Academic journal article Ethics & Medicine

The American Academy of Pediatrics and Female Genital Cutting: When National Organizations Are Guided by Personal Agendas

Academic journal article Ethics & Medicine

The American Academy of Pediatrics and Female Genital Cutting: When National Organizations Are Guided by Personal Agendas

Article excerpt

Abstract

The Committee on Bioethics of the American Academy of Pediatrics released a policy on female circumcision on April 26, 2010 proclaiming that some forms of genital cutting in minor females were permissible, particularly nicking the clitoris. The policy was quickly met with opposition and "retired" by the Academy on May 27, 2010. This paper explores the changes in policy from the Academy's 1998 position and the possible implications of the changes. It is argued that these changes were driven by the personal agendas of members of the Committee and of the author of the policy. The short-lived policy failed to recognize the basic human right to bodily integrity that applies to all humans, including infants and children, placing the Academy outside the mainstream of how ethicists currently view the rights of children.

Key words: American Academy of Pediatrics, female circumcision, human rights, bodily integrity, bioethics

The American Academy of Pediatrics (AAP) released a revised policy on female circumcision on April 26, 2010. (Committee on Bioethics 2010) The new policy was met with incredulity and opposition and was officially "retired" by the AAP on May 27, 2010. (American Academy of Pediatrics 2010) Consequently, for one month it was the policy of the AAP that some forms of genital cutting in minor females were permissible. By taking this position, the AAP, which had a reputation for working to protect the health and well being of children, had broken rank with the American Medical Association (1995) and other national and international medical organizations. This paper will explore the content of the AAP's revised April 2010 position on female circumcision, the flaws in its short-lived position, how the change in policy may have came about, and it will speculate why the AAP's Committee of Bioethics took the path they did.

The AAP's mission is "to attain optimal physical, mental, and social health and wellbeing for all infants, children, adolescents, and young adults. To accomplish this mission, the AAP shall support the professional needs of its members." (AAP Fact Sheet) Placing the needs of children first is laudable given a child's obvious vulnerabilities and lack of power. The revision in the policy on female circumcision appears to be incongruent with the AAP's focus on protecting the interests of children but rather emphasizes appeasing parents who, in some cases doubtlessly with the best of intentions, seek procedures that are harmful to their children. (Committee on Bioethics 2010)

The powerful movements of child advocacy over the past sixty-five years have resulted in the extension of basic human rights to all children. These rights have secured in a variety of international agreements. (Convention on the Rights of the Child 1989, International Covenant on Civil and Political Rights 1976, Universal Declaration of Human Rights 1948, International Covenant on Civil and Political Rights 1966) One of the primary and most basic rights guaranteed by these agreements is the right to bodily integrity and security of person. This right prevents the cutting or amputating of body parts without an individual's consent or a compelling medical reason.

A Change in Policy

The April 2010 AAP policy on female circumcision made several changes relative to the policy published in 1998. (Committee on Bioethics 1998) While the 1998 policy opposed all forms of female circumcision, the April 2010 policy only opposed forms that pose risks of physical or psychological harm. The original policy recommended that physicians actively seek to dissuade families from carrying out all forms of female circumcision, whereas the April 2010 policy recommended only dissuading family from carrying out the "harmful" forms. The April 2010 policy recommended that, in addition to the compassionate education recommended in the original policy, providers remain culturally sensitive "to the cultural and religious reasons that motivates parents to seek this procedure for their daughters. …

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