Comment & Debate
Somerville, Margaret (November 2000). “Altering Baby Boys’ Bodies: The Ethics of Infant Male Circumcision”. 2000. – Physicians who undertake infant male circumcision could be legally liable for medical malpractice (civil liability in battery or negligence), which can result in an award of damages simply for carrying out the circumcision even if it was competently performed. They could also, as explained, be charged with criminal liability for assault. In both ethics and law, a physician has a primary obligation of personal care to the patient. This obligation requires the physician both to place the patient first and to first do no harm. Physicians who undertake surgery on patients must prove that it is justified. The usual justification is that the surgery is necessary therapy and that the patient—or if incompetent, the patient’s legal representative—gave informed consent to the surgery. In general, parents cannot authorize non-therapeutic interventions—that is, routine circumcision—on their children. A competent adult man could consent to non-therapeutic circumcision on himself, but this does not mean he may consent to it on his son. If the parents’ consent to the circumcision of their son was held to be legally inoperative, the physician would be liable. Moreover, if, in the light of new medical evidence, a reasonably careful and competent physician would not consider it medically necessary to undertake circumcision on a child, to do so could result in legal liability regardless of the parents’ consent. Such liability is even more likely if a reasonably careful and competent physician would consider it not just unnecessary but contrary to a reasonable standard of medical care to undertake circumcision on a particular child in given circumstances. A long-recognized example of such a situation is when the child suffers from haemophilia, a condition that could cause him to bleed to death from circumcision. But as our knowledge of the risks and harms of circumcision expands, the range of circumstances in which undertaking routine circumcision on any child is a breach of a reasonable standard of medical care also expands. To summarize, it seems to me clear that, certainly outside the religious context, recent medical research on routine infant male circumcision shows that this operation cannot be ethically or legally justified on the basis of its potential medical benefits.
“Is Non-Therapeutic Circumcision Ethical?”. National Organization of Circumcision Information. Opposing Views – Parents and guardians do not have the right to consent to the surgical removal or modification of their children’s normal genitalia, just as they cannot authorize removal of their child’s normal ear, nose, or labia. Physicians and other healthcare providers have an obligation to refuse to remove or mutilate normal, healthy body parts. In addition, insurers are ethically bound not to fund such practices.
Only when a diagnosed condition exists, and after all less invasive treatments have been exhausted, can circumcision be performed on a minor and, then, only with the parent’s informed consent. This is the standard of care for all other procedures, yet it has never been applied to the medical anomaly of circumcision.
[From: (Cm 3793), November 1997 Government Response to the Reports of the Health Committee on Health Services for Children and Young People, Session 1996-1997: “The Specific Health Needs of Children and Young People” (307-I) Health Services for Children and Young People in the Community, Home and School” (314-I); “Hospital Services for Children and Young People” (128-I); Child and Adolescent Mental Health Services (26-I).]. – “Surgical interventions should only be performed when clinically necessary, especially in children. The setting of clinical guidelines and standards for clinical practice are, of course, a matter for the appropriate surgical professional bodies. Clinical audit arrangements should a always be in place to assist in the application of good practice.”[1]
Dr John Warren, New BMA Circumcision Guidance Given ‘Cautious Welcome’, NORM-UK, 8th April 2003 – …it remains our position that unless it can be unequivocally proven that a surgical procedure will not inflict long-term harm on the patient, it is irresponsible and unethical to perform it without a clear and pressing clinical need.[2]