Tag Archives: Ethics

The philosophy or code pertaining to what is ideal in human character and conduct. Also, the field of study dealing with the principles of morality.

Punishment of Minor Female Genital Ritual Procedures: Is the Perfect the Enemy of the Good?

Dev World Bioeth. 2017;17(2):134–140.

Punishment of Minor Female Genital Ritual Procedures: Is the Perfect the Enemy of the Good?

Jacobs AJ, Arora KS


Female genital alteration (FGA) is any cutting, removal or destruction of any part of the external female genitalia. Various FGA practices are common throughout the world. While most frequent in Africa and Asia, transglobal migration has brought ritual FGA to Western nations. All forms of FGA are generally considered undesirable for medical and ethical reasons when performed on minors. One ritual FGA procedure is the vulvar nick (VN). This is a small laceration to the vulva that does not cause morphological changes. Besides being performed as a primary ritual procedure it has been proposed as a substitute for more extensive forms of FGA. Measures advocated or taken to reduce the burden of FGA can be punitive or non-punitive. Even if it is unethical to perform VN, we argue that it also is unethical to attempt to suppress it through punishment. First, punishment of VN is likely to cause more harm than good overall, even to those ostensibly being protected. Second, punishment is likely to exceed legitimate retributive ends. We do not argue in favor of performing VN. Rather, we argue that non-punitive strategies such as education and harm reduction should be employed.

This article can be accessed in this LINK

Reconciling female genital circumcision with universal human rights

Dev World Bioeth. 2017 Sep 18. doi: 10.1111/dewb.12173. [Epub ahead of print]

Reconciling female genital circumcision with universal human rights

Gordon JS


One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), 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.

This article can be accessed in this LINK

Between Moral Relativism and Moral Hypocrisy: Reframing the Debate on “FGM”

Kennedy Inst Ethics J. 2016 Jun;26(2):105-44. doi: 10.1353/ken.2016.0009.

Between Moral Relativism and Moral Hypocrisy: Reframing the Debate on “FGM”

Earp BD


The spectrum of practices termed “Female Genital Mutilation” (or FGM) by the World Health Organization is sometimes held up as a counterexample to moral relativism. Those who advance this line of thought suggest the practices are so harmful in terms of their physical and emotional consequences, as well as so problematic in terms of their sexist or oppressive implications, that they provide sufficient, rational grounds for the assertion of a universal moral claim–namely, that all forms of FGM are wrong, regardless of the cultural context. However, others point to cultural bias and moral double standards on the part of those who espouse this argument, and have begun to question the received interpretation of the relevant empirical data on FGM as well. In this article I assess the merits of these competing perspectives. I argue that each of them involves valid moral concerns that should be taken seriously in order to move the discussion forward. In doing so, I draw on the biomedical “enhancement” literature in order to develop a novel ethical framework for evaluating FGM (and related interventions–such as female genital “cosmetic” surgery and nontherapeutic male circumcision) that takes into account the genuine harms that are at stake in these procedures, but which does not suffer from being based on cultural or moral double standards.

This article can be accessed in this LINK

Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines

Front Pediatr. 2015 Mar 18;3:18. doi: 10.3389/fped.2015.00018. eCollection 2015. FREE

Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines

Earp BD


The Centers for Disease Control and Prevention (CDC) have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. I offer a critique of the CDC position. Among other concerns, I suggest that the CDC relies more heavily than is warranted on studies from Sub-Saharan Africa that neither translate well to North American populations nor to circumcisions performed before an age of sexual debut; that it employs an inadequate conception of risk in its benefit vs. risk analysis; that it fails to consider the anatomy and functions of the penile prepuce (i.e., the part of the penis that is removed by circumcision); that it underestimates the adverse consequences associated with circumcision by focusing on short-term surgical complications rather than long-term harms; that it portrays both the risks and benefits of circumcision in a misleading manner, thereby undermining the possibility of obtaining informed consent; that it evinces a superficial and selective analysis of the literature on sexual outcomes associated with circumcision; and that it gives less attention than is desirable to ethical issues surrounding autonomy and bodily integrity. I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy.

This article can be accessed in this LINK

Ethical concerns in female genital cutting.

Afr J Reprod Health. 2008 Apr;12(1):7-16.FREE

Ethical concerns in female genital cutting. [Article in English, French]

Cook RJ.


Un souci éthique initial consiste à savoir comment appeler au juste ce que l’organisation mondiale  de la santé (OMS) a décrit comme:

Toutes les procédures qui impliquent l’enlèvement partiel ou complet des organes génitaux externes de la femme et/ou la blessure infligée aux organes génitaux pour des raisons culturelles ou d’autres raisons  non-therapeutiques.

Un nom qu’on emploie communément y compris par l’OMS elle-même, est la « mutilation génitale féminine », mais cette description peut être éthiquement inappropriée. De manière descriptive, le mot « mutilation » peut être exagéré, parce qu’il n’arrive pas à faire la distinction entre les quatre types d’incision génitale reconnue par l’OMS. Comme évaluation, le nom n’est pas une description neutre, mais un jugement grossement sévère, puisqu’il condamne ceux qui recherchent, autorisent et réalisent telle incision comme des mutilateurs des êtres humains.  Culturellement, le nom manque de respect, parce qu’il ne respecte pas la motivation avec laquelle ceux qui demandent la procédure pour leurs filles agissent.  Sur le plan personnel, encore une fois, le nom manque de respect, parce qu’il dit aux femmes qui ont subi les procédures qu’elles ont été mutilées par leurs parents ou par des membres de leurs familles.  Au sein des communautés dans lesquelles la pratique prédomine, elle est décrite par le mot qui signifie la purification. Dan certaines communautés, la purité est une condition pour le mariage d’une jeune fille, qui s’avère essentielle pour l’avenir des filles là où les femmes célibataires n’ont pas d’opportunités.  Une étude menée par l’OMS qui porte des critiques sur la procédure a conclu que…

This article can be accessed in this LINK.

A Tradition in Transition: Factors Perpetuating and Hindering the Continuance of Female Genital Mutilation/Cutting (FGM/C) Summarized in a Systematic Review

Health Care for Women International. DOI10.1080/07399332.2012.721417. Accepted author version posted online: 04 Sep 2012

A Tradition in Transition: Factors Perpetuating and Hindering the Continuance of Female Genital Mutilation/Cutting (FGM/C) Summarized in a Systematic Review

Rigmor C. Berg  & Eva Denison


Understanding the forces underpinning FGM/C is a necessary first step to prevent the continuation of a practice that is associated with health complications and human rights violations. To this end, a systematic review of 21 studies was conducted. Based on this review, the authors reveal six key factors that underpin FGM/C: cultural tradition, sexual morals, marriageability, religion, health benefits, and male sexual enjoyment. There were four key factors perceived to hinder FGM/C: health consequences, it is not a religious requirement, it is illegal, and the host society discourse rejects FGM/C. The results show that FGM/C appears to be a tradition in transition.

This article can be accessed for free in this LINK

Special commentary on the issue of reinfibulation

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.

This article can be purchased in this LINK

Should female genital cosmetic surgery and genital piercing be regarded ethically and legally as female genital mutilation?

BJOG 2012;119:389–392.

Should female genital cosmetic surgery and genital piercing be regarded ethically and legally as female genital mutilation?

Kelly B, Foster C.

Nuffield Department of Obstetrics & Gynaecology, Oxford University, John Radcliffe Hospital, Oxford, UK. brenda.kelly@obs-gyn.ox.ac.uk

No abstract is available for this article.

This article can be purchased in this LINK

Some Ethical Considerations Regarding Medicalization of Female Genital Mutilation/cutting (Female Circumcision)

rev.latinoam.bioet. vol.8 no.1 Bogotá Jan./June 2008

Some Ethical Considerations Regarding Medicalization of Female Genital Mutilation/cutting (Female Circumcision)

Ahmed R. A. Ragab

Médico Gineco-Obstetra con Maestría en Bioética. Profesor de investigación de la salud reproductiva aplicada de la Universidad de Al-zhar (El Cairo, Egipto). Email: arragab@yahoo.com


According to each society’s condition the ethical attitude of the individual may be colored by the attitude of the society. It is therefore not surprising to find what is ethical in one society might not be ethical in another. Female Genital Cutting, as an example, is seen in some societies as a must and something good for the whole community in general and for girls in particular, while in others, it is seen as mutilation and violation of human rights. The practice of female genital cutting is a complex issue that ties the traditional gender roles, superstition, local concepts on health and sexuality, as well as several other social relations. Worldwide, an estimated 130 million girls and women have undergone FGC.

The current paper examines medicalization of female genital cutting from ethical point of view. The paper discusses the issue in the following themes: definition of the practice, the justifications of the practice, the complications and lastly the ethical reflections. The paper argues that laws that prohibit the practice would not work, without wide socio-cultural change; any effort to eradicate the practice would not succeed.

This article can be accessed in this LINK