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A New Ethical Model for the Analysis of Care for Refugee Women Who Experience Female Genital Cutting Sharon R

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A New Ethical Model for the Analysis of Care for Refugee Women Who Experience Female Genital Cutting Sharon R Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Fall 1-1-2015 A New Ethical Model for The Analysis of Care for Refugee Women Who Experience Female Genital Cutting Sharon R. Higginbothan Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Higginbothan, S. (2015). A New Ethical Model for The Analysis of Care for Refugee Women Who Experience Female Genital Cutting (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/80 This Worldwide Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. A NEW ETHICAL MODEL FOR THE ANALYSIS OF CARE FOR REFUGEE WOMEN WHO EXPERIENCE FEMALE GENITAL CUTTING A Dissertation Submitted to the Center for Healthcare Ethics McAnulty College and Graduate School for Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Sharon R. Higginbothan December 2015 Copyright by Sharon R. Higginbothan 2015 A NEW ETHICAL MODEL FOR THE ANALYSIS OF CARE FOR REFUGEE WOMEN WHO EXPERIENCE FEMALE GENITAL CUTTING By Sharon R. Higginbothan Approved December 10, 2015 ________________________________ ________________________________ Dr. Henk ten Have, M.D., Ph.D. Gerald Magill, Ph.D. Center for Healthcare Ethics Professor of Healthcare Ethics Professor of Healthcare Ethics The Vernon F. Gallagher Chair of the (Dissertation Director) Integration of Science, Theology, Philosophy, and Law (Committee Member) ________________________________ ________________________________ Aaron L. Mackler, Ph.D. James Swindal, Ph.D. Associate Professor Dean, McAnulty College and Graduate Department of Theology School of Liberal Arts (Committee Member) (Committee Member) ________________________________ Dr. Henk ten Have, M.D., Ph.D. Director, Center for Healthcare Ethics Professor of Healthcare Ethics (Director) iii ABSTRACT A NEW MODEL FOR THE ETHICAL ANALYSIS OF CARE FOR REFUGEE WOMEN WHO EXPERIENCE FEMALE GENITAL CUTTING By Sharon R. Higginbothan December 2015 Dissertation supervised by Dr. Henk ten Have, M.D., Ph.D. The United States is rapidly becoming a location for refugee women who are migrating from countries that embrace different and distinctive practices. One such practice is Female Genital Cutting/ mutilation (FGC/m). FGC is a medical procedure that alters the natural structure and functioning of the female body. It is also a cultural tradition and custom. Until recently, worldwide studies estimated that approximately 80 to 140 million women have undergone FGC and that 228,000 of those women live in the U.S. However, the estimate of women and girls in the U.S. living with or at risk from FGC has grown from an estimated 228,000 to 513,000. Globally, FGC has raised justifiable concerns, particularly when the procedure is performed without consent. As female refugees migrate from FGC/m communities to a non- FGC/m reality, women not only bring their customs, beliefs, and values – they bring their health iv care needs. FGC is associated with alleged health consequences. A major challenge, then, for health care in the U.S. is how to provide care for this group of women whose native ethos is countercultural to the practices in the United States. When exploring FGC through a medical lens, FGC is considered an immoral practice that will result in harm and the need for healthcare. Conversely, however, when FGC is observed through the lens of respect for cultural diversity, it is not merely a negative construct, rather, it is a traditional cultural practice embraced by women who choose. The right for individuals to participate in their culture is a human right. Since FGC is a surgical intervention, care is needed for women who choose. FGC is relatively novel and unfamiliar in the United States. In that way, to provide care is realized through the Georgetown and the Global bioethics frameworks from which FGC is ethically examined. An investigation through the lens of FGC garners what is needed to construct a specific model of care. Therefore, the title of this dissertation was changed from “Female Genital Cutting: What Should Care Be For Refugee Women Experiencing Female Genital Cutting,” to “A New Model for the Ethical Analysis of Care for Women Who Experience Female Genital Cutting.” v DEDICATION This dissertation is dedicated to my daughter, and to women globally who embrace a diversity of rich cultures in which they have the right to participate and practice. vi ACKNOWLEDGEMENT My deep and heartfelt gratitude to Professor Henk ten Have, the director of my dissertation, and director of the Center for healthcare ethics. Professor ten Have introduced me to global bioethics in which I found an academic home. I am thankful for his remarkable expertise, invaluable critique and who encouraged me not only in the persistent of excellence but in engaging me in the fullness and weight of my topic. I am deeply appreciative and grateful to Professor Gerald Magill, Professor of Health Care Ethics and The Vernon F. Gallagher Chair for the Integration of Science, Theology, Philosophy and Law. Professor Magill set me on a robustly stimulating and engaging academic course in the field of health care ethics. Professor Magill inspired and influenced my further exploration of the ethics of care and mentored me in the pursuit of excellence. I also extend my thanks to Professor Aaron Leonard Mackler, associate professor of theology and healthcare ethics. Professor Mackler’s expertise in Jewish Law and Bioethics influenced the integration of my own theological training into the study of health care ethic and the ethics of care. My gratitude to Glory Smith, administrator and academic adviser at the Center for Health Care Ethics for her encouragement and whose lived mission to serve her students provided strength when I needed it most. To my mother whose love, and wisdom empowered me for one of hardest, grueling, most engaging and rewarding labor’s of love ever, my sisters, for your love, and prayers, and my daughter whose love, sacrifice, and care sustained me. To my inner soul circle, for their emotional and spiritual support never waivered, and didn’t let me quit. I am very grateful to my vii expert editor Sarah for her relentless editing and who supported the subject matter in ways that continued to inspire me to be a voice for women globally. And to my staff who helped me to balance through the power of laughter. viii TABLE OF CONTENTS Page Abstract .............................................................................................................................. iv Dedication .......................................................................................................................... vi Acknowledgement ............................................................................................................ vii Chapter One: Introduction: ..................................................................................................1 I. Understanding Female Genital Cutting .............................................................1 II. Historical Background and Overview of FGC...................................................2 A. Prevalence of FGC .......................................................................................8 B. Reasons and Justifications ...........................................................................9 C. Health Consequences Attributed to FGC ...................................................12 D. Efforts to Eradicate ....................................................................................14 III. Globalization and FGC in the U.S. .................................................................16 IV. Moral Status .....................................................................................................18 Chapter Two: Refugee Women, FGC and Care ................................................................23 I. Constructing the Concept of ‘Refugee.’ ..........................................................24 A. Types of Displacement ..............................................................................25 i. Internal Displacement ....................................................................25 ii. Forced Migration ...........................................................................27 iii. Asylum Designation.......................................................................30 iv. Refugee ..........................................................................................32 B. The Legal Guidelines for Determining Refugee Status .............................34 i. International Documents ................................................................36 ix ii. U.S. Documents .............................................................................39 iii. UNHCR..........................................................................................40 II. Contextualizing Refugees ................................................................................41 A. Distinct Groups of Refugee Women ........................................................41 i. Refugee Women Experiencing FGC Involuntarily........................42 ii. Refugee Women Who Voluntarily Choose FGC ...........................43 B. Human Rights and Refugees ......................................................................44
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