Sunday, March 07, 2010

Speaking of informed consent...

How many people consent to circumcision for their newborn sons without any real informed consent, simply because the procedure is considered "routine"?

Let's look at some information here:

  • Circumcision Deaths: "Neonatal circumcision has no medical indication and is now considered to be an unnecessary non-therapeutic operation. It is unethical to carry out such operations on minors who cannot consent for themselves. Consequently, most doctors who have a baby die after a circumcision would prefer to attribute the results of his unethical operation to secondary causes, such as infection or bleeding, while ignoring the primary cause, which is the circumcision that resulted in the infection or bleeding. .... Male infant mortality is higher than female infant mortality. It is not known how much of this increased mortality is due to the practice of male circumcision." Circumcision is typically recommended to prevent later cancer of the penis. "Sydney Gellis believed that "there are more deaths from complications of circumcision than from cancer of the penis. There are various figures for the number of deaths from penile cancer ranging from 200 to 480 deaths per year. Robert Baker estimated 229 deaths per year from circumcision in the United States."

  • Prophylactic interventions on children: balancing human rights with public health: "Although the complication rate from routine circumcision is low,32 the potential for these complications to be catastrophic, mutilatory, infective or haemorrhagic is very high.33 The tragedy of death, gangrene, or total and partial amputation of the penis are some of the possible complications of routine circumcision that cannot be justified on any grounds, either in terms of public health gains or the best interest of the child."

  • American Academy of Pediatrics Circumcision Statements: "There are no valid medical indications for circumcision in the neonatal period." (1971) "A program of education leading to continuing good personal hygiene would offer all the advantages of circumcision without the attendant surgical risk. Therefore, circumcision of the newborn cannot be considered an essential component of adequate total health care." (1975)

    And I really have to wonder how many parents would consent to routine circumcision for their sons if they knew of the following cases:

  • Boy in coma most of his 6 years dies
  • Baby bleeds to death after circumcision
  • Lack of post-surgery info angers grieving parents
  • Neonatal meningitis and circumcision
  • Overwhelming Infection with Group B β-Hemolytic
    Streptococcus Associated with Circumcision

    Some people consider mutilating an infant to be a preventative health measure, but I'm not buying it.

    Lilliput said...

    Christina as probably the only jew here who incidently went to two circumcisions last week in rooms filled with men that I knew all went through the same thing - what am I supposed to say to this post. Are you trying to say that Jews shouldn't do this?

    Christina Dunigan said...

    Lil, a religious decision is different from a medical decision. And what I'm addressing is the routine "prophylactic" circumcision of newborn males as a public health strategy. A bris is another matter entirely!

    Lilliput said...

    I don't know but it sounds to me that if a Bris is ok then male circumcision is ok then it can be offered as a public service for parents to be able to choose it? I don't think its something that should be forced or denied.

    army_wife said...

    I had my first two sons circumcised because at the time I was under the impression that there were good enough medical benefits to warrant doing so. However, by the time my last son was born, I realized that it was unnecessary and therefore did not have it done. I decided that for my last son (and any future sons, should we have more), I would leave it up to him to decide. If he wants it done as an adult, then great - at leats he's the one choosing what to do with his own body. I feel bad for circumcising my first two, but I didn't know any better and there's nothing I can do now. I thought I was doing it for their own good at the time. Circumcision is normative in my family so I didn't think there was anything wrong with it then. But live and learn.

    Mark Lyndon said...

    Not all Jewish people believe in circumcision. Brit Shalom is an alternative naming ceremony to celebrate the birth of baby boys to Jewish families. These sites are all run by Jewish people opposed to circumcision:

    Personally, I don't think that anyone's religious rights extend to cutting parts off their son's penis. No-one complained when it was made illegal to cut parts off the genitals of girls (regardless of the religious beliefs of the parents). It's illegal to cut the prepuce off a baby girl, or even to make an incision without removing any tissue. Why don't boys get the same protection? If someone wants to be circumised for religious reasons, that should be his decision, not something his parents decide for him.

    There is no other healthy living tissue that can be cut off a child's body. Why is an exception made for the male prepuce?

    Christina Dunigan said...

    Lil, a religious decision is just that. Just as an Amish patient will reject a pacemaker, NOT as a medical decision but as a RELIGIOUS one, Jewish parents having a bris are making a RELIGIOUS choice.

    But routine circumcision for either public health or as a prophylactic measure are MEDICAL decisions, and ought to be made based on sound MEDICAL information, and not just because Dad was circumcised so we'll do Jr. too.

    Christina Dunigan said...

    Mark, I can see your point. But it's hard to argue against a religious practice that's performing the same type of surgery that's being justified on medical grounds.

    L. said...

    Funny -- my (uncircumcised) Japanese husband inisted on having our first son (born in the U.S.) circumsized, because he had a close friend who was circumsized as an adult due to repeated infections and he wanted to spare his son this excrutiating possibility by getting a tiny snip with topical anesthesia. He also said he wanted our son's penis to "look American," which I can't even type without cracking up. I let my husband make all the penis-related decisions in our family, so I didn't argue, even though it seemed a bit unnecessary to me. Overall, I have to say, it didn't seem to be any big deal. And 15 years later, it still doesn't.

    Our second son was born in Tokyo, and I couldn't find anyone willing to circumcize him here without general anesthesia. (Granted, I didn't look very hard, since I wasn't the one pushing for it.) So my younger son will have to get it done later if he wants to "match" his brother. (Kidding. I really don't think it matters, either way.)

    I think comparing male circumcision to female circumsicion is like comparing hangnail removal to hand amputation!

    It's kind of like ear piercing -- I have a friend whose baby daughter's ears became horribly infected so I was against doing it, but I know in plenty of cultures around the world, it is done to girl babies right after birth and is usually fine.

    I do agree parents should be informed, and supported if they choose to leave things in their natural state -- and educated on how to prevent infections if they decide for any reason to go through with circumsizing/piercing.

    Kathy said...

    Some forms of female circumcision are similar to male circumcision -- as to what tissue and how much is removed. Other forms are worse, and even much worse. However, I think female circumcision is completely forbidden in the US and possibly/probably other Western countries, and I think the UN and/or the WHO have called for a worldwide ban on it.

    Katie said...

    Awesome post, thank you. Circumcision is messed up, and the irony of pro-abortionists supporting it is even more messed up. Apparently "my body my choice" only applies to females.

    And yes, RIC is totally different than a bris. While bris can be botched, too (sadly I've known a few Jewish families this happened to), in general it's a much different procedure. RIC involves the complete amputation of the foreskin, whereas bris traditionally involved only removing a small portion of the foreskin.

    Though, I think it's bizarre when cultural Jews do it, especially since I know a lot who do it on day 3 in the hospital. Which, if I'm understanding right, makes it an invalid circ anyway.