A humiliated medical profession seeks to hide its shame behind a preposterous circumcision has benefits apologia. The AAP appears to be forking off even further in an inexplicable departure from the views of the rest of the medical establishment on the morality and science of childhood circumcision. Even the American Medical Association agrees that there is insufficient justification for performing the procedure on newborns absent specific medical indications. Unlike the AAP, its peer organizations in Europe and also in Australia, the UK and Canada recognize that medical considerations must be considered in conjunction with ethical and legal considerations, and that under such an analysis, it should be neither recommended to parents nor funded by government insurance systems. The Finnish Union of Medical Doctors (Suomen Lääkäriliitto) is opposed to non-medical circumcision on the grounds that it involves risks, inflicts pain and injury, and violates the child’s right to decide about his body, and the Royal Dutch Medical Association (KNMG) has gone so far as to discourage its membership from participating in the procedure as it carries risks without countervailing benefits. The Swedish Paediatric Society has called infant male circumcision an ‘assault on boys.’ As discussed above, the German BVKJ also strongly opposes the procedure. Over 100 boys die each year from this needless procedure, even when performed under optimal conditions in a medical setting, yet the AAP fails to attach much significance to the deaths stemming from the practice. Rather than objectively evaluating all available evidence, the AAP selectively quotes and references highly contested and controversial studies to attempt to justify an entrenched, yet outmoded, cultural—not medical—practice. The lack of attention to detail and depth of discussion suggests that the AAP was not concerned about the medical quality of their product. Other policy statements by the AAP are typically extremely well written, well researched, with in-depth discussion. We question why the AAP is championing public funding for an unnecessary surgery at a time when the US faces a crisis in not being able to provide even necessary care for all its children. As was just demonstrated in a report by the Institute for Medicine, an astonishing US$750 billion is wasted on healthcare each year in the USA. In these days of rising medical costs and scarce resources, we simply cannot afford to continue to carry out such a harmful and outmoded practice. Even in the far from definite case that benefits do exist, as the KNMG notes, ‘it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy himself can decide about the intervention, or can opt for any available alternatives.’ Accordingly, the AAP should immediately retract its policy statement and technical report and replace them with documents reflecting such critical concerns as the functions of the lost tissue, medical ethics and the importance of respecting non-consenting children’s rights. ~J Steven Svoboda, Robert S Van Howe, J Med Ethics 2013;00:1–8. doi:10.1136/medethics-2013-101346 doctorsopposingcircumcision.org/pdf/2013-03-12_Svoboda-VanHowe.pdf
Posted on: Mon, 31 Mar 2014 16:31:24 +0000
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