It started with a policy update by the American Academy of Pediatrics a few weeks ago. The update was about female genital mutilation (FGM). The policy now advocated “federal and state laws [to] enable pediatricians to reach out to families by offering a ‘ritual nick’” to their daughters’ clitorises.
The supposed goal was harm minimisation: give families from cultures that perform FGM a less dramatic alternative than cutting out their daughter’s whole clitoris, sawing up labia leaving just a hole for urination etc. Some of those who would perform the barbarity at home might be talked into a pediatrician-endorsed “nick” that is much much smaller, safer and done in sanitary conditions. It can be argued that some mothers will not break with tradition as far as insisting nothing is done at all, but if a smaller procedure was offered they might stand up to their traditional families and fight for that over the full-blown “procedure”.
This got a huge backlash in the blogosphere as it was seen as giving official sanction to FGM. It’s an open debate as to what’s more important: the actual effects of a policy or the symbolic value. Personally I’m more interested in actual effects but I understand the symbolism affects future policy — once instantiated this policy would make FGM entrenched in the official medical system and this might make it a lot harder to get rid of it in the longrun. Plus there is the broader damage to the medical system done by letting doctors break their Hippocratic oath so blatantly.
Of course the supposed harm minimisation is definitely not obvious. You can argue that there are also huge numbers of people who already WILL stand up to families against FGM, but offering the ritual nick will make it harder.
The most illuminating comment I found was this one in PZ Myers’ post about it. Such things would be very bizarre if applied to other cases. People throw acid on girls’ faces in Afghanistan because they don’t like them attending school. Should we now offer a small “ritual scalding” with hot water to be done by doctors for harm minimisation? What about the long-standing cultural practice of honour killing. Should we let fathers “honour beat” daughters as an alternative? The mere entertaining of the ritual nick possibility suggests that even people who are against FGM can’t help but subconsciously see it as somehow legitimate.
Fortunately the AAP retracted this policy after the criticism. Alas, this proposal is now being debated in Australia.
The body representing Australia’s obstetricians and gynaecologists is considering whether to support a less extreme version of female circumcision known as a ritual nick.
Female circumcision has been illegal in Australia since the 1990s but doctors are worried that it is being done anyway, in unsafe conditions, by immigrants who take their daughters back to their home country.
The secretary of the Royal Australian College of Obstetricians and Gynaecologists, Dr Gino Peccararo, says by offering the alternative, some women may be spared the agony of being mutilated overseas. [More]
The Royal College site that says this was for debate purposes only, as a followup to the APA policy discussions:
While the procedure had been under review by the American Academy of Paediatrics, the matter will only be the subject of general discussion through the College’s Women’s Health Committee, which is the committee responsible for reviewing women’s health issues’, said Dr Weaver.
‘In no way should this be interpreted to mean our College would change its stated opinion on this important women’s health matter’, said Dr Weaver. [More]
Still, I suggest you have a think about your position since these discussions are already on the table and will come up again. Of course the other thing that inevitably comes up is male circumcision so I might as well give my view. I don’t see how circumcising someone not old enough to decide for themselves, whatever sex they are, is any different to cutting off a finger or toe, or at least making a hole in it. I don’t see how a country can call itself civilised where any of these things are legal. And the damage to the medical system from this extreme breaking of the Hippocratic oath by doctors must be great.
A lot of my Jewish friends are getting to childbearing age and I’m not sure how I should react. Fun times ahead.
6 comments ↓
I liked the comment on PZ Meyer’s site about applying it to other situations.
That male circumcision is still performed is barbaric. You have some interesting times when your friends want it done and you are forced to call them child abusers and immoral, stone-age thinkers.
You bring up the removal of a finger, but we do often remove a child’s 6th finger should they be born that way even if there is no health risk. I haven’t quite convinced myself why this is right and circumcision is wrong, even though my gut tells me it is… But you shouldn’t think with your gut or people will mistake you for George W Bush.
Obviously it’s a matter of degree: eg. my retort to the idea that say we don’t have a right to vaccinate infants is that we should then not have a right to cut the umbilical cord until the baby turns 18 and decides!
Some things are standard practice where the cost-benefit is all one-sided (eg. surgery to treat a disease). Removing a 6th finger is up one level since it’s not that necessary (I don’t think) but there are no big long-term effects so you could argue the only downside is the immediate discomfort of the baby. For a circumcision there are clear long-term effects — enough for there to be pros and cons to be decided by an adult not an infant.
Does that take the gut out of it?
Unfortunately not. The gut is still running the show on this. There is no necessary harm from a kid having a 6th finger (or sticking out ears for that matter) and we allow surgery on those types of deformity.
I guess it’s all based on what is the definition of deformity. 6th fingers and big ears happens to cut it, foreskins and clitori do not.
But that’s the point — there is no necessary harm from having a 6th finger OR having it removed. Because it’s minimal either way it’s fine to allow it (same as any other similar decision a parent makes for a child). Of course there’s no 100% definite rule as to what is minimal harm and what’s not, but surely you wouldn’t say that it’s arbitrary to say that genitals are about as extreme as you can get from the minimal harm border?
There is always the disgusting attitude that because the child is so young that they won’t remember the harm inflicted so there is no actual harm. That one makes me angry.
Many Jews (and PC non-Jews) argue that there is no harm in circumcision, and even go so far as to claim that it has certain health benefits (less likely to get aids or STDs etc.)
What I would say is that all the potential health problems a child having a circumcision could have equally apply to having a 6th finger removed. Except for the one where the Rabbi actually sucks the skin off – where the f*** did that tradition start?
Having an extra appendage removed does necessarily cause harm, even if it is only an increased percentage chance of death from anaesthetic.
I commented on this somewhere else and I think the general point would be that any parent who came and asked me for a genital snip (male or female) should immediately have the child taken into social services for their own protection and the parents charged with attempted abuse.
The rabbi doesn’t suck the skin but rather the mohel sucks out the blood from it (http://en.wikipedia.org/wiki/Brit_milah#Metzitzah), which makes sanitary sense in the pre-medical environment the custom grew out of. The main problem is that since everything in Judaism’s supposed to be unquestionable to Chareidi observers that kind of shit stays in long after the other branches have gotten rid of it.
I would agree that the actual pain during the circumcision is the least problematic part — if there was no long-lasting damage I don’t think it would be such a big deal because there is a huge difference between our experience of momentary pain and our experience of pain as a person with a stable identity and long term memory. But of course we can’t [yet] know what it’s like for an infant so shouldn’t be making pronouncements either way (ie. it’s just a little nip they forget OR it’s a terrible tortuous experience that psychologically damages them forever). Either way there’s definitely some pain for no immediate medical benefit.
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