Thursday, September 2, 2010

Cultural Relativism

One of my courses this semester is a Biocultural Medical Anthropology course (and my professor actually has a blog all about this topic, if you're interested).

The course consists of Anthropology graduate students and non-Anthropology graduate students. For instance, there are some nursing students who are taking the course to fulfill a requirement, probably something like "health and cultural competency."
 
A couple days ago our class got on a tangent discussion, and we started talking about Cultural Relativism. Cultural Relativism is the idea that a person needs to be viewed in terms of their own culture. You may think something you learn about another culture is weird, or wrong, but you have to realize that culture is all relative, and your ideas or practices may seem just as weird or wrong to someone in an outside culture. It is about accepting cultural traditions, practices, beliefs, and so on as being different but not necessarily wrong, and removing your ethnocentricity.

Unfortunately, this creates many moral problems when you get into an issue that is borderline a human rights issue, for instance the burning of wives on their dead husband's funeral pyre, stoning to death for adultery, or circumcision.

One of the nursing students brought up the issue of female genital mutilation, aka female circumcision.  She asked how one could argue for cultural relativism, in saying that it is OK for a physician in the United States to perform this procedure.

I believe she was referring to a statement issued by the American Academy of Pediatrics in April that many bloggers reacted strongly to. Here are some excerpts from a NYTimes article to give you some background information on the subject:

In a controversial change to a longstanding policy concerning the practice of female circumcision in some African and Asian cultures, the American Academy of Pediatrics is suggesting that American doctors be given permission to perform a ceremonial pinprick or “nick” on girls from these cultures if it would keep their families from sending them overseas for the full circumcision.
“It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm,” the group said.
“If we just told parents, ‘No, this is wrong,’ our concern is they may take their daughters back to their home countries, where the procedure may be more extensive cutting and may even be done without anesthesia, with unsterilized knives or even glass,” she said. “A just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good.” 
Another classmate, an Anthropologist, said that it is a woman's right to go to a physician and asked him/her to perform female circumcision, if that is an aspect of her culture she desires. If she does not get it done in the doctor's office, she may go home and have it done in an un-sterile environment with a razor blade. That may be a requirement of her culture... If she is not circumcised, even a little bit, she may not be able to find a husband, be accepted into the circles of adult women, etc. She would get it done no matter what, and it is preferable that it be a tiny cut by a skilled physician than a huge slice by an unskilled hand.

The nursing student could NOT understand this. She got really mad and started saying "how could a medical doctor in this country allow himself to believe it was OK to mutilate a woman in a way that may cause her to be unable to birth a baby without complications? We read all about how women with female genital mutilation develop fistulas during labor and it's just awful. What would you do if you were the physician, and you knew doing this could cause her to be unable to have a baby later?"
(to read about obstetric fistula, click)

The anthropology student tried to explain what I outlined above, about viewing it from the woman's cultural perspective, how it would be better for the physician to do it for her and have her "sign a form" saying he is not liable for future complications, she asked for it, etc.

Now this whole conversation reminded me of similar issue that you could argue similarly, that no one is shocked enough by (as we are by FGM aka female circumcision).

What about when a pregnant women goes to a doctor and says, "I want you to cut through the tissue and muscle of my abdomen and cut my baby out of me" even if there are ZERO health reasons to do so, and no matter what personal preferential reason the woman gives, and even if cutting through this woman's gut and uterus could cause uterine rupture with her subsequent pregnancies with the risk of hysterectomy (removal of the uterus entirely). Plus a host of other issues, including blood clots, infection, growth of adhesion tissue, bowel obstruction, ongoing pelvic pain, and so on.

Should that physician feel OK about cutting into that woman's gut just because she asked for it? Even though he is causing her a host of health issues and possibly making her unable to have a baby later?

DOCTORS DO THIS EVERY DAY.


And I am sure that there are many people, in cultures other than my own, who would find it morally repugnant to have physicians perform such a procedure, and yet it is done. It is called an elective cesarean section.
Why aren't there MORE outraged people?!


I feel like I have to note that just as I find it awful to perform an elective cesarean section for no health-related reason at all, I also find it awful to perform female circumcision. And I understand the reasons why many in this country and others find male circumcision equally immoral. Just because I understand cultural relativism, doesn't mean I necessarily condone the American Academy of Pediatrics' statement.

Here is a quote from the above-quoted NYTimes article,
“There are countries in the world that allow wife beating, slavery and child abuse, but we don’t allow people to practice those customs in this country. We don’t let people have slavery a little bit because they’re going to do it anyway, or beat their wives a little bit because they’re going to do it anyway.”
The academy’s statement acknowledged that opponents of the procedure, “including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure.” 
Though the nursing student wasn't taking into account that the physician's would only be performing a tiny nick on the clitoris, not even near the vagina (where childbirth issues, such as fistula, would be caused), I do not think it is right to condone even a minimal procedure if we are to attempt to rid the world of all forms of female genital cutting.


By the way, here is the result of the backlash:
(from CNN)

The American Academy of Pediatrics has rescinded a controversial policy statement raising the idea that doctors in some communities should be able to substitute demands for female genital cutting with a harmless clitoral "pricking" procedure.
"We retracted the policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world," said AAP President Judith S. Palfrey.
The contentious policy statement, issued in April, had condemned the practice of female genital cutting overall. But a small portion of statement suggesting the pricking procedure riled U.S. advocacy groups and survivors of female genital cutting.

6 comments:

  1. I think adults should be able to consent to modify their bodies however they choose. The issue lies in infants and young children being cut without consent or because they are pressured into it.

    ~Huntress

    ReplyDelete
  2. So this is a major medical ethics issue. The FIRST, BASIC principle of medical ethics, the first big part of the Hippocratic Oath is "First, do no harm." Non-malificence. You are NOT supposed to ever do something that will cause harm to the patient. Of course, this becomes complicated because nothing is black and white. In the case of genital cutting, if the alternative is full mutilation in the home country, then the doctor is doing more good than harm. But I agree with the nursing student. I don't like the idea of moral relativism at all, actually. I think there are absolutes. Like, no murdering, beating, adultery, etc. etc. No matter what culture you're from.

    ReplyDelete
  3. btw, I totally think your blog can have a "debate" if it actually emailed ppl when others responded to their comments! That's the only reason Facebook has been more successful :)

    ReplyDelete
  4. It is important to not that Cultural relativism is not the same as Moral relativism. I am a big fan of Cultural relativism. I also agree that there shouldn't be murder, beating, etc no matter what culture you're from.

    Good point, Huntress, its true that the issue mainly lies in infants and children being unable to make choices about modifications to their own bodies. But this can get tough - what if the modification did not have any adverse, medically-related effects? Like, the children were just "marked," like an ear piercing, or nose piercing? Is this acceptable?

    Ren - it does email you comments if sign in to a Google account when you comment.

    ReplyDelete
  5. ohhhh yeah well i dont wanna do that :)

    ReplyDelete
  6. @Emily, Anthro Doula: I don't agree with piercing infants either- however, if the jewelry is removed, the hole will heal. This is not the case with circumcision. It's the removal of healthy tissue... it doesn't grow back. (I've actually heard people argue that circ is like hair cutting or fingernail clipping! ~groan~)

    ~Huntress

    ReplyDelete

Related Posts Plugin for WordPress, Blogger...