Tuesday, August 28, 2012

Circumcision: maybe not so repugnant after all

While a German court's ban on circumcision earlier this summer continues to be debated in Germany (where criminal charges have now been filed against a mohel--a religious circumciser), the American Academy of Pediatrics has issued a report saying that the health benefits of circumcision outweigh the risks, and that it should be covered by medical insurance.

Here's the NY Times story: Benefits of Circumcision Are Said to Outweigh Risks

"The American Academy of Pediatrics has shifted its stance on infant male circumcision, announcing on Monday that new research, including studies in Africa suggesting that the procedure may protect heterosexual men against H.I.V., indicated that the health benefits outweighed the risks.

"But the academy stopped short of recommending routine circumcision for all baby boys, saying the decision remains a family matter. The academy had previously taken a neutral position on circumcision.

"The new policy statement, the first update of the academy’s circumcision policy in over a decade, appears in the Aug. 27 issue of the journal Pediatrics. The group’s guidelines greatly influence pediatric care and decisions about coverage by insurers; in the new statement, the academy also said that circumcision should be covered by insurance.

"The long-delayed policy update comes as sentiment against circumcision is gaining strength in the United States and parts of Europe. Circumcision rates in the United States declined to 54.5 percent in 2009 from 62.7 percent in 1999, according to one federal estimate. Critics succeeded last year in placing a circumcision ban on the ballot in San Francisco, but a judge ruled against including the measure.

"In Europe, a government ethics committee in Germany last week overruled a court decision that removing a child’s foreskin was “grievous bodily harm” and therefore illegal. The country’s Professional Association of Pediatricians called the ethics committee ruling “a scandal.”

"A provincial official in Austria has told state-run hospitals in the region to stop performing circumcisions, and the Danish authorities have commissioned a report to investigate whether medical doctors are present during religious circumcision rituals as required.

"Officials with the Centers for Disease Control and Prevention in Atlanta, which for several years have been pondering circumcision recommendations of their own, have yet to weigh in and declined to comment on the academy’s new stance. Medicaid programs in several states have stopped paying for the routine circumcision of infants."

The American pediatricians are unlikely to have much impact on the debate in Europe, but their opinion might make it even harder for attempts to ban circumcision in the U.S., like the failed attempt in California.


Anonymous said...

The AAP are way out of line with other national medical organizations, and it's very disappointing that they say this:
"Parents are entitled to factually correct, nonbiased information about circumcision"

but they provide information that is both biased and highly selective. They simply don't seem to consider that the foreskin might actually be valuable.

It's really easy to find circumcised doctors who are against circumcision, but surprisingly difficult to find male doctors in favor who weren't circumcised themselves as children.

How strange that all the health benefits the AAP claim don't seem to exist in Europe, where almost no-one circumcises unless they're Jewish or Muslim.

The AAP is the same organization that changed its policy on female cutting in 2010 btw saying "It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual [clitoral] nick as a possible compromise to avoid greater harm."
They were forced to retract this about six weeks later:

Dr Diekema, the chair of the committee said "We're talking about something far less extensive than the removal of foreskin in a male".

I suppose it's a good thing they didn't look at operating on girls to prevent breast cancer. 11% of women get breast cancer, and 3% die of it, so the health benefits to the girls would massively outweigh the risks.

Meanwhile, other national health organizations including the Canadian Paediatric Society and the Dutch Medical Association continue to recommend *against* circumcising newborns.

TLC Tugger said...

Other medical societies have looked at the same issue and reached the opposite conclusion.

Germany's PAP says it's "a scandal" to allow forced genital cutting of infants. Holland's recent KNMG policy says infant circumcision has "an absence of medical benefits and danger of complications." Perhaps not coincidentally, in places where doctors are on salary rather then getting paid per procedure, they don't find the procedure warranted.

Foreskin feels REALLY good. HIS body, HIS decision.