The Hippocratic Oath And Genital Mutilation

Hands up everyone who knows what the Hippocratic Oath is. My bet is that most of you have at least a vague idea it has something to do with a code of conduct for doctors. That it implies they will put the good of the patient before all other considerations is probably the most widely understood meaning of the oath.

It was written down by Hippocrates, or maybe one of his students, in the 4th century B.C. and, aside from the prayer to Apollo that opens the oath and some modernizations to accommodate our changed world, it’s still a pretty darn good set of guidelines: I won’t give my patients medicines that will harm them; I won’t do any procedure that I’m not capable of; and I will never do harm to anyone. These are all things we’d like to think our own doctor would adhere to.

Of course, you have to wonder these days the way some doctors run their practices if they’ve ever heard of that Oath or any one of the modern variations that they now have doctors recite — especially the part about medicines that will cause people harm. How many class action lawsuits are going on right now because of prescription drugs that caused severe complications for patients?

Sure, some of them are the fault of the pharmaceutical companies and the regulating agencies rushing some wonder drug onto the market without giving it proper testing. But there are also the instances, far more common than you’d think, of doctors not bothering to check a patient’s medical history to find out if they have high blood pressure and if the medication they’ve just prescribed isn’t supposed to be taken under those circumstances.

Then there are the doctors who look at their patients in terms of how much money they’re worth and how much work they involve. The ideal patient for this type of doctor is the one who won’t take up much of their time, but needs to see them on a regular basis so billable hours can be increased.

There have been cases reported in Canada where doctors are refusing to take on clients who are elderly or who will require extensive amounts of treatment, while not allowing the doctor to charge extra billable hours — so much for treating anyone in need.

But at least that’s only a case of neglect and not a case of subjecting a patient to unnecessary and harmful treatments like those that have been discovered in countries that still practice ritual female genital mutilation. The World Health Organization (W.H.O.) has released a report that reveals more and more doctors in developing countries are participating in these procedures.

While calling for the procedure to be stamped out as soon as possible, the W.H.O. reserved some of their harshest language for trained medical people participating in what they refer to as the torture of innocent victims. While conceding it may be helping to cut down on the risk of AIDS by the fact that clean instruments are being used, they liken it to using a clean knife to kill someone.

Three million girls under the age of ten are subjected to this procedure every year, which involves the cutting away of parts of the clitoris in an attempt to dampen their sexual appetites and increase their value as a wife. Lest we be in any rush to point the finger at any particular faith, it seems to be done equally amongst Muslims and Christians — yet another way in which the two faiths seem to agree on the place of women in society.

So what’s the big deal about doctors taking part, you may be asking? If it’s going to happen, shouldn’t it at least be done safely? Putting aside the simple morality of condoning torture by being present, the long-term health issues of the procedure should be enough to prevent any doctor from participating in the operation.

Depending on the severity of the mutilation, the risk of hemorrhaging during childbirth increases by 70% and the neo-natal death rate by as much as 55% compared to women who have not been tortured. In countries where the infant mortality rate is already high, you would think doctors and other health care professionals would be mindful of such results, wouldn’t you?

If a doctor were making the spurious claim of participating because he has the patient’s best interest at heart, then I would ask him wouldn’t the patient’s best interest be for the procedure not to take place at all? Wouldn’t you, as a respected medical professional, better serve your patient by explaining to those who want the procedure performed (most likely the father of the child) that they are actually decreasing the woman’s chances of coming to term safely?

People who would have this procedure done to their daughters, with the purpose of making them more attractive as wives, might think twice about it if they knew their daughters might not be able to fulfill their sacred duty of dropping babies that live after having their genitalia mutilated. When dealing with stock, you always want to make sure it breeds effectively; otherwise, it might affect the sale price, or dowry as the case maybe.

Any doctor having anything else to do with these procedures, aside from fighting against them as barbaric and claiming to be doing it for the good of the patient is, in my mind, akin to somebody saying they assisted at a death camp because they wanted to make sure the Jews got the fairest treatment possible. There is no excuse that can validate the action.

I’ve not always agreed with W.H.O. and their classifications of disease and ideas on treatment. But on this issue, they are right on the money. The practice of genital mutilation has no place in our world and any doctor who takes part in that disgustingness deserves nothing but our condemnation.

By lending the authority of their profession to the practice, they are giving an air of legitimacy to a barbarism that should have been outlawed years ago. This will only be stopped by isolating and ostracizing this behaviour. Seeking to make it more palatable only encourages its continuance.

Any doctor who willingly participates in one of these procedures needs to re-read his Hippocrates, at least the bit about not doing harm.