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7 Mich. J. Gender & L. 1 (2000-2001)
An Emerging Ethical and Medical Dilemna: Should Physicians Perform Sex Assignment Surgery on Infants with Ambiguous Genitalia

handle is hein.journals/mjgl7 and id is 11 raw text is: AN EMERGING ETHICAL AND MEDICAL DILEMMA: SHOULD PHYSICIANS PERFORM SEX ASSIGNMENT SURGERY ON INFANTS WITH AMBIGUOUS GENITALIA? Efazel §lenn 'Beh* (-M'ilton 'Diamond* INTRODUCTION • 2 I. THE REMARKABLE CASE OF JOHN/JOAN • 5 II. THE DEVELOPMENT OF A SURGICAL STANDARD OF CARE • 12 A. Standards of Care Within the Medical Community • 12 B. The Surgical Standard in Treatment ofAmbiguous Genitalia . 16 C. Standard Care and Malpractice Claims - 27 III. PARENTAL CONSENT TO GENITAL SURGERY AND SEX REASSIGNMENT ON BEHALF OF CHILDREN • 34 A. The Doctrine of Informed Consent • 34 B. Informed Consent and Parental Decision Making on Behalf. of Infants • 37 C. The Problems of Informed Consent and Infant Genital Surgery • 42 1. The Aura of Urgency • 43 2. Imparting Incomplete Information - 47 3. Perpetuating Secrecy and Deception • 50 4. Failing to Disclose The Uncertainty of the Long-Term Outcome • 56 5. Ignoring the Child's Right to an Open Future • 57 IV. LEARNING FROM THE PAST: WHAT SHOULD THE FUTURE HOLD? • 59 CONCLUSION • 61 Associate Professor of Law at the William S. Richardson School of Law, University of Hawaii. J.D. 1991, Ph.D. 1985, University of Hawaii; B.A. 1973, University of Arizona. •* Professor of Anatomy and Reproductive Biology at the John A. Burns School of Medicine, University of Hawaii. Ph.D. 1962, University of Kansas; B.S. 1955, City College of New York. The authors thank Kenneth Kipnis, Sylvia A. Law, Julie Greenberg and Sherri A. Groveman for reviewing and discussing early drafts or ex- cerpts. Thanks to the Eugene Garfield Foundation for partial support of Dr. Diamond's research.

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