Female genital mutilation is awful

The question “when should doctors perform female genital mutilation?” sounds as if female genital mutilation (FGM) is a normal procedure that doctors do every day in their practice. In fact, it is an awful traditional procedure that is nowadays considered a crime in many countries. In this world of multidisciplinary communities, however, it is more likely for doctors to come into contact with girls who are at risk.1

Most parents seeking this procedure for their daughters believe that they are making the right decision for the sake of their child. Based on traditional, social, or mistaken religious beliefs, the parent seeks the doctor's help to perform this procedure simply to ensure that it is done properly. The parent might ask the doctor to do the procedure and, in order to minimise pain, use anaesthesia, or because they believe that it is the doctor's job to do this type of operation. The parents reaching this stage are at a borderline between sticking to their traditions and caring for their child.

This makes it easier for the doctor because he or she can apologise for not performing FGM on the grounds that it is a harmful and criminal act. Besides, doctors are advised to talk with the parents, describe the complications of FGM, clear up the misunderstandings about the operation, and advise them not to do it for the sake of their child. The doctor in such a case might contact a community group, organisation, or the government authorities to seek help and prevention. In these circumstances FGM is very rarely performed.

But life is not always that simple. Sometimes the doctors might face the same situation in different settings and communities where FGM is widely performed, with no legislation prohibiting it. The doctor might be spending an elective, working for an international agency, or be the local practitioner.

What if the doctor knows that a girl is going to be mutilated but his or her view is at odds with the view held by her parents? Should the doctor just ignore the whole situation? Or should he or she ask the parents to perform the mutilation, in order to prevent the hazardous complications that would happen if it were to be done by other people?

The doctor in this dilemma has two difficult options—to mutilate or not. If it appears that the procedure will be done anyway, with or without medical input, the doctor might decide to prevent the severe pain, shock, infections, injury to the adjacent tissues and the rest of the complications of FGM by doing the procedure him or herself. In this case, the doctor is actually committing a crime, even though it is done on a noble basis. On the other hand, being informed and not taking any action to prevent the girl undergoing FGM, means that the doctor is abetting a crime.

Personally, I don't know what I would do in such a situation. I think the decision depends on the personal judgement and experience of the doctor, and the specific circumstances of the situation. There is no hard and fast rule; it is up to the doctor's good sense. I think it would be a hard decision to take, especially when you're committing a crime either way.