Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is loosely adapted from Appel's 2019 book, :
An 18-year-old girl from Ethiopia comes to a surgical clinic in the U.S., requesting that ritual female genital cutting be performed. She explains that her family is returning to Ethiopia permanently the following month and that they want the surgery done hygienically in a medical setting, rather than by an elder in their village, where the practice is far less safe and where complications often result. She tells the clinic staff that she will not be "marriageable" in Ethiopia without the surgery, and assures them that she wants the procedure.
Female genital cutting, also known as "female circumcision," is a procedure in which sections of the female genitals are removed as part of a cultural ritual common in parts of Africa, Asia, and the Middle East. The procedure is associated with decreased sexual function and pleasure. Also, when performed under substandard medical conditions, it can lead to infection and even death. Such procedures are outlawed in the U.S. for girls younger than 18.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases:
Let Alzheimer's Patients Have Sex?