Friday, May 7, 2010



Please write these AAP members today! use this letter if you need to. All addresses I sent to are below. You don't have to cc everyone I did....

Via email and USPS
Dena S. Davis, JD
All AAP Bioethics Committee members (present, 06-07, Liaisons)

Re: Your Recent FGC Statement

Dear Sirs and Mesdames:

You should have recently received my letter dated February 9, 2010, cc'd to you that I sent to the Circumcision Task Force in regard to the pending statement on infant circumcision. (enclosed) I have read your recent Policy Statement on the Ritual Genital Cutting of Female Minors and feel the need to write again.

It is no secret that this country views the amputation or cutting of infant and child genitals in two very different ways depending on whether the infant or child is male or female. It is quite unfortunate that this manifests in a difference in the way we protect the rights of children legally, and socially. I fully expect a “medical ethics committee” such as yours to ignore common acceptance of cultural habit, and encourage the highest form of ethics when it comes to the conduct of medical professionals and the services they provide. You have failed us all in this respect.

It appears for several reasons that rather than commenting on the boundaries of medical ethics, you have appointed yourselves guides for cultural practices, and are attempting to influence the growing debate over equal rights because of personal bias, or financial interest.

First, there is no reason for you to use softer language (“cutting” vs. “mutilation”) in general with the pediatricians in this country. You could have simply recommended this change in language be used by the small percentage of physicians who have actual dealings with families who are seeking FGM, rather than trying to soften everyone’s perception of this practice.

Next, you fail to mention in your description of motivations for FGM ANY belief of medical benefit. It’s interesting that even though you are addressing medical professionals that you should fail to mention this common relevant motivation. People who practice FGM are just as convinced that it is medically beneficial as those are who practice MGM (Male Genital Mutilation), as any FGM abolitionist can tell you. Physicians ought to be prepared to respond to this argument if they are truly expected by you to dissuade families from the practice. Omitting this motivation conveniently avoids recognition of the obvious similarity of attempted medical justification of MGM.

While you do mention that physicians may need to address our country’s double standard, I notice that you do not have an actual justification to offer.

The most grievous diversion from your capacity as “medical ethicists” is the arguments made in favor of physicians carrying out a cultural ritual that not only serves no medical purpose, but is a painful breach of human rights, and our law.

Whether or not such involvement of a pediatrician in this ritual would dissuade other mutilations of that child, or others by influence, is simply conjecture, and is quite debatable. The one thing it is guaranteed to do, however, is legitimize the practice.

The only proper response to any request for the genital mutilation or simple cutting of a child’s genitals is one already made by the Committee on Bioethics of 93-94 in the policy on Informed Consent. No doubt this statement was made without the hindrance of taking our own familiarity with genital mutilation into consideration.

"…providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. … the pediatrician’s responsibilities to his or her patient exist independent of parental desires or proxy consent."

Further, your re-classifying of some forms of FGM as non harmful based on our cultural acceptance of a more harmful practice is a failure of logic and is an inappropriate manipulation of perspective. “Harm” is an opinion that can only be decided by the individual, and it is NOT your place to decide that a painful, non-medically indicated cut is not harmful, especially when performed upon a non-assenting patient. No other such cutting is acceptable for a physician.

I expected you to heed my warnings before about the discrepancies between the genital autonomy rights of men and women, but not by attempting to legitimize the abuse of female infants or children! We are reaching a point where these discrepancies are becoming obvious and publicized. As medical ethicists that speak to a changing nation, I suggest you take a lesson from the Bioethics Committee of 93-94 and keep your political agenda, personal preference for altered genitals, or the potential income from those unnecessary procedures out of your evaluations. It would also be a shame to see you change the policy quoted above to corroborate those inappropriate motivations, as you have with the recent FGM policy.

Finally, if there are any who want to remove their name from this policy, or who want to publicly speak against it, please know that you have a lot of support.

Sincerelly hoping you will do the right thing,&Global Ambassador for fighting Female genital mutilation and standing up for women rights.Lucy Mashua FGM SURVIVOR
Social Activist
cc with enclosure:
AAP Board of Directors Executive Committee
AAP Bioethics Committee of 93-94
William J. Clinton Foundation
To be placed in video form at


“Consultant” and lead author of FGC Statement
Dena S. Davis, JD, PhD
Case Western Reserve University
Department of Bioethics
Cleveland, Ohio 44106

AAP Bioethics committee 2010:

*Mary E Fallat, MD –
University Pediatric Surgery
234 E Gray St Ste 210
Louisville, KY 40202-3702

*Ian Ronald Holzman MD FAAP
1 Gustave L Levy Place
New York, NY, 10029

Kathryn Louise Weise MD FAAP
Cleveland Clinic Main Campus
Mail Code S10A
9500 Euclid Avenue
Cleveland, OH 44195

*Armand H. Matheny Antommaria MD
Department of Pediatrics
Primary Children's Medical Center
100 North Medical Drive
Salt Lake City, UT 84113

*Sally Webb, MD
Pediatric Critical Care
MUSC Rutledge Tower
135 Rutledge Ave
Charleston South Carolina 29403

Aviva L. Katz, MD
Children's North Medical Center
2599 Wexford Bayne Road
Sewickley, PA 15143

AAP Bioethics committee 2006-2007 (this is the group credited for the current FGC Statement - and starred members above)

Douglas S. Diekema, M.D.
Department of Emergency Services
Children's Hospital & Medical Center
4800 Sand Point Way NE
Seattle, WA 98105

Steven R. Leuthner, MD
Pain and Palliative Care Center
9000 West Wisconsin Avenue Suite 640
Milwaukee, WI 53226

*Lainie F. Ross, MD
Comer Children's Hospital
University of Chicago
5721 S. Maryland Avenue
Chicago, IL 60637

Liaisons 2010

*Philip L. Baese, MD
Neuro Behavioral Home Program
650 Komas Drive, Suite 200
Salt Lake City, UT, 84108

Steven J Ralston, MD (ACOG)
Tufts New England Medical Center
800 Washington St.
Department of Neonatology
Boston, MA 02111

*Ellen Tsai, MD (Canadian Paediatric Society)
Kingston General Hospital
76 Stuart Street
Kingston, Ontario K7L 2V7

Jessica Wilen Berg, JD (Legal Consultant)
Case Western Reserve University
Department of Bioethics
Cleveland, Ohio 44106

Liaisons 06-07

Jeffrey L. Ecker, MD (ACOG)
Vincent Obstetrics
55 Fruit Street, Suite 4F
Boston, MA, 02114

Marcia Levetown, MD (American board of Pediatrics)
Healthcare Communication Associates .com

cc addresses :
AAP Board of Directors Executive Committee

Errol Alden, M.D.
American Academy of Pediatrics
141 Northwest point Blvd.
Elk Grove, IL 60007

David T. Tayloe, M.D.
Goldsboro Pediatrics
2706 Medical Office Place
Goldsboro, NC 27534

Judith S. Palfrey, M.D.
President-Elect, AAP
Children's Hospital Boston
300 Longwood Avenue
Hunnewell 201.3
Boston, MA 02115

O. Marion Burton, MD (President – Elect AAP)
South Carolina School of Medicine
Department of Pediatrics
Colombia, SC 29208

Committee on Bioethics, 1993 To 1994

Arthur Kohrman, MD, Chair

Ellen Wright Clayton, MD
Vanderbilt University School of Medicine
Division of General Pediatrics
2200 Children's Way
8232 Doctors' Office Tower
Nashville, TN 37232-9225

Joel E. Frader, MD
Children’s Memorial Hospital
2300 Children's Plaza,
707 W. Fullerton Ave.
Chicago, IL 60614-3363

Michael A. Grodin, MD
Boston University School of Public Health
715 Albany Street
Talbot T358W
Boston, MA 02118

Kathryn L. Moseley, MD
Livonia Health Center
20321 Farmington Road
Livonia, MI 48152-HCA

Ian H. Porter, MD
Albany Medical Center
Department of Pediatrics - A88
47 New Scotland Avenue
Albany, NY 12208

Virginia M. Wagner, MD
Children's Hospital of Wisconsin
9000 W Wisconsin Ave
Milwaukee, Wisconsin 53226

The man responsible (so to speak) for the passing of the FGM ban in '97
William J. Clinton
c/o William J. Clinton Foundation
55 West 125th Street
New York, NY 10027

Human beings live by symbols; therefore, any attack on a girl's
> genitals
> derives its meaning from a symbolic system that anchors her
> inequality.
> "Cultural sensitivity" is no less than acquiescence in the power
> imbalance
> that permitted such a harmful practice to arise in the first place,
> and, due
> to unbroken patriarchal power, to continue.!!
> Knowing that the AAP also subscribes to ideals of "universality,
> indivisibility and inalienability of human rights as confirmed by
> the UN
> declaration in 1993 at the Vienna human rights conference," we are
> confident
> that you will retract your endorsement of FGM Type IV and restore
> AAP's
> position as a champion of human, and in particular, girls' rights.

Ambassador Lucy .s .Mashua President of Mashua's voice for the voiceless International
Assisting refugees in the US and representation in advocasy
The Global Ambassador for fighting Female Genital Mutilation (FGM) and standing up for Women’s Rights.
And the Chairperson of a worldwide campaign against FGM.