Ethical Aspects

Since some followers of Islam in Africa, the Far East, and the Middle East endorse circumcision, it has been widely identified as an Islamic rite. However, female genital mutilation is not practiced in Saudi Arabia, Algeria, Iran, Iraq, Libya, Morocco, or Tunisia. Many Islamic and Christian religious leaders have categorically denied that female circumcision or female genital mutilation is an injunction in the Qur'an or a "commandment" in the Bible. Since the foundations of the practice lie outside Islamic or Christian religious law, the origins of circumcision and its justification must lie in the moral, social, and religious structure and operation of societies practicing it. Individuals practicing it act within a system of rules that strictly regulate sexual behavior in society. Female genital mutilation generally thrives in communities with strictly enforced conventions and social rules.

With the knowledge of its harmful effects now common, no social system endorsing this kind of mutilation can be said to promote a favorable climate for a fulfilling life.

The attitudes of women toward circumcision depend on their experiences and level of education. Most women affected by the practice are unaware that circumcision is the cause of their health difficulties (Koso-Thomas). Once aware of this relationship, however, many women who have some education and training and who are exposed to a modern environment are better able to assess what is involved in circumcision actions and, on that basis, to make a reasoned judgment of its rightness or wrongness. Many such women have come to believe that the practice is unacceptable and have refused to allow their female children to go through the same traumatic experience. Many feminists and health professionals have openly displayed a higher regard for women's health than for tradition.

It has been shown, however, that some women who admit to suffering under the unexpected effects of the operation still feel obliged to support the practice. A study carried out to obtain opinions on circumcision involving 135 men and 120 women showed that 25 percent were shocked at what happened to them on their circumcision day, as it was not what they had expected (Koso-Thomas). The majority of them, either semi- or nonliterate, believed that they had done the right thing and planned to have their daughters circumcised. Those women who were not shocked by their experiences were also mainly illiterate and did not see why their daughters should not undergo circumcision. The attitude of men in the sample also varied according to their level of education. Illiterate men insisted that all women should be circumcised to keep them in their place, while the literate men argued that women should be given a choice as to whether or not to be circumcised. They felt that to deny women this choice was a violation of their human rights. It has also been found that circumcision is supported in most women's organizations, particularly political and social groups, since these groups reflect the feelings of the majority in the community.

Usually the decision to have a girl circumcised is made by the female elder members of the family/clan who insist on carrying out the procedure. An aura of secrecy, celebration, and pride surrounds the circumcision and encourages voluntarism on the part of recruits by making membership in the group seem more attractive. A few educated women, however, who have had access to modern medical assessment of their health as well as information on the dangers of the practice also support circumcision but advocate changes to reduce its health hazards. A few healthcare personnel have felt that medical intervention at the early stages of the operation might prevent the more serious health consequences of circumcision. Since circumcision cannot take place without health consequences, the position of these women and health practitioners is untenable.

Women who live in a traditional environment tend to judge their actions on the basis of traditional rules and principles of their society. There may be some misogynistic attitudes among such women, but the dominant force directing their actions comes from the society that demands, among other things, that this ritual be performed in order for them to qualify for marriage and social acceptance.

There are also attitudes inherent in African sexuality that not only permit circumcision but foster it. In most African cultures, sexuality is regarded as a gift to be used for the procreation of the human species, and any public or even private display of sex-related feeling or enjoyment is seen as debasing this gift. In some communities, only a token expression of the sexual self is permitted. The issue of sexual fulfillment is unimportant. Thus, controls over the sexual behavior of women are designed to curb female sexual desire and response and to encourage disregard for the sexual aspects of their lives. The removal of the organ or organs responsible for sexual stimulation is therefore taken as necessary for the fixation of certain values within the community and for ensuring the acceptance of rigid standards of sexual conduct. Thus, the underlying concern of those who defend the institution of female circumcision is that women's sexuality will be corrupted if women are allowed the freedom to control it or indeed to pursue the personal satisfaction of their sexual desire. Implicit in this argument is the major premise that it is immoral for a woman to act on her sexual desire. Women who still support the practice continue to promote injury with confirmed medical consequences. In this respect the role of the healthcare practitioner in the society is crucial and may lead to personal dilemmas that have to be resolved. Many feel anger against the executors and supporters of the ritual and sadness at the futility of the exercise and at the intransigence of traditional circumcising communities. Healthcare professionals presented with the choice of treating or not treating women who have chosen to be circumcised are often determined to rescue a life they see as poised on the brink of destruction. On the other hand, traditional circumcisers have no moral dilemmas about the practice. They believe that they have no choice in a matter which concerns the preservation of their cultural heritage. That heritage dictates how women must live, and to them, life should be one of happiness in subservience to the will of the people and in obedience to customary and religious laws.

OLAYINKA A. KOSO-THOMAS (1 995)

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