Medically unnecessary genital cutting and the child’s right to bodily integrity: an international expert consensus statement

In American Journal of Bioethics (2019).

Duivenbode and Padela (2019) explored the “cultural boundaries” of Western medicine in light of a high-profile U.S. federal court case—the first to test the 1996 American law prohibiting “female genital mutilation.” Legally, this term refers to the intentional cutting or sewing of “the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years.” The sole exception to the law is medical necessity.  In support of this sole exception, and keeping our focus on the Western medicolegal context for the purposes of this statement, we argue as follows: Under most conditions, cutting a person’s genitals without their informed consent is a violation of their moral and legal right to bodily integrity. As such, it is ethically impermissible unless the person is non-autonomous (incapable of consent) and the cutting is medically necessary.

Full author list: Susan Bewley, King’s College London; Janice Boddy, University of Toronto; Clare Chambers, University of Cambridge; James Chegwidden, Old Square Chambers; Hossein Dabbagh, Doha Institute for Graduate Studies; Dena Davis, Lehigh University; Angela Dawson, University of Technology Sydney; Brian D. Earp, Yale University and University of Oxford; Nuno Ferreira, University of Sussex; Ellen Gruenbaum, Purdue University; Saffron Karlsen, University of Bristol; Antony Lempert, (UK) National Secular Society; Ranit Mishori, Georgetown University School of Medicine; Kai Möller, London School of Economics and Political Science; Steven R. Munzer, UCLA; Sarah O’Neill, Université Libre de Bruxelles; Charlotte R. Proudman, University of Cambridge; Fabienne Richard, Université Libre de Bruxelles; Elizabeth Reis, City University of New York; Eldar Sarajlic, City University of New York; Lauren Sardi, Quinnipiac University; Arianne Shahvisi, Brighton and Sussex Medical School; David Shaw, Maastricht University and University of Basel; Godfrey B.Tangwa, University of Yaounde and Cameroon Bioethics Initiative (CAMBIN); Michael Thomson, University of Leeds and University of Technology Sydney; Anna Wahlberg, Karolinska Institutet

Reasonable Disagreement and the Neutralist Dilemma

Chambers, Clare, “Reasonable Disagreement and the Neutralist Dilemma: Abortion and circumcision in Matthew Kramer’s Liberalism with Excellence” in The American Journal of Jurisprudence (May 2018).

You can read the paper here.

Abstract: This paper starts by investigating the idea of reasonable disagreement. It then considers Matthew Kramer’s argument that there is no neutral solution available to the disagreement over abortion. The paper argues that Kramer’s account has wider application, and identifies a neutralist dilemma. The neutralist dilemma applies when, of two policy options available to the state, one is unreasonable. It follows that the state should enact only the reasonable policy. However, in a neutralist dilemma the fact of reasonable disagreement due to the burdens of judgment means that it is not possible for the state to act at all, whether legislating or not, without deviating from neutrality. The paper develops the concept of the neutralist dilemma and then applies it to another case discussed by Kramer: infant circumcision. The paper argues that the debate over infant circumcision can be framed as a neutralist dilemma, but that the most plausible resolution of the dilemma results in an argument in favor of the legal prohibition of the practice. This is a surprising result, since most liberal states do not restrict circumcision and since prohibition of circumcision might initially appear to be non-neutral or even illiberal; however it is consistent with the tenets of neutralist liberalism.

Cosmetic procedures: ethical issues

Nuffield Council on Bioethics, 2017

This report was written by the Working Party on Cosmetic Procedures, of which I am a member.

There has been increasing demand for invasive cosmetic procedures in the UK, prompting questions about potential risks to users and the lack of regulation and professional standards in this area. This report explores ethical issues in cosmetic procedures with a particular focus on the role and responsibilities of health and scientific professionals and others in responding to demand for invasive non-reconstructive procedures that aim to enhance or normalise appearance. It engages in detailed ethical analysis and makes recommendations affecting all parts of the sector.

You can read the report here.

 

Medicalised Genital Cutting and the Limits of Choice

in Female Genital Cosmetic Surgery: Interdisciplinary Analysis and Solution, edited by Sarah Creighton and Lih-Mei Lao (Cambridge University Press, 2019).

In this chapter I challenge the idea that an appeal to choice exonerates Female Genital Cosmetic Surgery (FGCS). My argument proceeds in five stages. First, I consider the normative role that choice plays in liberal society and philosophy. Second, I note that UK law does not treat choice as adequate for accessing FGCS. Third, I consider the relationship between choice and the concept of normality. Fourth, I consider choice in the context of cosmetic surgery generally, and analyse the distinctive features of FGCS. Fifth, I consider the policy implications of my analysis.

You can find the book here.

Judging Women: 25 Years Further Toward a Feminist Theory of the State

Feminist Political Quarterly (Vol. 3 No. 2, 2017).

The title of this paper is “Judging Women”, a phrase that can be understood in three senses. First, when is it acceptable or necessary to make judgements about what women do? Feminists may be wary of subjecting women’s choices and actions to criticism, but the paper argues that such criticism is implied by a feminist perspective on patriarchy, a perspective which is necessarily critical. Second, when can women engage in the act of judging? The paper argues that being judgmental is popularly considered a vice, but only when done by women. Feminism should insist on women’s right to judge. Third, how are we to judge who counts as a woman? The paper investigates the commonalities and contrasts between feminism and trans issues, and discusses the concepts of essentialism and transphobia. The focus throughout is on MacKinnon’s work, which offers profound, sustained, rich analysis of these questions but does not fully resolve them.

You can read the paper here.

Autonomy and equality in cultural perspective: Response to Sawitri Saharso

home_cover-2Feminist Theory Vol. 5 No. 3 (December 2004).

This paper criticises Sawitri Saharso’s argument that hymen repair surgery and sex-selective abortion can be both multiculturalist and feminist policies.

You can read the paper here.