Kopelman Loretta M
*Kennedy Institute of Ethics, Healy Hall, Georgetown University, Washington, DC 20057, USA.
J Med Philos. 2014 Feb;39(1):8-25. doi: 10.1093/jmp/jht055. Epub 2013 Dec 20.
Recalcitrant disputes among health care providers and patients or their families may signal deep cultural differences about what interventions are needed or about clinicians's professional duties. These issues arose in relation to a mother's request for hymenoplasty or revirgination for her minor daughter to enable an overseas, forced marriage and protect her from an honor killing. The American College of Obstetrics and Gynecology committee recommends against members performing a hymenoplasty or other female genital cosmetic surgeries due to a lack of data concerning their safety and efficacy. A key issue in such cases is how to determine what is in the minor's best interest and the scope of health care moral or professional's duties. The Best Interests Standard can serve as a powerful moral tool for resolving cross-cultural disputes and identifying needed policy.
医疗服务提供者与患者或其家属之间难以解决的纠纷,可能预示着在所需干预措施或临床医生的职业职责方面存在深刻的文化差异。这些问题源于一位母亲为其未成年女儿进行处女膜修复术或恢复处女之身的请求,目的是促成一场海外强迫婚姻,并保护她免遭因维护家族荣誉而实施的杀害。美国妇产科学院委员会建议其成员不要进行处女膜修复术或其他女性生殖器美容手术,因为缺乏有关其安全性和有效性的数据。此类案件中的一个关键问题是如何确定什么符合未成年人的最大利益以及医疗保健道德或专业职责的范围。最佳利益标准可以作为解决跨文化纠纷和确定所需政策的有力道德工具。