Ethics of Child Circumcision
Including Current Statements from British Authorities
Last updated on 22nd June 2003It has become common among those who express flippancy or enthusiasm for circumcision to declare that the procedure offers unspecified "health benefits". This has been used as a way to coerce hesitant parents into agreeing to the procedure. The British Medical Association has recently made its position on such things very clear:
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’s best interests falls to his parents.
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]
NORM-UK regularly discovers cases of doctors in the UK performing circumcisions on young boys without either providing up to date written information to the parents or obtaining written consent*. We do not believe that this should be allowed to continue and are actively involved in trying to improve the situation. Neither do we believe that it is appropriate for the NHS to use taxpayers' money to subsidise any medically unnecessary surgery simply for religious or personal preference.
"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)]
Ultimately many do not believe that parents should have the right to make this choice. There is every reason to believe that amputation of part of a sexual organ has an irrevocable effect on the future sexual experience of the individual, and without compelling evidence to prove that this is not the case it seems irresponsible to perform it. Furthermore, if the child is left alone he will be free to exercise his own choice as an adult, whereas surgery will take that choice away.
"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."
"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]
*For example: The case of Doctors Michael Harbinson and Peter Silverstone [Circumcision doctors 'abused position'. BBC News, London, 21 August 2001.]