5. Intersex Rights: Ethical issues to do with sex assignment and surgery III
- Created by: Alasdair
- Created on: 09-12-17 15:48
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- 5. Intersex Rights: Ethical issues to do with sex assignment and surgery III
- Feinberg on the right to an 'open future'
- Joel Feinberg, 'The Child's Right to an Open Future'
- Children have a 'right to an open future'. This is a kind of 'right-in-trust'
- An adult has a right to religious freedom
- A child has a right to an open future with respect to religion
- i.e. a right to be treated in ways that mean they can freely choose and practice a religion once they are old enough to be capable of doing so
- This is why religious indoctrination of children is wrong
- When rights conflict
- Sometimes a child's right to an open future will conflict with a parent's rights to, for example, practice religion
- Example:
- Amish parents wanting to withdraw children from schools very early and teach them only traditional skills
- 'An education that renders a child fit for only one way of life forecloses irrevocably [their] other options.' (Feinberg)
- So children of Amish parents should be educated more broadly, against their parents' wishes
- The open future and surgery
- Feinberg's idea of a child's right to an open future seems to suggest that genital surgery should not be performed on infants even if parents want it to
- The child's right to an open future limits the parent's actions
- But there might be another way to apply idea of a right to an open future
- Quote from Caplan-Bricker (2017)
- ' ’Some
of the parents I interviewed argued that surgery was the
best way to leave the future open.
- “It’s something that, as a parent, you have to kind of war with and say, ‘Do I leave my child with the burden of being different when it can be adjusted to be less different?’ ”
- one father of a teenager with CAH told me. “To me, that kind of surgery, in its best case, allows the greatest amount of choice.”
- He
has presented his daughter with the option to meet other kids with CAH, he
says, but she hasn’t wanted to.
- “She doesn’t want to identify with CAH. She has CAH, but she’s not holding a banner out for it; she’s holding a banner out for other things.”’
- He
has presented his daughter with the option to meet other kids with CAH, he
says, but she hasn’t wanted to.
- one father of a teenager with CAH told me. “To me, that kind of surgery, in its best case, allows the greatest amount of choice.”
- “It’s something that, as a parent, you have to kind of war with and say, ‘Do I leave my child with the burden of being different when it can be adjusted to be less different?’ ”
- ' ’Some
of the parents I interviewed argued that surgery was the
best way to leave the future open.
- Quote from Caplan-Bricker (2017)
- Dreger
- Human rights
- Alice Dormut Dreger, 'Intersex and Human Rights: The Long View'
- Intersex as a human rights issue
- Medical intervention should be guided be an approach of 'first do no harm'
- This means it is impermissible to perform surgery
- Doctors should not do it even if parents ask
- This means it is impermissible to perform surgery
- ‘[I]ntersex is
about being a human being, and… therefore ethical analyses of intersex should
focus on what it means to treat the patient as a full-fledged member of the
human race. '
- What
it means to do well in a case of intersex is to end up with a person who feels
she or he was treated as fully human – as humanely as the next person.
- If you wouldn’t slice into the genitals of a non-intersex child because her parents wanted it… then you ought not to do it to an intersex child.’
- What
it means to do well in a case of intersex is to end up with a person who feels
she or he was treated as fully human – as humanely as the next person.
- Complication
- We do routinely slice into the genitals of non-intersex children simply because their parents want it
- Circumcision of male children for non-medical reasons (e.g. religious or cultural reasons)
- But Dreger can simply say that this is also wrong
- Circumcision of male children for non-medical reasons (e.g. religious or cultural reasons)
- We do routinely slice into the genitals of non-intersex children simply because their parents want it
- Human rights
- Rights as constraints on choice
- Both an open future perspective suggest that surgery should not be performed, but for different reasons:
- Open future
- Respect for the child's autonomy
- Human rights
- Respect for the child's equality
- Open future
- In both cases, the idea is the relevant right(s) 'trumps' considerations of welfare
- Even if parents did have good reason to think that surgery would be best for the child's welfare, they would still not be permitted to choose to have it performed
- Both an open future perspective suggest that surgery should not be performed, but for different reasons:
- Feinberg on the right to an 'open future'
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