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As a doctor, will you practice genital mutilation?

Discussion in 'Topics in Healthcare' started by Joe the Plumber, 03.29.12.

  1. Joe the Plumber

    Joe the Plumber

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    I'm currently really struggling with this issue. I am a Presbyterian, though not the ultra-conservative variety. But the issue is this: How far do we stretch the limits of reason and ethics when it comes to performing genital mutilation? Yes, there are vague references to health benefits, but I don't think the science is definitive. What do you guys think? If you're interested in pediatrics, this will be the kind of thing you might do regularly.
     
    Last edited: 03.29.12
  2. circulus vitios

    circulus vitios

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    What the hell are you talking about?
     
  3. Joe the Plumber

    Joe the Plumber

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    There was another case of female genital mutilation in the news and it really upset me. The 'just a prick' method is used now which I stil think is suspect at best. Obviously there is male genital mutilation (circumcision), too. I'm wondering if anyone interested in medicine has thought about how we will balance faith-based practices with medical ethics. Sorry if my original post was unclear.
     
  4. SeminoleVesicle

    SeminoleVesicle MS2

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    +1

    You don't have to do anything you don't want to bro.
     
  5. Joe the Plumber

    Joe the Plumber

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    Could that result in being blacklisted from a hospital? I shadowed a PP pediatrician who also does work at the local hospital. I watched him perform a male genital mutilation and while I was impressed with his sterile technique, it was disturbing.
     
  6. dbeast

    dbeast Neurorectal surgeon

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    This post is equally unclear...
     
  7. Joe the Plumber

    Joe the Plumber

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    Not sure if I understand how it's unclear. Maybe a hypothetical would help? Let's say you're a pediatrician. An expecting couple, whose older son is one of your pts, says they would like you to also be their new child's doctor. They indicate that because of their religious beliefs, they would like you to remove her clitoral hood and clitoris (or even the labia majora and minora, too), or if it's a boy, remove the foreskin of his penis. Or, maybe it's something else - a prick of the left ear lobe, removal of part of the cartilage of the nose. The specific body part doesn't really matter. What I'm wondering is if you would do this.
     
  8. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    I wouldn't. I don't think babies should have their bodies disfigured/permanently modified for no good medical reason (babies don't have sex and aren't at risk for contracting STDs through sexual, penile routes unless a rabbi sucks their dick) due to religious beliefs which might not be their own when they become adults. If they want to get the procedure once they have grown to adulthood they are more than welcome to. I would perform a purely cosmetic procedure for a baby that was born disfigured since I think that is a reasonable assumption of what the child would want, and the disfigurement could be restored if they child grew to adulthood and wanted that ( :confused: ). Inb4 a bunch of directly contradictory scientific literature regarding circumcision gets posted.

    And personally I think the pinprick procedure is just pandering. I know many hospitals and ped groups ban it because it is philosophically more sound to have a blanket ban on all genital mutilation procedures than to try to draw a blurry line somewhere.

    also can i win an award for avatar relevance?
     
    Last edited: 03.29.12
  9. tantacles

    tantacles Moderator Lifetime Donor

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    Yay archer.

    I'm definitely conflicted, but I don't really have a problem with circumcision of a child. Not exactly sure what I'll do with my own, though.
     
  10. Chip Chipperson

    Chip Chipperson

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    I have just stepped into the twilight zone.
     
  11. serenade

    serenade Medical Alchemist

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    Female genital mutilation is illegal in the United States, it is a tool and sign of the oppression of females. It produces no health benefits at all. It is also a generally bloody and painful procedure.
    Male circumcision is legal and a cultural practice, likely designed for keeping sand and dirt out of your penis. It today has been linked moderately with reduced sexual pleasure and reduced incidence of HIV infection.
    Honestly there is no way of comparing the two. But that being said since I have no intention of being a pediatrician, urologist, or family doctor this does not apply to me in the least.
     
  12. Joe the Plumber

    Joe the Plumber

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    I think it's a valid question. Genital mutilation of different sorts is very prevalent in many countries, both Western and Eastern. I'm curious to know what you would do if faced with this sort of quandary.
     
  13. dbeast

    dbeast Neurorectal surgeon

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    I feel like I've just stepped into a "cut vs uncut" thread on /b/

    All we need is dick pics and it will be complete.
     
  14. tantacles

    tantacles Moderator Lifetime Donor

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    I can direct you to several relevant sites.
     
  15. serenade

    serenade Medical Alchemist

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    Eh, there are plenty of elective procedures that parents opt for their child. I don't think circumcision is all that necessary, but I think that if parents want to do it then they should be able to.
     
  16. Joe the Plumber

    Joe the Plumber

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    On the contrary, I honestly don't see how you can differentiate the two. Both are faith-inspired actions done with no medical goal in mind. Female genital mutilation can be done in such a way that it is minimally invasive (the aforementioned 'prick'). Indeed, if it was more widely accepted and was performed by doctors, it would become much safer. Like male genital mutilation, it acts to reduce sexual pleasure. Perhaps it also reduces the incidence of HIV infection in women, I don't know. It's not my place to comment on the cultural and religious practices of others, and I don't feel comfortable issuing a blanket statement about the motivation behind genital mutilation, whether it be male or female. I'm more interested in how doctors walk the tightrope with this issue.
     
  17. ScholarStud

    ScholarStud

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    I agree; this is an extremely valid question. Personally, I think I would only perform circumcisions. Anything else would push me out of my comfort zone.

    As far as whether these practices are right or wrong? It's largely based on perspective. Cultural bias or taboo has a huge influence on what we see as right or wrong growing up, and in adulthood.
     
  18. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    i don't see how they can be philosophically differentiated either. The only difference is that one happens to be seen as normal in our culture.
     
  19. Ron G

    Ron G

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    u might wanna consider getting your MD before u worry about these things
     
  20. serenade

    serenade Medical Alchemist

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    Eh.. One is a tool of oppression, used by men to make women objects. One is done by people who are religiously clean freaks who lived in a desert. Do you want to constantly feel sand on your Johnson?
     
  21. tantacles

    tantacles Moderator Lifetime Donor

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    Well, one actually has a practical application - circumcised penises are easier to clean and maintain than uncircumcised ones.

    Whereas mutilated female genitalia don't really do anything better than their unmutilated counterparts except provide men with greater sexual pleasure in some cases and prevent women from feeling pleasure in some cases.
     
  22. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    We don't live in a desert, we live in the 21st century United States. People don't have trouble cleaning their dicks, unless you have something you'd like to share with us? Ask any adult male if he appreciates that his parents circumcised him because it saved him 2 seconds of time per shower and you will get a gigantic eye roll. Do you want to have sand in your johnson...More like do you want to have the most sensitive part of your dick cut off because your parents have marked your body according to the religious ideas of superstitious primitives? If you share those religious ideas when you grow up, then get the procedure done at that time. Body mutilation is not something a human should get to electively choose for any other human but themself.
     
  23. serenade

    serenade Medical Alchemist

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    That's because your analysis is shallow and superficial. You don't bother to spend the time to consider the history and unique cultures and what contributed to the development of these practices.
    One was developed to make women objects, end of story.
     
  24. Bacchus

    Bacchus PGY Too-many-expectations Moderator

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    Thread moved to "Topics in Healthcare." No pertinent to the application process.
     
  25. dbeast

    dbeast Neurorectal surgeon

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    In this thread: SDN users inadvertently giving out TMI about their packages based on which side of the argument they defend...
     
  26. serenade

    serenade Medical Alchemist

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    This is completely outside of the point. Your argument was that the origins and philosophy behind these procedures were the same. That is the point of disagreement, not the present day application. So this entire post is completely irrelevant.
     
  27. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    one was developed to religiously mark children as "set aside" to serve a god...that they might not even believe in. End of story.

    YOUR analysis is complete bull****. Arguing that a barbaric religious practice is sound simply because it had a coincidental practical use millenia ago or because it comes from a different culture with beautiful traditions that are so different from our own and hard to understand is exactly the same way that people justify female genital mutilation. You really thought it through, though, congrats.


    nope, nice try.


    But if I stop fighting on the internet I have to actually do my PBL :cry:
     
    Last edited: 03.29.12
  28. Joe the Plumber

    Joe the Plumber

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    What concerns me is that you are more interested in the origin of these practices rather than the present day application. There were probably "good" reasons to mutilate the genitalia of young boys and girls at one point in time. Does that make it okay now? I don't have an answer, but I think we're starting to see cultural bias rear its ugly head. Here in the States, I have noticed that circumcision is so common that it is not commonly viewed as male genital mutilation. Yet, in its present form, male and female genital mutilation are indistinguishable.
     
  29. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    looks like he dodged.
     
  30. serenade

    serenade Medical Alchemist

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    Because that was what I'm arguing about. I consider it an irrelevant procedure here in the US, but "philosophically" and "historically" the two practices are extremely different, if you honestly cannot see the difference then you guys are really blind.
     
  31. serenade

    serenade Medical Alchemist

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    You suffer from selective processing. Im not arguing with you about circumcisions relevance today in our country... I'm arguing that a comparison of the two is fallacious in multiple regards...
    Please get with the conversation, your comments continue to be irrelevant as we, or at least I am not arguing about its uses.
     
  32. serenade

    serenade Medical Alchemist

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    It was around 1 on the East Coast when the topic was discussed. I didn't dodge, I went to sleep...
     
  33. Joe the Plumber

    Joe the Plumber

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    I think a hypothetical would be of use. Pretend you're a pediatrician. Parents from a certain religious group ask you to be their kid's doctor. They have a religous/cultural/ethnic practice they would like you to perform. Basically they want you to remove a small, wedge-shaped piece of the child's left ear lobe. In their culture, this has historically has been used to mark royalty and is a sign of God's favor. It is performed only on males. It is the cultural norm. It would be quick and painless (and safe) if you, a trained medical doctor, did it. What would you do?
     
  34. Gambler 101

    Gambler 101

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    If I was morally opposed to a procedure, I would refer them to a pediatrician who was comfortable performing it. on a side note, female circumcision is performed in many african cultures to prevent females from enjoying sexual intercourse. I do think that rationale is different from that of male circumcision.
     
  35. serenade

    serenade Medical Alchemist

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    Eh, I'd do it if I was competent in the procedure and knew there were be no real damage produced. If not I'll refer them to another physician who is. Remember there is a clause of freedom of religion.
     
  36. serenade

    serenade Medical Alchemist

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    And likewise I would want to know if this procedure was linked to causing particular functional issues. If not I wouldn't have much problem with it.
    This unlike foot binding, head formatting, FGM, which are all extremely detrimental practices and in the case of two used to oppress females into a class of objects.
     
  37. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    The comparison is not fallacious, and you only wish my arguments were irrelevant. You have consistently either admitted or ignored all of my and Joe's arguments about how, despite not having exactly the same historical origins, the most basic and essential motivation between male and female genital mutilation is the same: desire to permanently mark one human being based on religious beliefs of another human being, with a link to reduced sexual pleasure for the future adult males. Instead you have tried to steer the conversation to the one argument you mistakenly think you can win, which is that the cultural motivation between male genital mutilation is different/less evil/less abhorrent than female mutilation and thus they cannot be compared and one should be illegal but not the other, but then you were unable to respond to my point that a portion of the cultures who practice female genital mutilation do it to mark the female as beautiful/holy/religious and claim that they do not themselves view it as abhorrent or to sexually restrict them. You show an ignorance of world cultures where female mutilation is legal, accepted, and not abhorrent but rather expected and not based on malicious intent. You personally feel the two cannot be compared, but you have been utterly unable to provide any argument for this other than male mutilation having a possible utility millenia ago and that you, coming from the culture/country that you do (and in total ignorance of the reverse argument being made by members of other cultures and countries), feel the motivations for female mutilation reveal a higher degree of malicious intent or are otherwise incomparable.


    unanswered.

    unanswered.

    unanswered.

    unanswered. I'll be back later and I await more of your non-arguments and attempts at dissembling. Yes, there are differences between male and female genital mutilation, but at heart they are they same and there is no sound philosophical basis for being willing to perform one medical procedure cosmetically on a non-consenting child due to the religious beliefs OF THE PARENTS but not the other procedure. That is what this thread is about and no protestations of topical irrelevance by you will change that. Based on your previous post, it seems like you would support male genital mutilation and the pinprick method of female genital mutilation, but such a pandering position has repeatedly been found to be philosophically untenable by pediatrician groups across the country. Male infant circumcisions continue to be offered out of a mix of ignorant cultural normalcy and religious medical practitioners (just like female mutilation in other countries), with the weak justification of eventual medical benefits trading off with reduced pleasure as sexually active adults (and I maintain that if an adult wishes to be circumcised for those benefits, he can choose it for himself).
     
    Last edited: 03.30.12
  38. serenade

    serenade Medical Alchemist

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    Alright, suncrush circumcising men is a designed method of objectifying men and helping the established matriarchy maintain power. It is also a great way to make men to cheat less by reducing all and any sexual pleasure. And was invented with those things in mind completely.
     
  39. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    :rolleyes: aaaand we've reached the completely-concede-all-arguments-but-pretend-to-actually-win-by-leaving-an-over-the-top-remark stage
     
  40. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    Aren't most circumsions done by surgeons ( uro?)??
     
  41. serenade

    serenade Medical Alchemist

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    No, I just am bored talking to you. I'm not arguing that circumcision isn't an irrelevant and pointless practice in the US and unnecessary. I'm arguing the philosophical etiologies behind FGM and circumcision are so different that even using them in the same sentence shows a general disregard to history and culture.
     
  42. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    Once again:

    unanswered, unanswered, unanswered, unanswered, unanswered.
     
  43. serenade

    serenade Medical Alchemist

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    Actually the fact that you believe FGM is a religious practice tells me you haven't even bothered to google the topic. Furthermore there is not a single nation on Earth today where FGM is legal. And finally again, there is significantly more malicious intent within the act of FGM, it along with many other practices including Foot Binding are forms of oppression.
     
  44. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    Regardless of the fact that I have used the word culture a whole lot in my posts (to which you still never respond to but only attempt to distract from), in many countries religious texts are, in fact, used to justify it, despite some but not all religious leaders condemning it...but the fact that you believe that FGM as a cultural practice in most countries isn't popular based on at a minimum the cultural norms brought about by religious beliefs (whether they are Abrahamic or tribal African superstitions) demonstrates willful ignorance. The prevalence is estimated at 92% in Mali where the practice isn't illegal; it only took me 5 seconds to find that your second statement is an obvious lie so I suspect there are many more examples. Sudan has explicitly legalized the sunna (religiously-backed) form of FGM. And I completely agree that types I-III are malicious, but Joe and I have been discussing type IV almost exclusively in this thread which is often seen as the non-malicious option to meet the religious/cultural expectation.

    Still: unanswered, unanswered, unanswered, unanswered...
     
    Last edited: 04.03.12
  45. Pharmavixen

    Pharmavixen foxy pharmacist

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    What is done to girls is the equivalent of chopping off the entire head of a guy's dick.

    Are you one of these people?
     
  46. Joe the Plumber

    Joe the Plumber

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    Maybe, idk. My experience is very limited, but I shadowed a pediatrician and I watched him do one. It's so crazy that we have made an unnatural, disfigured, circumcised penis the norm, and a normal penis weird.

    I repeat the hypothetical scenario to all SDNers: Parents from Religion X want you to remove a triangular piece of cartilage from their newborn son's right ear lobe. It's a sign of honor and God's favor in their culture. What do you do?
     
  47. Veritas86

    Veritas86

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    Agreed with the argument that circumcision is based upon Abrahamic religious practices and therefore medically irrelevant.

    Sad note, its a bit sad that it is seen as normal when there's so much conflicting studies on the "benefits" of circumcision.

    Then again, there are boob jobs. No real "need," its all cosmetic. The difference is that the child has no say in the matter.

    If a guy wants to be circumcised later in life, fine. But I don't think parents should be able to make that choice unless its medically relevant to the child's health.

    FGM is a disgusting practice, but it does happen. Thing is, comparing the two on a medical basis is apples to oranges. The only way the argument stands is comparing them on a cultural level. IE: what is seen as a "normal" practice of certain groups.
     
  48. Smurfette

    Smurfette smurfalicious Administrator SDN Senior Moderator

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    No. Most circs in babies are done by pediatricians (or FPs depending on location) or OB/Gyns. Different hospitals/groups work this differently. At mine, the peds guys do them. Where I did residency, the OBs did them. Once the kids are beyond newborn age, they generally get sent to a surgeon.

    Adults can be done by GU (usually) or GS.
     
  49. Joe the Plumber

    Joe the Plumber

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    I think a comparison is possible, and in fact, makes MGM looks much worse than FGM. Docs will remove the entire foreskin of the penis yet they won't even prick the clitoris? How does that makes sense?
     
  50. Suncrusher

    Suncrusher ☣ ☣ ☣ ☣ ☣ Lifetime Donor

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    no, not always, and that is definitely not the form that American doctors typically grapple with.

    yep...

    The (bad and untenable) reasons it currently happens like this is because

    1. male mutilation is culturally accepted in our part of the world and thus hardly anyone stands up to the improper application of religious freedom,
    2. it can be medically justified for infants in certain cases and for adults and is thus seen as a medical procedure, and
    3. because there is no slippery slope argument on the male side.

    For females,

    2. there is no way for doctors to medically justify it and see it as anything other than what it really is, and
    3. there is a slippery slope argument about where you can draw the line between all of the possible forms of FGM: ritual prick, small clitoral incision, clitoral scraping, and then of course all the progressively worse versions. What happens if the ritual prick is allowed by doctors in order that the families don't perform a more harmful or nonsterile form of FGM themselves, but then a family shows up to your office asking for a clitoral incision procedure with the same reasoning?
    1. Finally, FGM is not culturally accepted in our part of the world and therefore fallacious religious freedom arguments are properly disregarded (similar to how an American doctor would never agree to perform non-medical, cosmetic, permanently disfiguring African ash+scar tattoos on infants because of their parents religious/cultural beliefs...and I believe this also answers your former question about the ear lobe that the others were so typically unable to answer).

    Therefore, my stance is still the same: I would not perform either male or female genital mutilations on a non-consenting infant for any non-medical reason; they can get the procedure for themselves once they are adults, if they wish. As long as male mutilation remains legal, I would ensure my patients had full access to the procedure by referring them to another physician whom I trust to carry out the procedure well and safely...i.e. not a rabbi who is swarming with herpes.
     
    Last edited: 04.13.12

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