Les pratiques culturelles des excisions et des infibulations à Bamako au Mali : la contribution de la dignité humaine au respect de l’intégrité physique des femmes

One of the most debated issues in the area of ethics in the twenty first century between Africa and the Western world concerns the respect for the women’s physical integrity. Among human actions that most affect the bodily integrity of women, female circumcision and infibulation are the most denounced in Africa. Long regarded as rites of puberty and initiation of girls, these practices are now considered as exceedingly harmful to health, and commonly called "female genital mutilation" (FGM) by the international community. In recent decades, these practices have gradually been legally prohibited in most African countries as well as in Western countries. The Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) demands 'zero tolerance'. The international community fights them with legal weapons, basing on the medical consequences and the infringement of human rights.  Our thesis was born from a question on the reasons why these rites are still going on in Africa and more especially in Mali, while in Western countries; voices are strongly raised to denounce them as abusive to women. On the international front, we hesitate to impose universal values to a phenomenon, perceived to a large extent as a tradition in conformity with the social norms of the communities that maintain them.  In order to better circumscribe the subject, our question is as follows: “How do the cultural practices of female circumcision and infibulation  in the city of Bamako, Mali, challenge ethical norms : in what way does the analysis of these rites constitute a legitimate sphere of application of the principles of bioethics?” Our reflection starts from the assumption that human dignity is a standard against which measuring the ethical challenges associated with these rites.  A Bambara proverb says: “One hand does not properly wash an elephant.” The logic of this wisdom highlights the fact that using only one approach from a certain discipline cannot bring out the ethical issues of these practices. Our bioethical analysis is meant to be an interdisciplinary approach that allows one to articulate the philosophical, anthropological, sociological and biomedical approaches to these practices. The first chapter, through the literature review, presents the problem associated with these rites. The second chapter presents the theoretical framework based on the concept of human dignity, and delineates its contours: its sources, its forms and its consequences in order to make it more effective and operational as means of protection of the human being. The chapter three presents the methodology of the research based on the qualitative method and analytical induction, and describes the context of the study. The chapter four presents the results of the research which highlights the fact that these practices essentially refer to the control of female sexual desire. These practices are also “deritualized” and affect more and more children, which involves risks and consequences on health with enormous human and financial costs to society. The fifth chapter analyses these practices with the ethical principles which demonstrate that these ritual practices constitute a public health problem despite their cultural character finally. The sixth chapter presents the scope and the limit of the thesis. It shows that it is possible to have a debate on female circumcision and infibulation through an ethic of discussion. It provides a way to achieve this with a vision of the concept of human dignity as a “universal ethical value” which can be used in all actions  involving the human being and in all socio-cultural contexts. Our approach broadens the field of application of the bioethical principles to non-medical practices.  By this thesis, we wish to contribute to the enrichment of the ethical reflection on female circumcision and infibulation and to inspire public health policies keeping in mind the respect for cultural diversity. We also hope to inspire further research in view of bringing together the bioethics of traditional cultural practices in order to find reasonable compromises which could strengthen the role of protection of human dignity.

Keyphrases: Infibulation, Bioethic, Circumcision, Cultural, Dignity, Infibulation, Integrity, Person, Physical, Practice, Woman