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- Diamond, Milton, et al.
(författare)
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Evidence regarding cosmetic and medically unnecessary surgery on infants
- 2014
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Ingår i: Journal of Pediatric Urology. - Amsterdam : Elsevier. - 1477-5131 .- 1873-4898. ; 10:1, s. 2-6
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Forskningsöversikt (refereegranskat)abstract
- The Journal of Pediatric Urology has recently published several articles from the Annecy (France) Working Party on DSD. We question several of the presented findings and recommendations. In two key articles summarizing their review, the authors concluded that identified studies are not representative and suffer from methodological weaknesses, such that they "lack the necessary detail to base further recommendations". In a third article, the Working Party reported that the science supporting early surgery is "scanty", and that "no studies" support the belief that gender variant children require early genital surgery. Nevertheless, the Working Party warned that without long-term research, "if no effort is made, we will be left, in the next generation, to continue making the same judgment, based on 'experience' and 'expert opinion' ". None of the studies cited in the articles support such assertions as we read them. We maintain that reviewed evidence suggests a moratorium on early surgical intervention is imperative for children with differences in sex development, and that the best ethical and scientific considerations require that gender surgery should be delayed until the child can consent. We further present evidence that UN and case law presently under way in the USA support such a moratorium.
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- Garland, Jameson
(författare)
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Informed Consent as a Right : Regulatory Challenges in the Swedish Legal Framework
- 2018
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Ingår i: Förvaltningsrättslig Tidskrift. - 0015-8585. ; 2018:2, s. 233-267
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Tidskriftsartikel (refereegranskat)abstract
- Recent medical controversies in Sweden have reflected several ways in which Swedish authorities have struggled to recognize informed consent as a right under international law, particularly under the European Convention of Human Rights (ECHR). These controversies also expose significant gaps in Sweden’s legal framework, resulting from a problematic understanding of the relationship between informed consent and Sweden’s standard of care for medical interventions. They also raise the specter of criminal law, with grave implications for human rights, particularly when patients face the risk of death or serious injuries from interventions that do not, in fact, meet the standard of care. In particular, Sweden’s failure to recognize a judicial remedy for failures to obtain informed consent to medical interventions raises significant concerns as to whether Swedish law and medical practices violate the ECHR. This article, thus, examines the Swedish legal framework to determine its compliance with international law.
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- Garland, Jameson
(författare)
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On Science, Law, and Medicine : The case of gender-“normalizing” interventions on children who are diagnosed as different in sex development
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- For the last six decades in Sweden and the US, surgical and other medical interventions have been utilized to reconstruct and “normalize” children diagnosed as different in their sex development. Under traditional treatment protocols, clinicians chose an “optimal” gender for the children and used different procedures to give them a typical appearance for that gender – aspiring to support them psychologically – and to facilitate penile-vaginal intercourse. Because these treatments have involved reconstructive surgery and other measures, they risk genital dysfunction, loss of sensitivity, loss of fertility, and the risk that the gender assigned will be wrong for the child.Since the 1990s, expert practitioners have acknowledged that the evidentiary support for the safety and benefits of these procedures for young children is low, relative to later in life. Indeed, they have described the need for evidence has been described as “urgent”, with a “crisis in clinical management”. As of 2016, there appears to be no consensus among expert-practitioners on the timing and nature of these interventions, not only because of the invasive and irreversible nature of the procedures, but also because the gender identity of the children cannot be predicted with certainty. Human rights authorities have also called on nations to stop the procedures. Since 2013, eight such organizations have done so – three from the United Nations, two each from the Council of Europe and European Union, and most recently, the Organization of American States. To date, only three nations – Colombia, Malta, and Chile – have taken formal action in this regard.This study begins with the proposition that the issues involved raise critical questions about the limits of science, law, and medicine. Specifically, it is a study of medical law in Sweden and the US, to explore how the regulation of medicine might permit or restrict these procedures. It also places medical law in its broader context in relation to critical perspectives on rights related to gender and children. The study attempts to address the question of how law and medicine together determine what happens to the affected children, and what the studied treatments say about medicine, law, and the boundaries of science.
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