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Open Access Debate

Female genital cutting (FGC) and the ethics of care: community engagement and cultural sensitivity at the interface of migration experiences

Bilkis Vissandjée12*, Shereen Denetto3, Paula Migliardi4 and Jodi Proctor5

Author Affiliations

1 Faculty of Nursing, Université de Montréal, PO Box 6128, Station Centre-Ville-Montréal, QC H3C 3J7, Canada

2 SHERPA Research Centre and The Research Institute of Public Health at the Université de Montréal, Montréal, Canada

3 Immigrant and Refugee Community Organization of Manitoba (IRCOM), 95 Ellen Street, Winnipeg, Manitoba R3A 1S8, Canada

4 Sexuality Education Resource Centre (SERC) Manitoba, 200- 226 Osborne Street, North Winnipeg, Manitoba R3C 1V4, Canada

5 School of Social Work, McGill University, 845 Sherbrooke Street West, Montreal QC H3A 0G4, Canada

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BMC International Health and Human Rights 2014, 14:13  doi:10.1186/1472-698X-14-13

Published: 24 April 2014

Abstract

Background

Female Genital Cutting (FGC) anchored in a complex socio-cultural context becomes significant at the interface of access of health and social services in host countries. The practice of FGC at times, understood as a form of gender-based violence, may result in unjustifiable consequences among girls and women; yet, these practices are culturally engrained traditions with complex meanings calling for ethically and culturally sensitive health and social service provision. Intents and meanings of FGC practice need to be well understood before before any policies that criminalize and condemn are derived and implemented.

FGC is addressed as a global public health issue with complex legal and ethical dimensions which impacts ability to access services, far beyond gender sensitivity. The ethics of terminology are addressed, building on the sustained controversial debate in regards to the delicate issue of conceptualization. An overview of international policies is provided, identifying the current trend of condemnation of FGC practices. Socio-cultural and ethical challenges are discussed in light of selected findings from a community-based research project. The illustrative examples provided focus on Western countries, with a specific emphasis on Canada.

Discussion

The examples provided converge with the literature confirming the utmost necessity to engage with the FGC practicing communities allowing for ethically sensitive strategies, reduction of harm in relation to systems of care, and prevention of the risk of systematic gendered stigmatization. A culturally competent, gender and ethically sensitive approach is argued for to ensure the provision of quality ethical care for migrant families in host countries. We argue that socio-cultural determinants such as ethnicity, migration, sex and gender need to be accounted for as integral to the social construction of FGC.

Summary

Working partnerships between the public health sector and community based organisations with a true involvement of women and men from practicing communities will allow for more sensitive and congruent clinical guidelines. In order to honour the fundamental principles and values of medical ethics, such as compassion, beneficence, non-malfeasance, respect, and justice and accountability, socio-cultural interactions at the interface of health and migration will continue to require proper attention. It entails a commitment to recognise the intrinsic value and dignity of girls’ and women’s context.

Keywords:
Female genital cutting; Female genital mutilation; Traditional practices; Migration; Public health; Ethics; Harm reduction; Community engagement; Cultural sensitivity