circumcised. I blindly assumed all males were to be circumcised. Further complicating the circumstances surrounding their births and the decision to circumcise them is the fact that their father is Jewish. He most likely would have given me pushback on not circumcising our sons, even though we had agreed to raise our family as Roman Catholics, my religion.After delivering my sons, I was asked, "Who would you like to circumcise your son?" My reply was, "Who has performed more of these procedures? And please bring my son to me to nurse after you have finished." Not one person, not one family member, not my son's father, any healthcare providers, not my pediatrician, or my OB/GYN asked me, "What are your thoughts about circumcising your son?" Had I been asked that question, I might have pondered the concept that there was a decision to be made, not a procedure that was necessary, as is the case with cutting the umbilical cord. When my infant sons were brought to me to nurse, they were sobbing so violently that they were unable to latch on to my breast. One can only surmise that no numbing agents were applied or anesthesia given, further compounding my burden of responsibility. Imagine their trauma!Over the course of my radio career, I hosted a program for an American non-profit national media organization, and one of my guests, Steven Svoboda, was scheduled to promote his newly founded organization, Attorneys for the Rights of the Child (ARC). Steven has remained a colleague. I've interviewed him a dozen times over the decades to promote ARC's amazing work. Steven is the one that first opened my eyes to the ridiculousness of male circumcision. Subsequently, I now understand that circumcision is unnecessary, not medically mandated and that the procedure denies males their [End Page E1] right to genital integrity. What I have also learned is that the removal of the foreskin is the most important sensory component and it is comprised of thousands of Meissner's corpuscles as well as branches of the dorsal nerve and in between 10,000 and 20,000 specialized erotogenic nerve endings of several types.I have since apologized to my adult sons for the uninformed and ignorant decision I made after they were born. Two of my three sons have gracefully accepted my apology. The other son says that he's glad that he resembles both his father and most of his male peers.I have become such an "intactivist" that I earned my Ph.D. in Psychology, and my dissertation concerns itself with Female Genital Mutilation (FGM) and its eradication. To know that 200 million females who are alive today have experienced FGM is another responsibility... (shrink)

This study in moral, political, and legal philosophy contends that it is morally impermissible to circumcise male minors without a medical indication (nontherapeutic circumcision). Male minors have a moral anticipatory autonomy right-in-trust not to be circumcised. This right depends on norms of autonomy and bodily integrity. These norms generate three direct non-consequentialist arguments against nontherapeutic circumcision: (1) the loss of nonrenewable functional tissue, (2) genital salience, and (3) limits on a parental right to permanently modify their sons' bodies. An indirect (...) argument holds (4) that if it is morally impermissible to remove the female prepuce (clitoral hood), then it is also morally impermissible to remove the male prepuce (foreskin). Although there is debate across medical cultures, a reasonable understanding supports the claim that nontherapeutic circumcision causes some harms and imposes unwarranted risks on male minors. The overall moral case applies to secular circumcisions and, with some qualifications, to religious circumcisions in Judaism and Islam. Arguments of political philosophy that invoke the freedom of religion, toleration, multiculturalism, and social meaning qualify somewhat, but do not eliminate, the case against circumcising male minors without a medical indication. Nevertheless, the arguments deployed in this study do not warrant legal interference at this time with secular and religious practices of nontherapeutic circumcision. (shrink)