Should Boys be Circumcised?

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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Regarding Objection

Parents Have the Right and Duty to Protect Their Infant's Health

- From Edgar J Schoen MD

Open Objection Go to this Objection

It quacks like a duck

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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- YES: quacks like a duck. The Mighty Ducks
  
  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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- Mighty Ducks 2 - Paternalism
  
  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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If the medical side was clear...

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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Surgery has risks. There is no right to impose risk.

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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Negative effects MUST be considered

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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Genital integrity

"... 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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Loss of Bodily Integrity

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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A man has a right to choose

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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Schoen should stick to aspirin, and leave ethics to the pros

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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Nobody removes healthy tissue without reason!

"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
  
  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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  - You should also consider the harms
    
    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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Many diseases and disorders

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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STOP CIRCUMCISION

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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Why stop with the Prepuce, why not cut off the eyelids too?

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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Related Debates

Experts on "Yes" Side

Edgar J Schoen MD
Clinical Professor of Pediatrics See arguments
Dr Brian Morris
Professor of Molecular Medical Sciences See arguments

Experts on "No" Side

NOCIRC
Making a Safer World for Children See arguments
Doctors Opposing Circumcision
Physicians For Genital Integrity See arguments

Most Objections