GESTIÓN EN SALUD PÚBLICA: BioEdge: Should Americans excuse FGM as a minority cultural practice?

viernes, 24 de noviembre de 2017

BioEdge: Should Americans excuse FGM as a minority cultural practice?

BioEdge: Should Americans excuse FGM as a minority cultural practice?

Bioedge

Should Americans excuse FGM as a minority cultural practice?

by Michael Cook | 18 Nov 2017 | 2 comments

Dr Jumana Nagarwala

Eight people have been charged with involvement in female genital mutilation in Michigan – the first case in the United States. Dr Jumana Nagarwala is the central figure because she performed the procedure – nicking the clitoral hood of two Minnesota girls who were brought to her by their parents.

All of the defendants are members of an Indian Muslim sect called Dawoodi Bohra.

In a post on The Hastings Center blog, two Muslim physicians from the University of Chicago attempt the difficult task of calling for a compromise on this incendiary issue. They call for more understanding of ancient traditions.

Informed discussion can only take place when we use language that does not marginalize and pre-judge, that opens dialogue rather than obstructs it. Thus, like others before us, we believe that the term female genital mutilation, or FGM, should be discarded in favor of more neutral terminology. No doctor willfully seeks to mutilate. As we ask others to reexamine their rituals, we should reevaluate our use of language. For the terminology we use might reveal our unconscious biases, and a neutral stance is needed to allow the voices of those who engage in the practice to be heard.
Next, we require an accurate understanding of the procedures and data about their harms. To have a productive conversation about harm-reduction we need to understand all of the harms involved, both when the procedure is performed and when it is not. Thus, the medical data on harms and complications post-FGC; information about the social and psychological harms that accrue when these procedures take place and, importantly, when they are not performed; and anthropological data about the significance of these procedures in their cultural contexts all need to be brought to the dialogue. We need to objectively and critically examine both what we do and do not know before making moral assessments and delineating a path forward.

The two Muslim bioethicists, Aasim I. Padela and Rosie Duivenbode, claim that Dawoodi Bohra practices a form of gender equity, with the boys being circumcised and the girls being “nicked”.

Several of our stories this week deal with end-of-life issues. For a bit of a change, how about an historical diversion?

“And when Rachel saw that she bare Jacob no children, Rachel envied her sister; and said unto Jacob, Give me children, or else I die.” You might recognise this quote from the Bible. It is often used to illustrate the pain of infertility, which hurts no less 4,000 years later.

Jacob was a wandering pastoralist. But Turkish archaeologists announced this month that they had uncovered evidence of urban infertility in Kültepe, an Assyrian site in the centre of modern Turkey. It is a clay tablet with cuneiform script with a prenuptial agreement – also 4,000 years old. It may be the first pre-nup in recorded history.

If, after two years, the bride has still not borne a child, the tablet says, the wife will allow her husband to use a female slave as a surrogate mother to produce an heir. The slave would be freed after giving birth to a son.

Many ethical issues in the Reproductive Revolution have precedents, but it’s amazing to see that today’s surrogate mothers were anticipated by Assyrian slave girls four millennia ago.