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 Pediatricians reverse on genital mutilation
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 05/27/2010 :  21:55:50  Show Profile Send HalfMooner a Private Message  Reply with Quote
The American Academy of Pediatric has withdrawn their endorsement of so-called female "genital pricking." Looks like they found out that shit just won't fly in civilized countries:
The American Academy of Pediatrics has rescinded a controversial policy statement raising the idea that doctors in some communities should be able to substitute demands for female genital cutting with a harmless clitoral "pricking" procedure.

"We retracted the policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world," said AAP President Judith S. Palfrey.

The contentious policy statement, issued in April, had condemned the practice of female genital cutting overall. But a small portion of statement suggesting the pricking procedure riled U.S. advocacy groups and survivors of female genital cutting.

. . .

Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.

Edited by - HalfMooner on 05/27/2010 23:02:25

tomk80
SFN Regular

Netherlands
1278 Posts

Posted - 05/28/2010 :  03:03:14   [Permalink]  Show Profile  Visit tomk80's Homepage Send tomk80 a Private Message  Reply with Quote
You beat me to posting it.

In other news, the dutch KNMG (Royal Dutch Medical Society) posted a position statement today stating that it wants to reduce circumcision of young boys. It advices not to apply the procedure unless medically necessary.

Tom

`Contrariwise,' continued Tweedledee, `if it was so, it might be; and if it were so, it would be; but as it isn't, it ain't. That's logic.'
-Through the Looking Glass by Lewis Caroll-
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Elmo the Clown
New Member

31 Posts

Posted - 05/28/2010 :  12:24:52   [Permalink]  Show Profile  Visit Elmo the Clown's Homepage Send Elmo the Clown a Private Message  Reply with Quote
I posted it in this erronous report:
http://www.skepticfriends.org/forum/topic.asp?TOPIC_ID=13156
about a week ago.

I win! What do I win?

I do find pathetic that one of the dissenting doctors claim that providing the service would prevent parents taking their children to their home third world country to have it performed in less then hygenic conditions.

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pleco
SFN Addict

USA
2996 Posts

Posted - 05/28/2010 :  12:34:39   [Permalink]  Show Profile  Visit pleco's Homepage Send pleco a Private Message  Reply with Quote
It is pathetic that they had to "reverse" anything on this topic.

by Filthy
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tomk80
SFN Regular

Netherlands
1278 Posts

Posted - 05/28/2010 :  14:39:27   [Permalink]  Show Profile  Visit tomk80's Homepage Send tomk80 a Private Message  Reply with Quote
Originally posted by Elmo the Clown

I posted it in this erronous report:
http://www.skepticfriends.org/forum/topic.asp?TOPIC_ID=13156
about a week ago.

I win! What do I win?

I do find pathetic that one of the dissenting doctors claim that providing the service would prevent parents taking their children to their home third world country to have it performed in less then hygenic conditions.

From reading some of the reactions on Pharyngula, a "nick" or similar minimally invasive procedures were suggested by women from the culture where this happens itself. As I stated in the previous thread, I don't think reasoning from such a pragmatic perspective is à priori bad. Suppose that a small incision in the labia, which would leave a small, hardly visible scar without any measurable physical or psychological consequences, prevents the parents from performing the ritual in a less sanitary and more gruesome manner. Would this not be preferable to minimize the harm to the girl in this way. Especially if the procedure is comparable to or less harmfell than male circumcision performed routinely on boys?

I am still of the opinion that the original guidelines weren't as bad as they were made out to be by some. The guidelines clearly discussed the various pros and cons of this.

I'm reasoning from a physician's perspective here. If I were a doctor and I would be faced with a family heavily infected with cultural zeal, and they want me to mutulate there daughter. And I know that if I cannot convince them they'll perform this mutulation at home, where I cannot foresee the consequences. I first lay out the risks. While this has helped in a number of cases according to the guidelines, it doesn't here. The family is heavily infected with culture and prefers culture above the life of their daughter. Perhaps if I can then convince them to make a small incision that will not have dire consequences this is better than letting them have their way?

I don't know. I don't know what the procedures are in this case. If I would make the rules, the procedure would be as follows. Child protection would be warned and the parents would be given to understand that as long as they stay in the USA (or the Netherlands in my case) they will not be allowed to perform this procedure. Then, child protection will have a nice, long talk with the parents, explaining to them very carefully that their daughter is to be checked by a physician every half year up to her 16th (or 18th or whatever) birthday for FGM and that if FGM is performed on her, her parents will spend a very long time in a very unpleasant place and her daughter will be taken away from them and adopted by a nice atheist (or catholic or whatever the infidel du jour is) family.

But as far as I know, such a legal pathway is not in place. So I truly don't know what the best option is, if such a situation would present itself.

Tom

`Contrariwise,' continued Tweedledee, `if it was so, it might be; and if it were so, it would be; but as it isn't, it ain't. That's logic.'
-Through the Looking Glass by Lewis Caroll-
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 05/28/2010 :  16:16:52   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Originally posted by Elmo the Clown

I posted it in this erronous report:
http://www.skepticfriends.org/forum/topic.asp?TOPIC_ID=13156
about a week ago.

I win! What do I win?

I do find pathetic that one of the dissenting doctors claim that providing the service would prevent parents taking their children to their home third world country to have it performed in less then hygenic conditions.
Sorry, I tried for over an hour to find that thread. I wanted to post the OP here as a reply to it.

Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 05/28/2010 16:19:11
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 05/28/2010 :  16:29:35   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Originally posted by tomk80

From reading some of the reactions on Pharyngula, a "nick" or similar minimally invasive procedures were suggested by women from the culture where this happens itself. As I stated in the previous thread, I don't think reasoning from such a pragmatic perspective is à priori bad. Suppose that a small incision in the labia, which would leave a small, hardly visible scar without any measurable physical or psychological consequences, prevents the parents from performing the ritual in a less sanitary and more gruesome manner. Would this not be preferable to minimize the harm to the girl in this way. Especially if the procedure is comparable to or less harmfell than male circumcision performed routinely on boys?

I am still of the opinion that the original guidelines weren't as bad as they were made out to be by some. The guidelines clearly discussed the various pros and cons of this.

I'm reasoning from a physician's perspective here. If I were a doctor and I would be faced with a family heavily infected with cultural zeal, and they want me to mutulate there daughter. And I know that if I cannot convince them they'll perform this mutulation at home, where I cannot foresee the consequences. I first lay out the risks. While this has helped in a number of cases according to the guidelines, it doesn't here. The family is heavily infected with culture and prefers culture above the life of their daughter. Perhaps if I can then convince them to make a small incision that will not have dire consequences this is better than letting them have their way?

I don't know. I don't know what the procedures are in this case. If I would make the rules, the procedure would be as follows. Child protection would be warned and the parents would be given to understand that as long as they stay in the USA (or the Netherlands in my case) they will not be allowed to perform this procedure. Then, child protection will have a nice, long talk with the parents, explaining to them very carefully that their daughter is to be checked by a physician every half year up to her 16th (or 18th or whatever) birthday for FGM and that if FGM is performed on her, her parents will spend a very long time in a very unpleasant place and her daughter will be taken away from them and adopted by a nice atheist (or catholic or whatever the infidel du jour is) family.

But as far as I know, such a legal pathway is not in place. So I truly don't know what the best option is, if such a situation would present itself.
I'm an absolutist on this. These are physicians we're talking about. "First, do no harm" has to be their primary rule.

When asked to do a genital mutilation, their reply should not be "Will you settle for just a teensy little one?" The answer must be "Hell, no! That's barbaric and illegal!" Doctors should then report the incident to police or child protective services for follow-up to prevent mutilation by family members or clerics.

Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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@tomic
Administrator

USA
4607 Posts

Posted - 05/28/2010 :  19:30:10   [Permalink]  Show Profile  Visit @tomic's Homepage Send @tomic a Private Message  Reply with Quote
I thought that a big part of the reasoning for allowing the "nick" is the fear parents would take their children out of the country to have done to them what we definately don't want done to them.

I thought about posting here after another discussion I had about this subject elsewhere. Most of that discussion was based on this url:

Intact America’s Statement in Response to the Release of the American Academy of Pediatrics’ Policy Statement - Ritual Genital Cutting of Female Minors

Some of the claims made in that link are interesting to say the least.

@

Gravity, not just a good idea...it's the law!

Sportsbettingacumen.com: The science of sports betting
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Machi4velli
SFN Regular

USA
854 Posts

Posted - 05/28/2010 :  23:15:50   [Permalink]  Show Profile Send Machi4velli a Private Message  Reply with Quote
Originally posted by HalfMooner
I'm an absolutist on this. These are physicians we're talking about. "First, do no harm" has to be their primary rule.

When asked to do a genital mutilation, their reply should not be "Will you settle for just a teensy little one?" The answer must be "Hell, no! That's barbaric and illegal!" Doctors should then report the incident to police or child protective services for follow-up to prevent mutilation by family members or clerics.

That isn't really the question, no one wants it to happen (except members of that culture), the position the AAP took initially was meant to be a pragmatic measure to reduce harm as @tomic said. If we force the activity underground, the argument goes, there will be no one to report to child protective services because the parents will not ask doctors and, we think, will go to their home countries and have a more dangerous procedure resulting in more actual harm than allowing the less dangerous procedure. The rebuttal seems to be either (1) it won't do more harm, which kills their argument or (2) it might do more harm but we cannot let it occur here, which is difficult to mesh with trying to do the least harm.

I lean toward the former, but I have little evidence.

I do think we need to hold the same position for male circumcision to be consistent. Medical reasons for it have been pretty much debunked. We would struggle much more to make that illegal, but I would still try to stop FGM since we have a shot at reducing it.

"Truth does not change because it is, or is not, believed by a majority of the people."
-Giordano Bruno

"The greatest enemy of knowledge is not ignorance, but the illusion of knowledge."
-Stephen Hawking

"Seeking what is true is not seeking what is desirable"
-Albert Camus
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 05/29/2010 :  02:06:08   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Originally posted by Machi4velli

That isn't really the question, no one wants it to happen (except members of that culture), the position the AAP took initially was meant to be a pragmatic measure to reduce harm as @tomic said. If we force the activity underground, the argument goes, there will be no one to report to child protective services because the parents will not ask doctors and, we think, will go to their home countries and have a more dangerous procedure resulting in more actual harm than allowing the less dangerous procedure. The rebuttal seems to be either (1) it won't do more harm, which kills their argument or (2) it might do more harm but we cannot let it occur here, which is difficult to mesh with trying to do the least harm.

I lean toward the former, but I have little evidence.

I do think we need to hold the same position for male circumcision to be consistent. Medical reasons for it have been pretty much debunked. We would struggle much more to make that illegal, but I would still try to stop FGM since we have a shot at reducing it.
For a physician to do any harm, even with the justification that the patients' parents may do worse if the physician doesn't cut just a little is flat out wrong.

Some "slippery slope" arguments are valid, and I think this is one of them. Once a physician is accustomed to doing "genital pricking," what happens when that doctor is told that is not enough? Would the pediatrician then excise just a little of the clitoris to prevent an amateur total clitorectomy? The logic would be the same.

No. This is an instance where physicians must simply say no on principle. Even if some parents do mutilations in secret after being refused by physicians, physicians cannot be child mutilators. I'm glad pediatricians realized this and spoke up.

Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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Elmo the Clown
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31 Posts

Posted - 05/29/2010 :  06:55:35   [Permalink]  Show Profile  Visit Elmo the Clown's Homepage Send Elmo the Clown a Private Message  Reply with Quote
There is a huge difference between between male and female circumcision. It's folly to compare. They are separate issues, and need to be looked at seperately.

I'm circumcised. I'm 43, and have had thousands of orgasms. OK, I guess I could say it sucks that I was circumcised. But I have no comparison, and I am just fine. I will continue to enjoy sex for many years to come.

The point if FGM or FGC, or whatever is to deny a women the enjoyment of sex, to hold her beholden to her husband, and greatly decreasing any desire to sleep around. She is probably not having orgasms, and sex might be painful to her. THese is just no comparing the two.

Furthermore, attacking FGM while attacking male circumcision is not going to garner you the support of the followers of the covenant. If you haven't figured this pout, our destinies are intertwined. You will never be rid of them, so you might as well find common ground where you can. Let me break it down for you:

"FGM is for them there towel heads, and don't have no place here in the God fearin' US of A, but God said cut that hood on my boy" is what you are dealing with. Use it to your advantage. Plus, how can anyone who "votes for the lesser of two evils" balk at such a slam-dunk common ground shot towards the light?

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Machi4velli
SFN Regular

USA
854 Posts

Posted - 05/31/2010 :  00:52:11   [Permalink]  Show Profile Send Machi4velli a Private Message  Reply with Quote
Originally posted by Elmo the Clown
I'm circumcised. I'm 43, and have had thousands of orgasms. OK, I guess I could say it sucks that I was circumcised. But I have no comparison, and I am just fine. I will continue to enjoy sex for many years to come.

I was under the impression the smaller "pricking" procedure didn't do that as the full one does, I don't know. Male circumcision is not generally dangerous in the industrialized world (though there have been isolated incidents), but I still oppose it for being an unnecessary "medical" procedure on a child, which is at least one reason I oppose any sort of FGM, whether it ruins sex or not.

We cannot realistically make male circumcision illegal, and that isn't an argument not to fight FGM, as I said previously. Of course we can use common ground when we have it.

"Truth does not change because it is, or is not, believed by a majority of the people."
-Giordano Bruno

"The greatest enemy of knowledge is not ignorance, but the illusion of knowledge."
-Stephen Hawking

"Seeking what is true is not seeking what is desirable"
-Albert Camus
Edited by - Machi4velli on 05/31/2010 01:32:41
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Machi4velli
SFN Regular

USA
854 Posts

Posted - 05/31/2010 :  02:17:36   [Permalink]  Show Profile Send Machi4velli a Private Message  Reply with Quote
Originally posted by HalfMooner
For a physician to do any harm, even with the justification that the patients' parents may do worse if the physician doesn't cut just a little is flat out wrong.

Physicians do harm in attempts to get a good final result all the time, amputating limbs to save lives, use treatments that do harm in hopes they will do good overall (though they may fail). I see that the fact that this is done to children, with the decision made by a guardian, but the same dynamic applies to any medical procedure, including the ones that do harm. Small children never have a say.

There is the difference that the expected good result from the bad action is convoluted with more human factors in case of FGM, maybe that makes a significant difference. But I think the argument that it actually won't do more harm is independent of the one based on principle. The AAP would have to be the ones to justify the idea that it would cause more harm overall before supporting this mutilation procedure, which they didn't seem to do.

No. This is an instance where physicians must simply say no on principle. Even if some parents do mutilations in secret after being refused by physicians, physicians cannot be child mutilators.

Sounds a bit like religious right folks arguing against anything medical. "This is an instance where physicians must simply not (kill babies / kill patients) on principle, even if some (mothers have abortions / patients commit suicide) in secret after being refused by physicians, physicians cannot be (baby killers / murderers)."

We can say abortion isn't analogous because x or PAS isn't analogous because y, but the similarity of argument at some level just struck me, I mean no offense. I think it may be a symptom of making the argument based on a principle rather than a result. What is the principle? Who determined it? Is it justified?

"Truth does not change because it is, or is not, believed by a majority of the people."
-Giordano Bruno

"The greatest enemy of knowledge is not ignorance, but the illusion of knowledge."
-Stephen Hawking

"Seeking what is true is not seeking what is desirable"
-Albert Camus
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 05/31/2010 :  06:49:15   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Originally posted by Machi4velli

Physicians do harm in attempts to get a good final result all the time, amputating limbs to save lives, use treatments that do harm in hopes they will do good overall (though they may fail).
This is not the excision of a tumor. There is no medical justification for FGM.
The AAP would have to be the ones to justify the idea that it would cause more harm overall before supporting this mutilation procedure, which they didn't seem to do.
. . .
That part I agree with.
No. This is an instance where physicians must simply say no on principle. Even if some parents do mutilations in secret after being refused by physicians, physicians cannot be child mutilators.

Sounds a bit like religious right folks arguing against anything medical. "This is an instance where physicians must simply not (kill babies / kill patients) on principle, even if some (mothers have abortions / patients commit suicide) in secret after being refused by physicians, physicians cannot be (baby killers / murderers)."

We can say abortion isn't analogous because x or PAS isn't analogous because y, but the similarity of argument at some level just struck me, I mean no offense. I think it may be a symptom of making the argument based on a principle rather than a result. What is the principle? Who determined it? Is it justified?
Again, there's no medical justification for any type of FGM. That's why opposing "genital pricking" isn't at all like arguing against abortion.

Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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Machi4velli
SFN Regular

USA
854 Posts

Posted - 05/31/2010 :  17:08:43   [Permalink]  Show Profile Send Machi4velli a Private Message  Reply with Quote
Originally posted by HalfMooner
Again, there's no medical justification for any type of FGM. That's why opposing "genital pricking" isn't at all like arguing against abortion.

What is the medical justification for abortion in cases where the health of the pregnant woman is not at risk? We could argue for abortion only in such cases, but I don't find that position to be particularly good or as common as variation of the extremes.

How is there ever a medical justification for suicide? (Maybe you oppose that, I don't know, in which case it wouldn't really matter.)

I didn't mean to suggest there is any medical justification for the FGM, but rather a (plausible) justification that allowing the procedure would promote the most goodness overall. I don't think this reasoning (either way) matters for the argument on principle, but for a utilitarian argument exclusively. If the AAP did provide strong evidence that allowing the procedure would reduce harm, would you consider it okay? If so, where did the principle go? If not, should we allow more harm to occur? Why?

Why does the medical value of the procedure determine whether we can be utilitarian?

"Truth does not change because it is, or is not, believed by a majority of the people."
-Giordano Bruno

"The greatest enemy of knowledge is not ignorance, but the illusion of knowledge."
-Stephen Hawking

"Seeking what is true is not seeking what is desirable"
-Albert Camus
Edited by - Machi4velli on 05/31/2010 17:27:13
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