Editorial Note

This quarter’s issue of the Kennedy Institute of Ethics Journal is unusual, because it hosts a symposium focused Brian Earp’s provocative and groundbreaking article, “Between Moral Relativism and Moral Hypocrisy: Reframing the Debate on ‘FGM.’” Along with Earp’s article, we are presenting critical responses by Richard Shweder, Robert Darby, and Jamie Nelson. Earp tackles the ethics of female genital cutting or “mutilation” (an ethically loaded term). This is a difficult topic that brings on board gender inequity, the integrity of the body, the value of cultural traditions, sexuality, colonialism, ethnocentrism, and other fraught axes of reflection.

Earp argues against the common view that all forms of FGM are obviously morally impermissible, and only the purview of misogynist cultures deeply different from “ours.” But he also argues against the view of a vocal minority that FGM cannot be critiqued by “outsiders” because ethical norms are entirely relative to local cultures. Both of these views, he shows, are rooted in a deeply ethnocentric understanding of the participants in these practices as fundamentally alien others who exist across an ethical and hermeneutic divide from us. In contrast to this alienating move, Earp demystifies FGM by showing the ways in which it is ethically, practically, and symbolically continuous with male circumcision, on the one hand, and cosmetic genital surgery for women, on the other. In all three cases, we use surgery to stream bodies into culturally acceptable forms of binary gendered embodiment. Earp carefully dismantles a variety of apparent disanalogies between FGM, on the one hand, and these practices of “ours” that we treat as more or less acceptable and normal, on the other. But his goal is not to show that FGM is ethically acceptable. Rather, he argues that it is ethically complicated and problematic in much the same way as these other practices are, and that it is hypocritical for us to treat it as belonging in some separate alien category. He argues for a nuanced ethical critique of FGM that attends to concrete differences in how it is practiced; the severity of the intervention, the age at which it is done, and the cultural context in which the decision is made all matter to the permissibility of the surgery.

Earp’s respondents are fundamentally sympathetic readers, but they also raise a series of important critical challenges. For instance, Shweder wonders whether Earp focuses too exclusively on the impact of surgery on individuals, without concern for the role of rituals in the survival of cultures and communities. Darby pushes Earp’s analogy between female and male genital cutting even farther, arguing that, as practiced, male circumcision is in some ways yet more ethically troubling than its female counterpart. Nelson focuses on Earp’s charge of hypocrisy, and wonders whether a focus on hypocrisy will leave us unable to effectively critique the more dramatic and abusive forms of genital cutting that are practiced in some cultures.

In “On Physician–Industry Relationships and Unreasonable Standards of Proof for Harm: A Population-Level Bioethics Approach,” Daniel Goldberg asks what sort of evidence we need that physician-industry relationships cause harm in order to be motivated to curtail or control these relationships. According to one dominant line of argument, he contends, there is no need to constrain these relationships because we have no evidence that they actually cause harm to patients. Goldberg argues that the standards of evidence used in this line of argument are both too high and inappropriate. Rather, he claims, we should be using the standards of evidence that we use in the domain of epidemiology and public health. There, we tolerate a fair amount of uncertainty, and recognize that we often need to intervene despite this uncertainty. Goldberg’s article provides an effective antidote to those who unfairly assume the mantle of rigorous science in order to dismiss concerns about the influence of private industry on the practice of medicine.

Finally, this issue also includes an article by Ruiping Fan, entitled “Nonegalitarian Social Responsibility for Health: A Confucian Perspective on Article 14 of the UNESCO Declaration on Bioethics and Human Rights.” Fan rightly points out that the Confucian perspective on the right...