12 - Consent and cultural conflicts: ethical issues in pediatric anesthesiologists’ participation in female genital cutting

Summary

Female genital cutting (FGC) has wide acceptance in many cultures across the globe despite gender-related and more general human rights concerns raised by the practice. This chapter presents a case study on a healthy 5-year-old female patient scheduled for surgical correction of clitoral phimosis. Physicians must understand the potential medical sequelae of FGC to make reasoned decisions about whether or not to participate in the procedure. Immediate adverse outcomes of FGC include pain, post-operative infection, shock, tetanus, hemorrhage, and death. Whether an anesthesiologist should participate in FGC depends on his or her interpretation of ethical considerations. Mostprofessional societies provide only guidance, without a binding effect on members.Physician participation in FGC may prevent some health consequences but also perpetuates objectionable social practices. Physicians' decisions to participate in FGC currently rely on personal judgments, weighing adverse medical and psychological consequences against potential cultural benefits and harms.