No Medical Association in the World recommends male infant circumcision
“The official viewpoint of KNMG (The Royal Dutch Medical Association) and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.”
“Recent policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns.5,8-10” – American Medical Association
“benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised.”
The Canadian Paediatric Society “does not support recommending circumcision as a routine procedure for newborns.”
The Paediatrics & Child Health Division, The Royal Australasian College of Physicians (RACP) has prepared this statement on routine circumcision of newborn and infant boys. Released Aug.27, 2009
“When considering routine infant circumcision, ethical concerns have focused on recognition of the functional role of the foreskin, the non-therapeutic nature of the operation, and the psychological distress felt by some adult males circumcised as infants. The possibility that routine circumcision contravenes human rights has been raised because circumcision is performed on a minor for non-clinical reasons, and is potentially without net clinical benefit for the child.
Recently there has been renewed debate regarding both the possible health benefits and the ethical concerns relating to routine male circumcision. The most important conditions where some benefit may result from circumcision are urinary tract infections, and in adults HIV infection and cancer of the penis. The frequency of these conditions, the level of protection offered by circumcision and complication rate of circumcision do not warrant a recommendation of universal circumcision for newborn and infant males in an Australian and New Zealand context.”
No evidence to support routine circumcision
September 12, 2009
The key point of the recent statement on circumcision from the Royal Australasian College of Physicians is that the college believes there is no evidence to support routine circumcision of newborn and infant males (”Doctors circumspect on circumcision”, September 11).
Your article sends the dangerous message that circumcision prevents HIV transmission. It is vital that everyone engage in safe sexual practices such as condom use, whether circumcised or not. Recent reports of circumcision offering some protection against HIV infection in Africa relate to circumcision of adult males, not of infants.
The stated benefits of protection against urinary tract infection are marginal, and do not justify mass circumcision. Our changing understanding of the relationship between urinary tract infection and chronic renal disease further weakens the case for routine circumcision.
There is evidence that circumcision does result in memory of painful experiences, and is not quite as simple and low risk as your report suggests.
The college’s statement is not anti-circumcision, but clearly states that parents should be informed of risks and benefits, and then supported in their decision. When circumcision is undertaken it should be with appropriate anaesthesia, and by a skilled operator who can minimise the risk of side effects.
The option of delaying the decision to circumcise is one way of dealing with the ethical and potential legal issues of undertaking an elective procedure in a minor. The procedure is not to be equated with vaccination, either in its delivery or its effectiveness.
Professor Brian Morris, quoted in your report, is not a member of the college. He is not and has not been engaged as a reviewer for the college.
David Forbes Chairman, pediatrics and child health policy and advocacy committee, Royal Australasian College of Physicians, Sydney