International Journal of Gynecology & Obstetrics. 2010 May;109(2):97-99
Special commentary on the issue of reinfibulation
Cook RJ, Dickens BM
Faculty of Law, Faculty of Medicine and Joint Centre for Bioethics, University of Toronto, Toronto, Canada
Policy on reinfibulation exposes the interface between individual or micro-ethics and population-wide or macro-ethics. If, following childbirth, an infibulated woman requests reinfibulation, a gynecologist may respectfully advise her of its negative implications, but would not act in breach of ethical or usually legal requirements in undertaking the procedure. However, as a matter of health policy and professional responsibility, physicians should refuse to initiate infibulation, and advise their patients and communities that the procedure is harmful, not required by religious or other ordinance, and frequently if not always unlawful. Reinfibulation is not genital cutting (or “mutilation”) in itself, but when undertaken by a physician may appear to condone infibulation. This is contrary to medical professional ethics, which condemn medicalization of infibulation and generally of reinfibulation, even as a harm-reduction strategy to spare women the risks of injury and infection from unskilled interventions.