According to the interest theory of rights, the primary function of rights is the protection of fundamental interests. Since children undeniably have fundamental interests that merit protection, it is perfectly sensible to attribute rights, especially welfare rights, to them. The interest theory need not be hostile to the accommodation of rights that protect agency because, at least in the case of adults, there is a strong connection between the protection of agency and the promotion of welfare. Children have welfare rights (...) similar to those of adults. But children lack the agency rights adults have because children initially lack and only gradually develop the kinds of capacities for agency that are necessary for agency rights. Children's rights to culture, religion, and free expression are ill‐conceived. (shrink)

This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we distinguish (1) between a person-oriented and a body-oriented approach and (2) between four levels of interpretation, i.e. bodily integrity conceived of as a biological wholeness, an experiential wholeness, an intact wholeness, and (...) as an inviolable wholeness. We argue that bodily integrity is a prima facie principle in its own right, closely connected with, but still fundamentally different from, the principle of personal autonomy, that is, autonomy over the body. (shrink)

People in liberal societies tend to feel a little uncomfortable talking about male genital cutting, but generally do not think it is morally abhorrent. But female genital cutting is widely consider...

ABSTRACT In Germany, applied ethics is under attack from a diverse coalition of left‐wing organisations, disability groups, and some conservative defenders of a strict doctrine of the sanctity of human life. The attack has been pressed to the point of forcing the cancellation of conferences and disrupting lectures or classes so that they cannot take place. This essay describes the extent and nature of the attack, and makes a preliminary assessment of its significance.

Circumcision of a male child was recently ruled illegal by a court in Germany on the grounds that it violates the child's rights to bodily integrity and self-determination. This paper begins by challenging the applicability of these rights to the circumcision debate. It argues that, rather than a sweeping appeal to rights, a moral analysis of the practice of circumcision will require a careful examination of the interests of the child. I consider three of these interests in some detail. The (...) first is the interest in avoiding a moderate decrease in expected future sexual pleasure. I argue that even if such a decrease were to occur, it is not wholly unreasonable to think that this might actually be a good thing for the child. Second, I consider the interest in self-determination. I argue that this interest is not as strong as it might appear because the adult's circumcision decision is subject to a variety of biases and a significant lack of information. Finally, I consider the child's interest in avoiding the future costs of adult circumcision. I argue that this interest becomes much stronger in the religious case because the child is quite likely to choose to become circumcised as an adult. The likelihood of the child choosing circumcision in the religious case also reduces the extent to which infant circumcision violates his interest in self-determination. I conclude that male infant circumcision falls within the prerogative of parental decision-making in the secular case and even more clearly so in the religious case. Finally, I distinguish male circumcision from female genital cutting in several important respects and argue that we can coherently hold that male circumcision is permissible without also endorsing all forms of female genital cutting. (shrink)

When is it ethically permissible for clinicians to surgically intervene into the genitals of a legal minor? We distinguish between voluntary and nonvoluntary procedures and focus on nonvoluntary procedures, specifically in prepubescent minors (“children”). We do not address procedures in adolescence or adulthood. With respect to children categorized as female at birth who have no apparent differences of sex development (i.e., non-intersex or “endosex” females) there is a near-universal ethical consensus in the Global North. This consensus holds that clinicians may (...) not perform any nonvoluntary genital cutting or surgery, from “cosmetic” labiaplasty to medicalized ritual “pricking” of the vulva, insofar as the procedure is not strictly necessary to protect the child’s physical health. All other motivations, including possible psychosocial, cultural, subjective-aesthetic, or prophylactic benefits as judged by doctors or parents, are seen as categorically inappropriate grounds for a clinician to proceed with a nonvoluntary genital procedure in this population. We argue that the main ethical reasons capable of supporting this consensus turn not on empirically contestable benefit–risk calculations, but on a fundamental concern to respect the child’s privacy, bodily integrity, developing sexual boundaries, and (future) genital autonomy. We show that these ethical reasons are sound. However, as we argue, they do not only apply to endosex female children, but rather to all children regardless of sex characteristics, including those with intersex traits and endosex males. We conclude, therefore, that as a matter of justice, inclusivity, and gender equality in medical-ethical policy (we do not take a position as to criminal law), clinicians should not be permitted to perform any nonvoluntary genital cutting or surgery in prepubescent minors, irrespective of the latter’s sex traits or gender assignment, unless urgently necessary to protect their physical health. By contrast, we suggest that voluntary surgeries in older individuals might, under certain conditions, permissibly be performed for a wider range of reasons, including reasons of self-identity or psychosocial well-being, in keeping with the circumstances, values, and explicit needs and preferences of the persons so concerned. Note: Because our position is tied to clinicians’ widely accepted role-specific duties as medical practitioners within regulated healthcare systems, we do not consider genital procedures performed outside of a healthcare context (e.g., for religious reasons) or by persons other than licensed healthcare providers working in their professional capacity. (shrink)

The paper questions the view that the alleged lack of autonomy displayed by certain practices and cultural behavior may constitute a sound justification for limiting toleration of those practices. Not only is the concept of autonomy open to endless controversy, but it also entails a conflict with liberal public morality and often nurtures double standards. To this end, the paper first examines the assumptions and basis of the lack-of-autonomy approach; this analysis perforce leads the author to unravel the notion of (...) autonomy and its rival conceptions. Second, it will be argued that liberal and democratic politics, though indebted to the value of personal autonomy in a fashion, requires only a purely political principle of autonomy. It is also contended that if comprehensive notions of autonomy are used instead of a purely political conception, unacceptable consequences for the public morality of liberal democracy may follow. Finally, the point will be illustrated with some examples drawn from multicultural politics. (shrink)

The WHO, American Academy of Pediatrics and other Western medical bodies currently maintain that all medically unnecessary female genital cutting of minors is categorically a human rights violation, while either tolerating or actively endorsing medically unnecessary male genital cutting of minors, especially in the form of penile circumcision. Given that some forms of female genital cutting, such as ritual pricking or nicking of the clitoral hood, are less severe than penile circumcision, yet are often performed within the same families for (...) similar reasons, it may seem that there is an unjust double standard. Against this view, it is sometimes claimed that while female genital cutting has ‘no health benefits’, male genital cutting has at least some. Is that really the case? And if it is the case, can it justify the disparate treatment of children with different sex characteristics when it comes to protecting their genital integrity? I argue that, even if one accepts the health claims that are sometimes raised in this context, they cannot justify such disparate treatment. Rather, children of all sexes and genders have an equal right to bodily autonomy. This includes the right to decide whether their own ‘private’ anatomy should be exposed to surgical risk, much less permanently altered, for reasons they themselves endorse when they are sufficiently mature. (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in the context of measures (...) to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)

Children with innate variations of sex characteristics (also termed differences of sex development or intersex traits) are routinely subjected to medical interventions that aim to make their bodies appear or function more typically female or male. Many such interventions lack clear evidence of benefit, they have been challenged for thirty years, and they are now understood to violate children’s rights to bodily autonomy and bodily integrity. In this paper I argue that these persist in part due to epistemic injustices and (...) biomedical authority. Epistemic injustices include limited disclosure of current practices, the systemic marginalisation of community voices and psychosocial professionals, and attempts to discredit or misrepresent testimony. Bioethics has largely failed to change medical practice, and sometimes plays a role in perpetuating epistemic injustices. I find that the development of an intersex movement provides opportunities for epistemic justice and liberation by engaging with other disciplines and promoting oversight of medical decision-making. The paper draws particularly on Australian sources, including internationally influential ethical principles. (shrink)

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In the history of philosophy, children have been seen as the property of their parents and as beings who must develop into adults. Both views provide some kind of warrant for the exercise of parental authority. There is renewed interest today in the moral and political status of the child. The principal areas of interest are rights, autonomy and education, families, and justice.