Citation

Cranfield R, Cranfield E. Practitioner 1983; 227(1379): 816-817.

Copyright

(Copyright © 1983, Morgan Grampian Publishers)

DOI

unavailable

PMID

6889246

Abstract

The question that arises is whether assault is sometimes committed in the guise of quasi medical operations whose desirability is as yet unchallenged in the courts. Female circumcision is a procedure that raises this question. In the UK legal system assault has been defined as "any hurt or injury calculated to interfere with the health or comfort of the prosecutor." The degree of hurt can be relatively minor and has been held to include a hysterical or nervous condition resulting from the act complained of. The law insists that some acts remain assaults in the eyes of the law, despite the fact that the victim has consented to their being carried out. Recently there has been a restatement of the circumstances in which the courts will permit consent to render lawful what could otherwise constitute an assault. For example, injuries sustained in dangerous exhibitions such as knife throwing will not be unlawful. Then, too, it is considered in the public interest to allow some acts of harm, e.g., parents and teachers may practice lawful chastisement on children without being guilty of an assault. Yet, if the injury is unreasonable they may lose this protection. The most relevant area for physicians is that of "unreasonable surgical interference," where it is clearly in the public interest that certain necessary procedures should be carried out without giving rise to liability for assault, i.e., if the patient has consented. The consent must be acceptable to the courts, must have been given freely and after a comprehensive explanation of the contemplated procedure. If these requriements are not satifsifed, the courts may disregard the consent. In a few exceptional cases the courts as well as the doctors will become involved in determining whether a procedure is desirable. What is acceptable depends on the state of knowledge and existing values at the time. In regard to female circumcision, it is difficult to think of arguments in favor of the practice. Although circumcision of the male is an accepted procedure on grounds of religion and medical grounds, neither of these apply to the female. The operation apparently involves the removal of the clitoris and additional areas of the foreparts of the labia, leaving behind raw areas which are stitched together. This painful procedure, which is known in many instances to have led to longterm difficulties in sexual relationships and childbirth, is now being studied by the UN Human Rights Body. This is clearly a procedure that should be ruled to be unlawful, and the consent of the woman should not be allowed to defend it. The current concern with upholding the traditions of ethnic groups should not overrule the humanitarian considerations.

Language: en