By Misbah Shah

Ethical issues involve gender inequality, unbalanced resource distribution, and danger to vulnerable populations. Although it is important to embrace other cultures, different beliefs can lead to ethical dilemmas. Global health encompasses a broad spectrum of problems, but one of the primary obstacles is morality. Female genital mutilation is one example which demonstrates a distinction in cultural behaviors. By injuring the female genitalia for non therapeutic purposes, women can suffer physically and psychologically. According to Simpson, Robinson, Creighton, and Hodes (2012), many Western civilizations view this practice as obscene, but individuals who reside in African countries such as Somalia, Ethiopia, Sudan, and Eritrea consider this action as tradition.

Not only is female genital mutilation a controversy which exhibits injustice amongst genders, but it also results in short and long term health complications. For instance, Reisel and Creighton (2015) mention several consequences which can develop when extracting and harming private parts of a female. “During and immediately following the procedure, the girl or woman is at significant risk of traumatic bleeding and infection including wound infection, septicaemia, gangrene and tetanus”. Several of these short term complications are due to the use of unsanitary instruments and lack of anesthesia. Therefore, along with pain, they are at high risk for infections which often remain untreated. In addition to the immediate effects, long term ramifications can occur. These can be categorized in three different sections. One division consists of gynecological issues, such as genital scarring, blood related infections, menstruation problems, and difficulty with conception (Reisel & Creighton, 2015). Another group involves pregnancy and childbirth complications. A few examples are prolonged labor, postpartum hemorrhage, perineal damage, and an increased risk for Cesarean section. Maintaining a pregnancy can be difficult with this condition, but even when the gestation is successful, there is a high risk for neonatal compromise (Reisel & Creighton, 2015). Along with the physical consequences, mental health considerations also play a role in genital mutilation. Gele, Kumar, Hjelde, and Sundby (2012) indicate that, “The practice is often performed on girls between the ages of 0-9 thus making it one of the most horrific child tortures of our time”. Since this operation occurs at such a young age, it can lead to psychosocial problems in the future including anxiety, depression, and post traumatic stress disorder (Reisel & Creighton, 2015). Female genital mutilation encompasses both physical and psychological consequences. Thus, it is unethical to place girls and women in an indecent situation which does not produce benefits.

Over 140 million females undergo genital mutilation. The majority of these individuals reside in African countries. However, Western countries and certain parts of Asia do manifest this action as well due to the immigrant population (Gele et al., 2012). When considering a cultural perspective, it is known that many Somalis practice Islam. Although the majority of Muslims worldwide recognize female circumcision as a sin, this African group classifies the practice as “sunna” which translates to tradition. It is a procedure that is performed as a custom in the Somali culture (Gele et al., 2012).

The primary reason I chose female genital mutilation as my topic is because I am interested in women’s health. Attempting to maintain a healthy pregnancy or avoid infections can be difficult especially for women who do not have proper medical services. Since several African countries are identified as underdeveloped, they do not always have access to the appropriate supplies and facilities. In addition to the third world country circumstances, performing female genital mutilation heightens the risk for pregnancy, childbirth, and menstruation problems.

Since this ethical dilemma involves tradition and culture, it would be challenging to minimize because the procedure revolves around a belief. However, healthcare professionals such as nurses play an essential role in educating patients and informing them of the negative effects the operation could potentially cause. Simpson, Robinson, Creighton, and Hodes (2012) explain ways nurses can identify females who are at risk for genital mutilation. For instance, one factor to consider is that the daughters of women who have had their genitalia harmed are in jeopardy. Since their mothers experienced the painful act, there is a chance that the tradition will continue in the family. Therefore, nurses must provide patient education and be aware of individuals who may be at risk (Simpson, Robinson, Creighton, and Hodes, 2012). In addition, for patients who have already undergone the circumcision or cutting should be referred to specialists who can assist them further. For instance, a women’s health nurse practitioner would be a helpful option to guide women who are suffering the short or long term outcomes of the procedure.

The African female population is at high risk for undergoing genital mutilation and circumcision. Although many Muslims worldwide categorize this practice as immoral, there are certain groups of people who recognize it as tradition. This operation is rare in Western civilization, but some immigrants carry on the “sunna”. Therefore, healthcare professionals must understand the consequences of the procedure and be able to identify females who are at risk for participating in this unethical act. Overall, female genital mutilation can be acknowledged as immoral because it portrays gender inequality and poor treatment to a vulnerable group of individuals.

Misbah Shah is a Registered Nurse, who graduated from St. Francis Medical Center School of Nursing in 2016, and is currently a student at The College of New Jersey.

References:

1. Gele, A. A., Kumar, B., Hjelde, K. H., & Sundby, J. (2012). Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study. International Journal of women’s Health, 4, 7.
2. Reisel, D., & Creighton, S. M. (2015). Long term health consequences of Female Genital Mutilation (FGM). Maturitas, 80(1), 48-51.
3. Simpson, J., Robinson, K., Creighton, S. M., & Hodes, D. (2012). Female genital mutilation: the role of health professionals in prevention, assessment, and management. BMJ, 344(e1361).

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.