Argument: Circumcision wrongly inflicts severe pain on infants

Issue Report: Infant male circumcision


Rosemary Romberg. “Circumcision – The Painful Dilemma. Chapter Eleven: Complications of Circumcision (Condensed)”. Bergin & Garvey Publishers, Massachusetts. 1985 – “Critics of infant circumcision frequently express outrage that newborn infants are usually given no anesthesia for an operation considered painful enough to warrant anesthesia for an older child or an adult. However, administration of such drugs to newborn infants is riskier than anesthetizing an older individual.” Certainly if all newborn infants undergoing circumcision were being given general anesthesia for the operation we would see many more cases of death or difficulty from the anesthetic.”

Rosemary Romberg. “Circumcision – The Painful Dilemma.”. 1985 – Another reason to reject infant male circumcision is the pain it causes. In considering their obligation to “first do no harm,” physicians must give great weight to one of the most immediate harms of circumcision-it causes pain. Research has shown that we have been insensitive to those who are unable to verbalize their pain, that is, to put their suffering into words. We have carried out procedures on children that would never be carried out on adults without adequate and full anesthesia; as recent research on infant male circumcision has shown, traumatic pain experiences in very young children heighten their pain sensitivity, possibly for life. Research also shows that newborn babies have a unique nervous system that makes them respond to pain differently from adults. As journalist Victoria MacDonald, describing the recent research of Maria Fitzgerald, professor of neurobiology at University College, London, reports in London’s Sunday Telegraph:

Somerville, Margaret (November 2000). “Altering Baby Boys’ Bodies: The Ethics of Infant Male Circumcision”. 2000. – People have a fundamental human right not to have pain intentionally inflicted on them and, where pain is unavoidable, to have fully adequate treatment for the relief of that pain. These people include babies and children. Breach of this fundamental human right should be regarded as very serious wrongdoing. Recent medical research, people’s own observations and our own experience and common sense show that circumcision is an intensely painful procedure. It is therefore in violation of human rights unless it can be justified in particular cases. One issue is whether adequate pain relief can be obtained with local anesthesia, even a dorsal penile nerve block, or whether general anesthesia would be required to make the surgery involved in infant male circumcision pain-free. In my opinion, a physician would not be ethically or legally justified in administering a general anesthetic for a non-therapeutic intervention on a child who could not himself consent. There is also the question whether adequate pain relief can be obtained after the effects of the anesthetic have worn off. It takes approximately a week for the wound to heal, during which time, apart from other causes of pain, the open wound is in contact with the child’s urine. It is, indeed, a harsh welcome to the world.

George C. Denniston, MD, MPH. “Circumcision and the Code of Ethics”. Human Medicine Health Care. – Circumcision causes severe pain.4 Does a doctor who unnecessarily causes severe pain practice “with compassion?” Doctors may use a local anaesthetic; this does nothing for pain and suffering during the healing process. Also, does a doctor who removes a normal part of another person’s body without his consent “respect human dignity?” Every individual is entitled to an intact body and to fully informed consent before any part of his body is removed. These principles apply even more strongly to a healthy normal body part.

“The Pain of Circumcision Impacts Babies (and the Adults They Become)”. National Organization of Circumcision Information. Opposing Views – Circumcision is excruciatingly painful for a baby. Analgesia does not eliminate the pain of the amputation; the harm and pain persist long after any anesthesia has worn off. In addition, researchers observed a strong reaction to pain by circumcised babies undergoing vaccinations at four- and six-months and equated this reaction with post-traumatic stress disorder (PTSD).

[…]Whether or not infants feel pain has been an issue over the years. In 1656, Felix Wurtz, in The Children’s Book, asserted the idea that the less mature the infant, the greater degree of pain experienced. An infant’s pain was considered very real in the mid-19th century. In 1898, in his book, Therapeutics of Infancy and Childhood, A. Jacobi cautioned against chloroform, which produces shallow respirations, and ether, which has a detrimental effect on kidneys and lungs. He was aware of the need for analgesia in the newborn and the difficulty accomplishing it successfully.

This understanding was lost when Charles Darwin, in his 1872 book, The Expression of Emotions in Man and Animal, claimed that children’s physical responses to pain reflected sensory or emotional reactions to pain, but were just reflex actions, reinforced by habit. Even up to the 1980s, physicians performed surgery, including open-heart surgery, on infants without anesthesia. But, we now know that Wurtz was correct. Babies do feel and experience pain.

During the 1980s, Anand and Hickey monitored pain responses of babies undergoing circumcision and, in their landmark 1987 New England Journal of Medicine article, “Pain and Its Effects in the Human Neonate and Fetus,” concluded that infants feel as much—or more—pain as adults. It took another twelve years for the American Academy of Pediatrics to recommend analgesia for babies undergoing circumcision. Still, today, more than 50% of babies are circumcised without pain relief.