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Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non- Therapeutic Circumcision

Posted: April 15th, 2015 | Author: | Filed under: Babies, Children, Circumcision, Foreskin | No Comments »

Excerpt from an article by Robert Darby, published by Kennedy Institute of Ethics Journal Vol. 25, No. 1, 1–34 © 2015 by The Johns Hopkins University Press. Emphasis added by this website.

It is a sign of the increasingly controversial status of routine circumcision that the American Academy of Pediatrics policy released in August 2012 attracted strong dissent, not merely from long-standing critics of circumcision, but from previously uncommitted child health experts in Europe as well. The scale of the dissent is all the more striking given that the policy differs little from the quietly received 1989 statement (which found that circumcision had potential benefits, but not enough to justify it as a routine) or even the 1999 statement, which reached a neutral stance and left it up to the parents. The only major difference in the new policy is that while it continues not to recommend circumcision, it states that the benefits outweigh the risks and are great enough to authorize parental decision-making and payments by health insurance providers. Although this is largely a continuation of the status quo, it is precisely on these points that objections have fallen most heavily.

According to the critics, the AAP policy is flawed because it does not establish that the benefits of circumcision outweigh the risk and does not justify its secondary (but unrelated) contention that the decision about whether a boy should be circumcised should be made by his parents. While the brief (widely quoted) statement asserts that “the health benefits of newborn male circumcision outweigh the risks” the lengthy (but less readily available) report acknowledges that

The true incidence of complications after newborn circumcision is unknown, in part due to differing definitions of “complication” and differing standards for determining the timing of when a complication has occurred (ie, early or late). Adding to the confusion is the comingling of “early” complications, such as bleeding or infection, with “late” complications such as adhesions and meatal stenosis.

In its reply to their critics, the AAP admitted that it had not surveyed the literature of complications case reports, but added that the benefits of circumcision “were felt to outweigh the risks of the procedure” (AAP Task Force on Circumcision 2013).

“…had not surveyed the literature… benefits… were felt to outweigh the risks…? Surely real scientists would actually study the subject before expressing their feelings! Oh, ethics! Oh, evidence-based medicine, wherefore art thou? How revealing and how embarrassing for them that they did not bother to study the complications case reports. “Don’t confuse us with the facts,” head-buried-in-sand ostrich behavior here – and so, children continue to be tortured and traumatized by people masquerading as “healing professionals”.

Read the full article and save it to your computer if you wish: Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non- Therapeutic Circumcision