Ethics of Child Circumcision

Including Current Statements from British Authorities

Dr Peter Ball MB,B Chir

John Dalton Bsc,Msc

Last updated on 22nd June 2003

The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks. It is essential that doctors perform male circumcision only where this is demonstrably in the best interests of the child. The responsibility to demonstrate that non-therapeutic circumcision is in a particular child

Consent for any procedure is valid only if the person or people giving consent understand the nature and implications of the procedure. To promote such an understanding of circumcision, parents and children should be provided with up-to-date written information about the risks.

In all cases, doctors should ask parents to confirm their consent in writing by signing a consent form. [The law & ethics of male circumcision - Guidance for Doctors, BMA, 2006]

"It is a matter of concern that it appears that a considerable number of surgical interventions are being performed on children and young people unnecessarily. This is not only costly but is bound to be the cause of unjustified distress to some of those who are the most vulnerable. We recommend that the DoH should conduct urgent research in this area and then issue guidance to all those involved in the treatment of children." [From: "Hospital Services for Children and Young People" (128-I)]

"Surgical interventions should only be performed when clinically necessary, especially in children. The setting of clinical guidelines and standards for clinical practice are, of course, a matter for the appropriate surgical professional bodies. Clinical audit arrangements should a always be in place to assist in the application of good practice."

[From: (Cm 3793), November 1997 Government Response to the Reports of the Health Committee on Health Services for Children and Young People, Session 1996-1997: "The Specific Health Needs of Children and Young People" (307-I) Health Services for Children and Young People in the Community, Home and School" (314-I); "Hospital Services for Children and Young People" (128-I); Child and Adolescent Mental Health Services (26-I).].

"The right to physical and personal integrity, that is to protection from all forms of inter-personal violence, is a fundamental human right which extends fully to children, who are entitled to special care and assistance.

The Convention [on the Rights of the Child] establishes the right to protection from 'all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse' while in the care of parents and other carers (Article 19); from 'inhuman and degrading treatment and punishment' and unlawful or arbitrary restriction of liberty (Article 37); from harmful traditional practices (Article 24.3), and from all forms of exploitation (Articles 34 and 36). In particular the Convention emphasises that this right to freedom from all forms of violence must be available to all children without discrimination. Forms of violence to children cannot be justified on grounds of; for example, religion, culture or tradition."

[From: "Child Health Rights", subtitled "Implementing the UN Convention on the Rights of the Child within the National Health Service", ISBN 0 9525928 00, 1995 (Price

"To receive health care on the basis of your clinical need..." [The Patients' Charter]

...it remains our position that unless it can be unequivocally proven that a surgical procedure will not inflict long-term harm on the patient, it is irresponsible and unethical to perform it without a clear and pressing clinical need. [Dr John Warren, New BMA Circumcision Guidance Given 'Cautious Welcome', NORM-UK, 8th April 2003]