Parents face so many difficult decisions when it comes to having a child: decisions about nursing, sleep patterns, discipline, teaching methods and, in the case of boys, whether or not to circumcise. In addition to being the most common surgery for males in the U.S., circumcision has been practiced in various cultures for centuries. Yet when it comes to the health and best interest of your newborn, is circumcision the way to go?
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They why, Dr. Schoen, has your own AAP and every other medical association in the world decided you are wrong?
Parents, and physicians, have the duty to protect the normal healthy bodily functions of their children . As much as you wish (and work to make it) otherwise, males have a protective, sensitive foreskin.
The evidence is clear, and medical associations agree, circumcision does not provide any benefit which exceeds the risks.
Nearly all doctors agree, it is still performed only for cultural, not medical reasons.
- GenitalIntegrityPolicy August 7, 2008 4:18PM
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Cirucmcision is a ritual, not a medical procedure. It is essential to understand ritual process - especially how some, as 'Mighty Ducks,' have replaced the witch doctor. Key words below: Domination, subordination, control, authority where Dr. Catherine Bell in "Ritual Theory, Ritual Practice" stated:
"As institutions of specialists take on the formulation of reality, there is a decreased need for personal or collective rituals to assume that function. Ultimately, when the strategies of ritualization are dominated by a special group, recognized as official experts, the definition of reality that they objectify works primarily to retain the status and authority of the experts themselves... Specific relations of domination and subordination are generated and orchestrated by the participants themselves simply by participating... it is this type of control that must be understood. These bodies of knowledge act simultaneously to secure a particular form of authority."
- DevilDocRetired
August 20, 2008 12:59PM
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The suspect procedure now used to maintain such 'ritual expert status' and inhibit people's autonomy is Paternalism. Johnson, Seigler and Winslade in "Clinic Ethics" wrote:
"One of the most common ethical issues raised by the peinciple of respect for autonomy is paternalism. The term refers to the practice of overriding and ignoring a person's preferences in order to benefit them or enhance their welfare. In essence, it consists in the judgment that beneficience takes priority over autonomy. Historically, the medical profession has endorsed paternalism. Today, while still common it is considered ethically suspect."
The point with circumcision is that it is flawed improper medicine and advocates are practicing a sham from arguments through paternalism.
- DevilDocRetired August 20, 2008 1:18PM
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Your argument would make sense IF there was a reasonable consensus on whether or not circumcision is truly helpful or not. Now all you have is conflicting studies on both sides of the debate. Many of the older "accurate preventative measures" have been disproven... all the while children keep being circed as doctors try and find a good medical reason for it. Kinda backwards from the procedures you describe.
Unless the actual medical benefit is reasonably clear, then yes, it IS unethical to perform a cosmetic procedure requested by the parents. Also, we aren't talking about an internal organ or teeth that are removed at an older age where ample pain relief is provided, we are talking about removing part of the genitals when there is no current issue and the use of strong pain relief is dangerous. Not to mention possible lifetime emotional issues that can arise from not being left with a choice.
- jserral August 7, 2008 4:37PM
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Parents have no such right. Because the child is not old enough to state his preference, they have proxy consent. We assume they will act in his best interest. But he is still an individual with human rights. They have no moral standing to violate those for their reasons.
When their child faces a medical need, parents have an obligation to act in the child's best interest. The reasonable course is for the parents to choose the most effective and least invasive solution. Resorting to surgery when an antibiotic will work as well is hardly the least invasive.
But medical need is the appropriate prerequisite. Without need, there is no valid decision to be made. Statistics demonstrate that a male left intact will rarely need or choose circumcision in his lifetime. Fear of disease is not an appropriate excuse to abandon logic.
Parents do not have a right to remove their child's healthy appendix. The greater ease of removing the foreskin does not confer parents any such right.
- RollingDoughnut August 7, 2008 8:02PM
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It is not right to consider preventive health benefits without ALSO considering the negative effects. Many health problems are caused by circumcision, and it takes away nearly all of a specific sense organ.
- geskoi August 8, 2008 8:21AM
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"... has someone without an appendix lost their “intestinal integrity”, and does removal of wisdom teeth means one no longer has “oral integrity”?" Well, strictly speaking, yes. The term is a perfectly accurate one, coined because we were tired of the normal penis being called "uncircumcised" and the movement to leave babies' genitals alone being called "anti-circumcision". (We're also anti-infant-castration, anti-infant genital piercing, and anti infant Extreme Genital Modification, but those go without saying.) Dr Schoen tries to pretend that the penis is as emotionally and culturally neutral as the back teeth or an internal organ, but most people know that men have an intense emotional involvement with their penises, and it is only because circumcision has become a cultural norm in the US that it is not generally perceived as the human rights affront that it is. It continues mainly because babies can't resist it being done by men who don't want to know what they're missing.
- Hugh7
August 10, 2008 1:30AM
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Dr. Schoen is quite correct. A person who has had wisdom teeth extracted has lost oral integrity and a person who has had an appendix removed has lost intestinal integrity.
The difference is that there is a medical indication for these operations. There is no medical indication for non-therapeutic neonatal circumcision, so parental consent for this "elective" operation is inappropriate.
Although legally competent adults have very broad powers of consent, parents have very limited powers to grant permission for diagnosis and treatment of existing diseae or deformity. Non-therapeutic circumcision (body alternation) does not qualify.
- George August 11, 2008 6:36AM
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Dr Schoen's comments would be laughable if they weren't so serious and so sad.
He compares amputating nerve rich healthy sexual tissue without consent to filling a rotten tooth or giving a vaccination. The former gives no immediate benefit (as likelihood of UTI protection is small and cancelled out by complications) and is hugely invasive, reducing ergogenous sensation and even the size of the penis. The latter are minimally invasive and immediately beneficial.
Why not let adult men have the choice, given that the benefits are a. disputed and b. only affect adulthood?
The reason is fairly simple - Schoen and Morris know that most would choose to keep their foreskin. Its joyful! And it's care is so simple! Wash it regularly and use condoms! Same as the care of a vulva, except a foreskin is easier to wash because you can see all of it!
Why don't S & M want men to have this choice? Because they were denied it.
- vikinggirl
August 11, 2008 11:56AM
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Once again, Schoen gets it almost right, but unlike in horseshoes, in medicine and ethics, close is not good enough.
Parents do not have a right to scar their child physically or emotionally, let alone remove and discard healthy tissue. Just replace foreskin with any other body part and you'll understand. Or, replace boy with girl and you'll be facing incarceration in a Federial prison.
Parent do have a duty, prescribed by law, to care for their child, and as such, the care should benefit the child, not the parent. Circumcision cannot be performed because the dad happens to have been circumcised, because mom (mistakenly) believes he will be easier to clean, or that the parents are worried about what their physician/family/neighbors will think of them.
Schoen is right, circumcision is a choice, but it isn't a choice for docs or parents, it is a choice for who owns the foreskin.
- Dan Bollinger August 15, 2008 7:19AM
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"As for “genital integrity”, has someone without an appendix lost their “intestinal integrity”, and does removal of wisdom teeth means one no longer has “oral integrity?"
It does if those parts were healthy. If a parent walked into a hospital and asked that their infant receive an appendectomy, and that baby did not have appendicitis, that parent would likely lose custody of that child!
You might as well argue that families with a history of breast cancer have a moral obligation to have their infant daughters' breasts removed.
- crunchymom September 21, 2008 4:03PM
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Interesting that you look at this in that way. While at the hospital visiting some friends of mine the other day (Sunday to be exact) who just had a new baby, the Dr. came in and asked them if they wanted the Boy to be Circumcised. They asked the Doctor why should they. He presented this with some health information as to why boys should be circumcised. I will see if I can get that information and Post it.
- justsomeguywithanopinion November 13, 2008 2:03PM
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If you are going to learn about the benefits of circumcisions, you should also learn about the harms and risks of circumcisions. According to the American Academy Of Pediatrics the harms and risks of circumcisions are equal to the benefits of circumcisions. Circumcised males are missing about FIFTEEN square inches of penile skin, so circumcisions are a huge genital alteration.
No national medical organization in the world recommends that baby boys be circumcised. The U.S. is the only place in the world where it is common to circumcise minors without religious reasons. The reason circumcisions got started in the U.S. in the first place was to decrease the sexual pleasure of males.
I would be all for circumcising baby boys if 100% of males wanted to be circumcised. But many males don't want to be circumcised. It is horribly wrong to circumcise baby boys when many males would much rather not be circumcised.
- Allen706 November 14, 2008 8:00PM
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Oh yes, Dr Schoen, male circumcision does indeed prevent many diseases and disorders. I compiled a neat list myself of all the benefits from it that have been trotted out since the late 19th century. It's quite impressive already - and I know its effects as a panacea reach even wider than this:
Masturbation, bed-wetting, epilepsy, paralysis, chorea, convulsions, headache, insanity, paralysis, strabismus, rectal prolapse, hydrocephalus, clubfoot, alcoholism, arthritic hips, asthma, balanitis, blindness, boils, cervical cancer, chicken pox, epididymitis, epilepsy, gallstones, gout, hernia, HIV, hydrocephaly, hydrocoele, hypertension, insanity, kidney disease, kleptomaina, leprosy, moral depravity, paraphimosis, penile cancer, plague, phimosis, posthitis, prostate cancer, rheumatism, schistosoma, spinal curvature, stomach infection, tuberculosis, urinary tract infections and/or yeast infections.
How could any right-minded parent forgo this miraculous pre-emptive treatment for their sons? Or, for that matter, for their daughters? Now, I'm not talking about the horrendous forms of "female circumcision" that are more akin to subincision or penectomy than male circumcision - I'm talking about removing the female foreskin - the clitoral hood - and perhaps the labia minora too.
Just like the male foreskin, this area is a haven for smegma, unpleasant smells and bacteria that can lead to infections - particularly if the clitoral hood is phimotic.
This is noted on this website: http://www.islam-qa.com/en/ref/45528
"The secretions of the labia minora accumulate in uncircumcised women and turn rancid, so they develop an unpleasant odour which may lead to infections of the vagina or urethra. I have seen many cases of sickness caused by the lack of circumcision...
... With regard to the type of female circumcision which involves removal of the prepuce of the clitoris, which is similar to male circumcision, no harmful health effects have been noted."
I mean, how many women do you know who get up to wash their smegma-filled genitals after a good lovemaking session, instead of simply lying there and letting the bacteria breed all night?
And this was also once common knowledge amongst the anglophones who had originally applied their anti-masturbation hysteria to girls as well as boys.
http://www.noharmm.org/CircintheFemale.htm
http://www.noharmm.org/circumfemale.htm
http://www.noharmm.org/femcirctech.htm
But unfortunately, they did not continue to reinvent spurious health benefits with the turn of each generation as they did with male circumcision - so unfortunately female prepuce clipping died out, and is now considered barbaric, and is now even ILLEGAL in a country that was happily practising it but 50 or so years ago. Makes you shudder to think that male circumcision might have gone the same way if the good doctors hadn't kept on top of keeping its purported health benefits up-to-date.
We can but also pray that the Doubting Thomases who care to throw a jaundiced view on male circumcision and its properties as a panacea might also go away, and stop writing such sceptical articles as this:
http://www.cbc.ca/news/viewpoint/vp_strauss/20051121.html
And even filling scientific journals with their nonsense:
http://www.cirp.org/library/disease/HIV/vanhowe2005a /
http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431
http://www.jaids.org/pt/re/jaids/abstract.00126334 -200712150-00017.htm;jsessionid=J1ZWRnsP1H8stJ2w9zmbpWksYB7y8thF2z4kp8xQqxCX2HyWxLYN!418234175!181195628!8091!-1
http://www.circumstitions.com/HIV.html #studies
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2064110
And these people are actually carrying influence down to the ground level!
http://www.change.org/ideas/view/intactivism
Oh, how awful that they cannot see the evident benefits of a practice, just because it happens to have travelled via superstitious pagans, to monotheistic bronze-age goatheards, and only imparted its wisdom on us initially from our masturbation hysteria - and has had its reputed health benefit claims move with the times...
- lordpasternack December 7, 2008 12:09PM
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ok, so since it's a "health measure" should we all pull our teeth so we don't have to clean that either? GET A GRIP!!!!! STOP CIRCUMCISING BABY BOYS FOR NO REASON!!!!!!!
- nocircusa December 9, 2008 1:58PM
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Circumcision is a preventive health measure which protects against many diseases and disorder: - debateable
It is analogous to having infants immunized:- immunisation is given to get herd immunity to a group that is at risk of infection, 8 day old babies are not at risk of STD's
... or having children 's teeth filled:- children's teeth are filled because there is disease (caries) present
Of course parents have the right, if not the duty, to give permission for their infant to have a procedure that promotes their future health - except for elective irreversable surgical procedures, it is their child but it is not their penis
As for it being ethical for a physician to perform newborn circumcision :- it is unethetcal to perform an elective procedure without patient consent, the procedure must be delayed until informed consent can be obtained
...preventive health is the main role of a physician in this modern world - circumcision is a procedure of the ancient world.
One could more easily argue that it would be unethical for a physician to refuse to perform a circumcision requested by the parents - a physician would refuse to remove the eyelids, ear lobes, toe nails or any other part of their child's body regardless of the demands of a parent or their belief system
As for “genital integrity”, has someone without an appendix lost their “intestinal integrity”,- the apendix was removed in an emergency to prevent the patient's condition worsening
.... and does removal of wisdom teeth means one no longer has “oral integrity”? - yes you no longer have a complete compliment of teeth.
- Ethics August 15, 2009 8:33AM
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Read the history of circumcision because you're repeating it.
http://www.icgi.org/medicalization / Everyone of your anti-intact arguments have been debunked.
Even your own country in Australia shuns infant circumcision on healthy newborns despite your efforts to promote this surgery on boys who would otherwise never need it.
http://www.abc.net.au/news/stories/2007/12/09/2113665.htm
After your publication to promote circumcision in Africa, South African Parliament provided legal protection to boys under the age of 16 from circumcision.
http://www.info.gov.za/gazette/acts/2005/a38-05.pdf
If I touted a birth control that prevented the chances of conception by up to 60% I'd be thrown out of the building. The men in Africa are lining up to be circumcised because they think they're getting a "Natural Condom". Congratulations, you've created an even bigger problem.
- keepyoursonWHOLE August 11, 2008 11:57AM
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Morris' defense is to call others liars, saying, for example, "Then they mention their myth that circumcision was used commonly in Victorian times as a cure for masturbation. ... WRONG!" Certainly, Victorians tried to prevent circumcision, as this photo from the BBC documents:
http://news.bbc.co.uk/1/shared/spl/hi/pop_ups/03/sci_nat_wellcome_exhibition/html/7.stm
It's also not difficult to find documentation that Victorians used circumcision to prevent masturbation: http://www.dukehealth.org/HealthLibrary/AdviceFromDoctors/YourChildsHealth/circumcision says "In an era of sexual repression, circumcision was widely (and mistakenly) accepted as a means to prevent masturbation." I don't think Morris can accuse Duke Medicine of being a liar, too.
- geskoi August 11, 2008 4:40PM
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It is an exaggeration for Morris to say that circumcision is harmless. Even if circumcision benefits most, some still suffer from blood loss and infections. A few are maimed for life by infant circumcision.
Harm reduction consists of ensuring that circumcision risks are minimized. One way to do this is to make it unlawful for unqualified operators to perform circumcisions. Another way is to insist that no boy be circumcised unless he has been tested for hemophilia.
- Michael Glass
August 16, 2008 8:32AM
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ethical? or 'not yet illegal'? if it is profitable, someone will promote it, whether cutting babies' healthy genitals or injecting deadly vaccinations -- http://www.msnbc.msn.com/id/26219689 /
is anything an MD does, including cutting healthy male genitals and injecting animal puss into healthy bodies, 'ethical'? are MDs our 'gods'? are they above the law? in a poll, some MDs said they would circumcise even if it was illegal.
does money make right? a retired ob/gyn told me, 'i didn't like doing them, but if i didn't, then someone else would get the money'.
when i was a child, clitoridectomies were still legal (see my book, 'the rape of innocence' at www.aesculapiuspress.com ). there will come a day when all cutting of healthy genitals is seen for what it is -- socially-sanctioned childhood sexual abuse.
- Patricia Robinett August 17, 2008 10:37AM
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Urinary Tract Infection: "Using numbers from the literature, one can estimate that 7 to 14 of 1000 uncircumcised male infants will develop a UTI during the first year of life, compared with 1 to 2 of 1000 circumcised male infants. Although the relative risk of UTI in uncircumcised male infants compared with circumcised male infants is increased from 4- to as much as 10-fold during the first year of life, the absolute risk of developing a UTI in an uncircumcised male infant is low (at most, ~1%)" (Conclusion of the paragraph on UTIs and circumcision in the 1999 Circumcision Policy Statement by the AAP)
- aquarius1986 August 26, 2008 9:06PM
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HIV Infection: Safe sex practices (using condoms) seem to be much more effective than circumcision in preventing HIV/AIDS. I don't understand how circumcision prevents HIV. Could you help me? The studies I've read about seem flawed, in that the circumcised men were instructed not to have sex after the operation, while uncircumcised men were left to do what they wanted (so of course they would have a lower chance of getting HIV). Also, I've read that the double blind RCT is the gold standard of epidemiology, not just a simple RCT. Explain how you would set up a double blind RCT testing the effects of circumcision.
Penile hygiene: It would be much easier to clean in one's ears if you cut off all the folds, but that seems a bit silly. Just wash it.
Syphilis: Again, safe sex practices seem much more effective in preventing STDs.
- aquarius1986 August 26, 2008 9:08PM
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If you teach your child to have safe sex, and you teach your child to wash down there, then there's only a very low absolute risk of a UTI in a baby's first year to worry about.
Weigh that against the risk of surgical complications, trauma, and sexual side-effects (perhaps low, but definitely more serious than a UTI), and as a parent I'd choose not to have my son circumcised. The benefits are slim to negligible, and the potential detriments too great. Unless there are some other benefits of circumcision that you haven't told me about.
- aquarius1986 August 26, 2008 9:11PM
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Is Non-Therapeutic Circumcision Ethical?
- From NOCIRC
By National Organization of Circumcision Information - Making a Safer World for Children
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Schoen's bias against nature
Schoen's objection to the ethical argument against adults mutilating children's healthy sex organs - "Parents Have the Right and Duty to Protect Their Infant's Health” - implies that amputating healthy body parts from children protects their health. Absurd. It does the opposite. It kills a normal, important, healthy body part, traumatizes the child physically and emotionally, and leaves him only part a man. It damages his health and wholeness. Schoen states a fact, but misuses the fact to advocate a medically unnecessary sex crime against babies. He can hardly be called an unbiased expert, since he is mutilated himself and has sexually mutilated, with his own hands, thousands of boys, and has been responsible for the mutilations of thousands more. He is an old man. It would be very hard if not impossible to teach this old dog new tricks. He is too busy trying to justify his old tricks. He seems to think he's smarter that God, Mother Nature and evolution combined. Wrong again, Dr.
- Van Lewis
August 8, 2008 9:15PM
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twisting law
Twisting legal arguments to pretend that there is something unethical about it is one thing but I find the question strange to begin with. It is the same as asking: Is non-therapeutic immunisation ethical?
- deni
August 10, 2008 4:22PM
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NO - twisting law
Do not confuse Law with Philosophy. Ethics resides in Philosophy. If slavery was legally acceptable, would it then be ethical? According to your statement it would be.
Your correlation to the question about ethics states: "Is non-therapeutic immunization ethical?" is a wrong correlation. A more proper correlation to your thread would be for someone to to say to you: "If you were given the Date Rape drug and then taken advantage of, a rape did not occur."
- DevilDocRetired
August 17, 2008 3:42AM
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No it is not...
Like non-therapeutic circumcision, non-therapeutic "immunization" is unethical as well. Like circumcision, vaccines are ineffective at providing significant protection from disease and have nothing but numerous complications, just as circumcision.
- bagpiper2005
October 25, 2008 9:23PM
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Ethnicity plays a huge part in perception torward circumcision
You will also find that Edgar is Jewish, which would lead him to rationalize scientific data to support God's reasoning for introducing circumcision to Abraham and his decedents.
The std's that he mentions, are condition which are passed on from an infected person and not the result of having natures design penis. These virus or pathogens are more likely than not, to enter the urethra during sexual activity, rather than passing through a more membrane type glans penis of a natural male. Sexual activity is a fluctuating pressure against the head of the penis as in and out! It causes the partners fluids to enter the urethra and move in and out of it during the pressure changes... from positive pressure to negative pressure as ...in and out!!! There is verbal deception and misleading being used to support a notion! For this above reason, a circumcised male who does not wear a condom is equally vulnerable to the same std's!....simple principle of physics..doctor or no doctor!
- Me2
August 10, 2008 7:57PM
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Yes: Ethnicity
This may very well be true for those Jewish who have for the past 150 years and also for many Christian religious including G. Ellen White who headed the Adventists - Kellogg and Queen Victoria. Edward Edinger in "Ego and Archetype wrote:
"The Self is the ordering and unifying center of the total psyche (conscious and unconscious) just as the ego is the center of the conscious personality. Or, put in other words, the ego is the seat of the 'subjective' identity while the Self is the seat of the 'objective' identity. The Self is thus the supreme psychic authority and subordinates the ego to it. The Self is most simply described as the inner empirical deity and is identical with the 'imago Dei'... Since there are two autonomic centers of psychic being, the relation between two becomes vitally important... Indeed the myth can be seen as a symbolic expression of the ego-Self relationship."
- DevilDocRetired
August 19, 2008 9:15PM
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Nothing else to say
This is the definitive piece on circumcision... all other debates aside as to the worth or non-worth of the procedure. It comes down to a boy's right to choose. I never had the choice - and although they did an ok job, this part of my body wasn't theirs to take.
- ukmarcus
August 21, 2008 5:09PM
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I'll say it again anyway
You hit the nail on the head, ukmarcus. The fundamental issue here is the unalienable human right to one's own body. It's all about private property rights. We don't call them "privates" for nothing. Our own body parts are the most important private property anybody on earth has ever owned. Every healthy organ and tissue and cell in every human body belongs, by right, to the person whose body grew it. Other people are entitled to have whatever negative opinions they like about anybody's body part(s), but having a negative opinion about other people's body parts does not entitle anyone to CUT OFF other people's body parts. My negative opinion about your penis or any other body part - to which opinion I have an absolute right - does NOT entitle me to CHOP UP your penis or any other body part. I hope you can agree with me, and acknowledge that your negative opinion about my body parts does not entitle you to chop up mine either. Everything else is a side issue or a non-issue. This is the most no-brainer of all no-brainers. If you want to chop up sex organs, start - and stop - with the only one you'll ever own.
- Van Lewis
September 17, 2008 10:49PM
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Circumcision of child or adult is foremost undeontological
And here is an answer about this that has been accepted by the British Medical Journal;
EXPERT REFUSAL: THE PHYSICIAN’S RIGHT AND DUTY
(Sexual mutilation, the physician’s point of view)
Considering on the one hand, that deontology forbids amputations without serious and strict medical motive, on the other hand Foldès’s and Taylor’s discoveries of the importance of the second sex organs of woman and man, the specific organs of autosexuality, however not yet Nobelized these discoveries may be, it is the physician’s duty to turn away requests of cosmetic or religious intervention that might alter the function of sexual organs, whatever the age, sex or religion of the person may be. They must inform them that it is their duty, and right, to do so and will not let them go without having taught them the value of the organ in question.
They must not yield to the blackmail of their ability in matter of anaesthesia or prevention and treatment of haemorrhages and infections. On the contrary, they must warn the person not to turn towards somebody else and foremost not doing it by a non-physician or by themselves, which would be illegal exercise of medicine.
In this aim and in order to protect the patient or their children from likely resorting to either other physicians (and risk spending their money in vain) or taking high risks resorting to non physicians, they must warn them that, since they are themselves now informed, they have the absolute professional obligation, by exception to the principle of privacy of consultation, to inform public authorities (health services, school staff and legal authorities) about the patient’s claim right away, so that further request will not be refunded by private or public insurance, the operation be impeded or parents and the possible operator be prosecuted. In case this would not be the law in some countries, associations of physicians must ask for such laws to be enacted.
Expert refusal renders informed consent of the parents or the patient lapsed.
- Sigismund
October 21, 2008 8:39AM
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