The Ethics of Circumcision in Medicine - Special Academic Support

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If you were to ask parents why they might have their son circumcised most would probably answer hygiene. This decision is also almost always made directly after birth or in other words neo-natal. The consenting parties in most cases are the birth parents who are in most cases told nothing by a doctor and themselves likely know very little about its risks. All of this is compounded with the fact that a decision must be made quickly reducing their chance to take into account ethical questions that arise with irreversible procedures. Among these questions are Is it ethically acceptable to surgically alter the natural genitals of a child without a compelling therapeutic reason; and Who is the appropriate person to give permission for elective, nontherapeutic cutting of an infants genitals. These are questions are worthy of further consideration because they can only pertain to baby boys, they would never be asked in the case of an adult or baby girls who are protected from circumcision by federal law (18 U.S. Code § 116). So why must these questions be considered in America {amount of male newborns a day}. Established rules on human rights and medical ethics do not support the removal of healthy, functional tissue, unless that person elects to do so voluntarily.

Historically in the united states the one that made the decision was the doctor. In most situations the first time a mother held her child the procedure would have already been performed. However, in the 1970s medical ethics changed to a point where it was acknowledged that the patient had a right to make decisions about their childs body. This is not far enough as the person whose body is affected most by this decision is not the parent but the child himself. Circumcision is often referred to as a personal choice but how can it be if the person who has been circumcised didnt make the choice.

In medical ethics there are 4 fundamental principles they are; Non-maleficence, Beneficence, Autonomy, and Justice (Jahn). Non- maleficence is the idea that the proposed intervention will not cause unnecessary harm. Most would think of this harm as only physical but what many dont consider is emotional or sexual harm that may manifest in the childs future. Beneficence deals with the idea that the patient may stand to benefit from proposed intervention. At present this is the most common justification for the procedure. The most commonly cited benefit is a small amount of protection against HIV(Sazabo). However, this would only ever benefit a small proportion of males and so is no justification for the procedure to be as common as it is. In addition, there are also far more conservative ways of warding off infection by way of basic hygiene and safe sex behaviors. Autonomy is when the patient has a recognized right to make their own decisions about medical interference. This is the most important principal because respects the patients right to self determination and knowing what is best for themselves. In all cases of neo natal circumcision this principle is infringed upon. The final principal of medical ethics is justice which is the idea of fairness and discrimination and is this medical intervention deserved based on benefits and burdens. As no other type of patient is treated this way the answer is obviously no, this is unjust.

On top of medical ethics principals, the united nations have made a number of pertinent statements on human rights. Like medical ethics these human rights statements are based on the inherent dignity of all human beings and the rights derived from it. In 1948 the united nations Made their Universal Declaration of Human Rights. This declaration lists children as having the same rights as adults. However, because of inherent vulnerability of children they were granted unique protections at the convention on rights of the child in 1989. Of the rights listed in 1948 that pertain to circumcision are; The Right to Life, Liberty, and security of person (United Nations). In international human rights law, the phrase security of person can be taken as meaning the physical integrity of every person. Also in 1948 people were granted a Right to freedom from cruel, inhumane and degrading treatment. As we have already seen above circumcision fails pass medical ethics and could be easily argued as infringing on any of the those three. The convention of 1989 enumerated several more rights that impugn neo natal circumcision. Among these is the right to opportunities for children to develop physically, mentally, morally, spiritually, and socially in a healthy and normal manner, and in conditions of freedom and dignity. Another right given was right to protection from all forms of mental and physical violence, injury, or abuse, including sexual abuse. The third and most poignant the right of protection from traditional practices prejudicial to the health of children. (United Nations)

Circumcision is a non-therapeutic medically unnecessary, irreversible amputation of a normal, healthy, functional body part from aa non-consenting person. Even when there is no disease or deformity present in the newborn baby this surgery is offered. It is offered for social, religious and most often for the cosmetic preference of the parents. Most amputative surgeries are offered as a last resort due to their irreversible nature and the effect of such surgeries will permanently alter the patients life. In almost any other case the such a procedure would be ethically ok because it is made by an informed consenting adult. There is no medical professional whose code of ethics would allow them to perform an amputative surgery at a non-patients request. Yet this is done everyday to baby boys without anesthetic based solely on the whims of their parents. In cases with no valid medical reason neo natal circumcision is unethical and morally impermissible because it violates a persons sovereignty over their own body as well as their autonomy.

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