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Open Access Highly Accessed Debate

Recommendation by a law body to ban infant male circumcision has serious worldwide implications for pediatric practice and human rights

Michael J Bates1, John B Ziegler23, Sean E Kennedy3, Adrian Mindel4, Alex D Wodak5, Laurie S Zoloth6, Aaron AR Tobian7 and Brian J Morris8*

Author Affiliations

1 PO Box 29, Springwood 4127, Qld, Australia

2 Department of Immunology & Infectious Diseases, Sydney Children’s Hospital, Randwick, Sydney, NSW 2031, Australia

3 School of Women’s & Children’s Health, University of New South Wales, Sydney, NSW 2052, Australia

4 Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia

5 St Vincent’s Hospital and Kirby Institute, University of New South Wales, Sydney, NSW 2010, Australia

6 Program in Bioethics and Medical Humanities, Northwestern University School of Medicine, Chicago, IL 60611-3015, USA

7 Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA

8 School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW 2006, Australia

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BMC Pediatrics 2013, 13:136  doi:10.1186/1471-2431-13-136

Published: 8 September 2013

Abstract

Background

Recent attempts in the USA and Europe to ban the circumcision of male children have been unsuccessful. Of current concern is a report by the Tasmanian Law Reform Institute (TLRI) recommending that non-therapeutic circumcision be prohibited, with parents and doctors risking criminal sanctions except where the parents have strong religious and ethnic ties to circumcision. The acceptance of this recommendation would create a precedent for legislation elsewhere in the world, thereby posing a threat to pediatric practice, parental responsibilities and freedoms, and public health.

Discussion

The TLRI report ignores the scientific consensus within medical literature about circumcision. It contains legal and ethical arguments that are seriously flawed. Dispassionate ethical arguments and the United Nations Convention on the Rights of the Child are consistent with parents being permitted to authorize circumcision for their male child. Uncritical acceptance of the TLRI report’s recommendations would strengthen and legitimize efforts to ban childhood male circumcision not just in Australia, but in other countries as well. The medical profession should be concerned about any attempt to criminalize a well-accepted and evidence-based medical procedure. The recommendations are illogical, pose potential dangers and seem unworkable in practice. There is no explanation of how the State could impose criminal charges against doctors and parents, nor of how such a punitive apparatus could be structured, nor how strength of ethnic or religious ties could be determined. The proposal could easily be used inappropriately, and discriminates against parents not tied to the religions specified. With time, religious exemptions could subsequently be overturned. The law, governments and the medical profession should reject the TLRI recommendations, especially since the recent affirmative infant male circumcision policy statement by the American Academy of Pediatrics attests to the significant individual and public health benefits and low risk of infant male circumcision.

Summary

Doctors should be allowed to perform medical procedures based on sound evidence of effectiveness and safety with guaranteed protection. Parents should be free to act in the best interests of the health of their infant son by having him circumcised should they choose.

Keywords:
Circumcision; Infancy; Law; Ethics; Surgery; Public health; Religion; Tasmanian Law Reform Institute; American Academy of Pediatrics; Australia