22,263
edits
Changes
Jump to navigation
Jump to search
m
replace <coauthors> parameter
| accessdate=2011-09-27
}}</ref><ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=The authors suggested that a “ritual nick,” in which the clitoral skin is pricked or incised, might satisfy these symbolic requirements, and “is no more of an alteration than ear piercing”. | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> the reasoning being that female circumcision had symbolic or ceremonial aspects for many parents,<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=...female circumcision had symbolic or ceremonial aspects. | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> and offering a "ritual nick" might dissuade parents that were resolute, from sending their daughters to their home countries,<ref>{{REFnews
| last=Luscombe
| accessdate=2011-09-27
}}</ref> The AAP had deviated from a much more forceful statement published in 1998, which unequivocally condemned FGC in any form.<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=...the AAP revised a much more forceful statement published in 1998, which unequivocally condemned FGC in any form. | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref>
The AAP's endorsement of a "ritual nick" sparked a backlash<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=The American Academy of Pediatrics (AAP) sparked a backlash... | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> which was swift and universally negative. The AAP's recommendation had been perceived by many as a tacit endorsement of the "ritual nick," and an effort to appease parents who threatened to subject their daughters to worse procedures.<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=...was interpreted by many as a tacit endorsement of the ritual nick... | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> In short, the AAP was forced to retract its endorsement, and on May 1, Judith Palfrey, President of the AAP, released a statement that read in part, “the AAP does not endorse the practice of offering a ‘clitoral nick’. This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members”.<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=On May 1, Judith Palfrey, President of the AAP, released a statement... | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> Palfrey reiterated this stance in an interview with The Lancet, saying “we want to make it clear to the international community we are opposed to any form of female genital cutting, and that includes the ritual nick.”<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=we want to make it clear to the international community we are opposed to any form of female genital cutting, and that includes the ritual nick. | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref> The AAP has since withdrawn the committee's report and is re-writing it completely.
<ref>{{REFjournal
| last=MacReady | first=Norra | coauthors= | date=2010-07-03 | title=AAP retracts statement on controversial procedure | journal=The Lancet | volume=376 | issue=9734 | pages=15 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext | quote=The AAP has since withdrawn the committee's report and has rewritten it completely. | DOI=10.1016/S0140-6736(10)61042-2 | accessdate=2011-09-27
}}</ref>
}}
:The above sentence cited <u>Caring for Gravely Ill Children</u><refname="Fleischmann 1994">{{REFjournal | last=Fleischman AL, |first=A.L. |last2=Nolan |first2=K, . |last3=Dubler NN, et al. | firstfirst3=N..N. | coauthorsetal=yes | date=1994 | title=Caring for gravely ill children | journal=Pediatrics | volume= | issue= | pages=7 | url=http://pediatrics.aappublications.org/content/94/4/433 | quote= | accessdate=2011-10-09
}}</ref> as its source. While this document focuses primarily on sick children and not infants, it does go into much detail on the ethics surrounding autonomy and consent, particularly with respect to patient-centered vs. parent-centered medicine. That document says the following, which the AAP's "hands-off" position on circumcision might contradict:
}}
The AAP has no official position on whether a baby can refuse a procedure, nor does it specify if crying in pain counts as reluctance or refusal. However, they do write that a patient's discomfort should be taken into account, and that children should have the necessity of a procedure communicated to them.<ref>{{REFjournal | last=Fleischman AL, Nolan K, Dubler NN, et al. | first= | coauthors= | datename="Fleischmann 1994 | title=Caring for gravely ill children | journal=Pediatrics | volume= | issue= | pages=7 | url=http://pediatrics.aappublications.org/content/94/4/433 | quote= | accessdate=2011-10-09}}<"/ref> (It might follow that inability to do so means that proceeding with an intervention that could be harmlessly deferred constitutes needless violation of autonomy, or inadequate consent):
{{Citation
| Text=Although very young children may be unable to envision the future benefits of treatment that may justify its associated burdens (eg, pain, discomfort, and hospitalization), their perceptions of those burdens should not be ignored. [...] Regardless of the child's level of participation in planning care, he or she should be given as much control over the actual treatment as possible.