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“They get a C-section…they gonna die”: Somali women’s fears of obstetrical interventions in the United States.

J Transcult Nurs. 2010 Jul;21(3):220-7. doi: 10.1177/1043659609358780.

“They get a C-section…they gonna die”: Somali women’s fears of obstetrical interventions in the United States.

Brown E, Carroll J, Fogarty C, Holt C.

University of Rochester Medical Center, Rochester, NY 14620, USA. elizabeth_brown@urmc.rochester.edu

ABSTRACT

The authors explore sources of resistance to common prenatal and obstetrical interventions among 34 Somali resettled adult women in Rochester, New York. Results of individual interviews and focus groups with these women revealed aversion to or outright fear of cesarean sections because of fear of death and substantial resistance regarding other obstetrical interventions. Because Somali women expressed resistance to many common U.S. prenatal/obstetrical care practices, educating health professionals about Somali women’s fears and educating Somali women about common obstetrical practices are both necessary to improve maternity care for non-Bantu and Bantu Somali women.

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Comparative Study of Meanings, Beliefs, and Practices of Female Circumcision Among Three Nigerian Tribes in the United States and Nigeria

J Transcult Nurs. April 2004 15: 103-113

Comparative Study of Meanings, Beliefs, and Practices of Female Circumcision Among Three Nigerian Tribes in the United States and Nigeria

Prisca O. Anuforo, Lola Oyedele, Dula F. Pacquiao, Kean University

ABSTRACT

The study was conducted to gain insight into the meanings, beliefs, and practices of female circumcision among three Nigerian tribes in the United States and Nigeria. Participant-observations occurred in three sites in Nigeria (Ibadan, Lagos, and Owerri) and in Essex County, New Jersey (Newark, Irvington, and East Orange). A total of 50 informants included adult males and females from the three main Nigerian ethnic tribes: Igbo, Yoruba, and Hausa. Leininger’s culture care theory of diversity and universality was the study framework. Findings revealed existence of similarities and differences in the cultural meanings, beliefs, and practices among the tribes. Religion, education, and occupation were significant factors influencing informants’ attitudes toward continuation of the practice. Government-sponsored public education and influence by the media were found to increase informants’ awareness of complications of female circumcision. Changes in attitudes toward the practice and use of alternative practices were evident.

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Circumvention tourism.

Cornell Law Rev. 2012 Sep;97(6):1309-98.FREE

Circumvention tourism.

Cohen G.

Harvard Law School Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics.

ABSTRACT

Under what circumstances should a citizen be able to avoid the penalties set by the citizen’s home country’s criminal law by going abroad to engage in the same activity where it is not criminally prohibited? Should we view the ability to engage in prohibited activities by traveling outside of the nation state as a way of accommodating cultural or political differences within our polity? These are general questions regarding the power and theory of extraterritorial application of domestic criminal law. In this Article, I examine the issues through a close exploration of one setting that urgently presents them: medical tourism. Medical tourism is a term used to describe the travel of patients who are citizens and residents of one country, the “home country,” to another country, the “destination country,” for medical treatment. This Article is the first to comprehensively examine a subcategory of medical tourism that I call “circumvention tourism,” which involves patients who travel abroad for services that are legal in the patient’s destination country but illegal in the patient’s home country–that is, travel to circumvent domestic prohibitions on accessing certain medical services. The four examples of this phenomenon that I dwell on are circumvention medical tourism for female genital cutting (FGC), abortion, reproductive technology usage, and assisted suicide. I will briefly discuss the “can” question: assuming that a domestic prohibition on access to one of these services is lawful, as a matter of international law, is the home country forbidden, permitted, or mandated to extend its existing criminal prohibition extraterritorially to home country citizens who travel abroad to circumvent the home country’s prohibition? Most of the Article, though, is devoted to the “ought” question: assuming that the domestic prohibition is viewed as normatively well-grounded, under what circumstances should the home country extend its existing criminal prohibition extraterritorially to its citizens who travel abroad to circumvent the prohibition? I show that, contrary to much of current practice, in most instances, home countries should seek to extend extraterritorially their criminal prohibitions on FGC, abortion, assisted suicide, and, to a lesser extent, reproductive technology use to their citizens who travel abroad to circumvent the prohibition. I also discuss the ways in which my analysis of these prohibitions can serve as scaffolding for a more general theory of circumvention tourism.

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Issues in Islamic Biomedical Ethics: A Primer for the Pediatrician

Pediatrics. Oct 1, 2001 (108)4, 965 -971 (doi: 10.1542/peds.108.4.965)

Issues in Islamic Biomedical Ethics: A Primer for the Pediatrician

Kamyar M. Hedayat and Roya Pirzadeh

ABSTRACT

The United States is becoming increasingly pluralistic. Pediatricians must become familiar with the factors that affect the emotional, physical, and spiritual health of their patients that are outside the ken of the traditionally dominant value system. Although many articles have addressed the cultural and ethnic factors, very few have considered the impact of religion. Islam, as the largest and fastest-growing religion in the world, has adherents throughout the world, including the United States, with 50% of US Muslims being indigenous converts. Islam presents a complete moral, ethical, and medical framework that, while it sometimes concurs, at times diverges or even conflicts with the US secular ethical framework. This article introduces the pediatrician to the Islamic principles of ethics within the field of pediatric care and child-rearing. It demonstrates how these principles may impact outpatient and inpatient care. Special attention is also given to adolescent and end-of-life issues.

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Alan Scott: Letter to the Editor

Pediatrics. September 1, 2007 120(3) pp. 695 -696

Letter to the Editor

C. Alan Scott MD

EXTRACT

To the Editor.—

I fear that Dickerman may have lost sight of our responsibility as physicians: primum non nocere.1 His recent commentary2 advocating a change in the American Academy of Pediatrics policy on circumcision is ill-founded. His view that a decline in the prevalence of infant circumcision is “very disturbing” unfortunately shows how much more education infant advocacy groups need to perform to accomplish a ban on newborn male genital mutilation.

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AAP: Female Genital Mutilation

Pediatrics1998; 102:1 153-156

Female Genital Mutilation

AMERICAN ACADEMY OF PEDIATRICS. Committee on Bioethics

ABSTRACT

The traditional custom of ritual cutting and alteration of the genitalia of female infants, girls, and adolescents, referred to as female genitalmutilation (FGM), persists primarily in Africa and among certain communities in the Middle East and Asia. Immigrants in the United States from areas where FGM is endemic may have daughters who have undergone a ritual genital procedure or may request that such a procedure be performed by a physician. The American Academy of Pediatrics (AAP) believes that pediatricians and pediatric surgical specialists should be aware that this practice has serious, life-threatening health risks for children and women. The AAP opposes all forms of FGM, counsels its members not to perform such ritual procedures, and encourages the development of community educational programs for immigrant populations.

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Ritual genital cutting of female minors.

Pediatrics. 2010 Jul;126(1):191. Epub 2010 Jun 7.

Ritual genital cutting of female minors.

American Academy of Pediatrics Board of Directors.

The American Academy of Pediatrics (AAP) reaffirms its strong opposition to female genital cutting (FGC) and counsels its members not to perform such procedures. As typically practiced, FGC can be life-threatening. Little girls who escape death are still vulnerable to sterility, infection, and psychological trauma.

The AAP does not endorse the practice of offering a “clitoral nick.” This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members.

The AAP is steadfast in its goal of protecting all young girls from the harms of FGC….

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AAP retracts statement on controversial procedure.

Lancet. 2010 Jul 3;376(9734):15.

AAP retracts statement on controversial procedure.

MacReady N.

Comment in
Lancet. 2010 Oct 9;376(9748):1222; discussion 1222.

There is no LINK to view this article online.

 

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Female genital mutilation. US policy on genital cutting.

BMJ. 2010 Jul 27;341:c4013. doi: 10.1136/bmj.c4013.

Female genital mutilation. US policy on genital cutting.

Palfrey JS.

The American Academy of Pediatrics never intended to encourage the practice of female genital cutting, and has withdrawn …

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What is the AAP’s real view on medical involvement in ritual cutting of children?

Lancet. 2010 Oct 9;376(9748):1222; discussion 1222.

What is the AAP’s real view on medical involvement in ritual cutting of children?

Bewley S.

Comment on Lancet. 2010 Jul 3;376(9734):15.

Norra MacReady (July 3, p 15) is incorrect that the American Academy of Pediatrics (AAP) moved quickly to control the damage caused by the toning down of its 1998 policy on female genital mutilation.
The lead author of the revised policy, published on April 26, 2010, posted an e-letter on May 13 defending “the compromise of a ‘nick’”. The following day, the AAP President claimed that the 2010 policy needed to be read to be understood. The AAP did not release a statement saying that it did not end …

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