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8/4/2003 New BMA Circumcision Guidance Given 'Cautious Welcome'
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08 April 2003
FOR IMMEDIATE RELEASE

New BMA Circumcision Guidance Given "Cautious Welcome"

Leading campaigner Dr John Warren has today given a cautious welcome to "The law & ethics of male circumcision - guidance for doctors", which has just been issued by the British Medical Association. Dr Warren is chairman of NORM-UK, the charity that provides medical information about male circumcision and the functional value of intact male genitals.

"The BMA is clearly giving the subject careful thought", he said,"However 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 Warren began to educate the public about circumcision in 1994, providing information and advice about the effects and promoting non-surgical alternative treatments. NORM-UK is now a national charity which also provides information to many circumcised men who want to restore some of what they have lost. The organisation has helped more than 3,000 people, produces a quarterly magazine and runs a website.at www.norm-uk.org.

The BMA guidance is an update to that issued in 1996 and makes a clear distinction between therapeutic and non-therapeutic male circumcision. It restates "to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate" which first appeared in the original document.

The document summarises the present law on non-therapeutic male circumcision by saying that it is generally assumed to be lawful provided that it is performed competently, it is believed to be in the child's best interests, and there is valid consent. Guidance on the detailed requirements for valid consent are given. In particular the wishes that children express must be taken into account and consent should be confirmed in writing. Where parents disagree about whether or not a child may be circumcised, doctors are advised not to circumcise without leave from a court.

Whilst the the BMA guidance falls short of saying that male circumcision is always harmful, it confirms that parental preference alone is not sufficient justification for performing a surgical procedure on a child. The BMA considers that the evidence suggesting health benefit from non-therapeutic circumcision is insufficient to be a justification for doing it, and that the procedure has "widely acknowledged medical and psychological risks". Doctors are advised to ensure that any parents seeking circumcision for their son in the belief that it confers health benefits are fully informed of the lack of consensus amongst the profession over such benefits. Doctors are under no obligation to comply with a request to circumcise a child. If doctors are asked to do so but have a conscientious objection, they should explain this to the child and his parents.
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--CONTACT--
For further information contact
NORM-UK http://www.norm-uk.org
NORM-UK, David Smith: tel/fax 01785 814044, 07751 915921, info@norm-uk.org
The BMA - Medical Ethics Department: tel 020 7383 6286, fax 020 7383 6233, ethics@bma.org.uk

--NOTES--
* Dr Warren is a consultant physician at the Princess Alexandra Hospital in Harlow, Essex.
* NORM-UK was founded in 1995 and gained charity status in 1998. The registered charity number is 1072831
* The charity is run by volunteers and relies entirely on private donations for funding
* The BMA guidance for doctors is available to read on the internet at http://www.bma.org.uk/
* In May 2002 a study in the Journal of Urology reported that circumcision appears to result in worsened erectile function, decreased penile sensitivity and that 38% of men circumcised as adults reported harm to sexual function.
* In 2001 Sweden outlawed circumcision of boys under 18 years except where medically indicated or specially licensed.
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