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Circumcision policy: A psychosocial perspective

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An article by Ronald Goldman, PhD, published in Paediatrics & Chid Health, Vol. 9, No. 9, pp. 630-33 (November 2003).  The article provides a very good overview of the current social standing of male infant circumcision. The author makes the point that the current reluctance to confront the religious issue undermines the core values (e.g., the health of the patient is paramount) and ethics (e.g., first, do no harm) that drive medical decision-making.

The ubiquity of circumcision in America may influence which questions are researched and which are ignored in American medical circumcision literature. Most American studies that assess the advisability of circumcision focus on the search for a benefit. Accordingly, one AAP Task Force on Circumcision member stated that the committee was formed "to determine if there was scientific evidence to justify circumcision." The answer is limited by the assumption inherent in the statement of the problem. Although claims of benefits generally do not withstand the scrutiny of policy committees, their continued publication over the years has led to medical myths believed by professionals and the public.
 

Policy statements from medical organisations in other English-speaking countries are generally more critical of circumcision, but they still tolerate it. Given the lack of proven safety and effectiveness, the principle of "first, do no harm," and the priority of the patients welfare over parental requests, why have these organizations not published stronger statements opposing circumcision? The answer may be related to the fact that in public discussions about circumcision in Canada and Britain, religious groups were the only ones to defend the practice. Some Europeans believe that the reluctance to criticize circumcision is due to fear of being accused of religious intolerance. This type of concern may have been involved when an investigation of circumcision by Australian authorities was halted after Jewish protest. Furthermore, in response to an inquiry about discouraging nontherapeutic circumcision, a representative of the United States Department of Health and Human Services stated that it is not proper for our Government to adopt a policy that is directly or indirectly critical of a religious practice.

The original article is available at the Paediatrics & Child Health website.

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