Is infant male circumcision an abuse of the rights of the child?December 10, 2007Circumcision is one of the commonest surgical procedures performed on males. Opponents argue that infant circumcision can cause both physical and psychological harm, while recent evidence shows that circumcision is medically beneficial. Two doctors debate the issue in this week's BMJ. There is now rarely a therapeutic indication for infant circumcision, yet ritual (non-therapeutic) male circumcision continues unchecked throughout the world, long after female circumcision, facial scarification, and other ritual forms of infant abuse have been made illegal, writes Geoff Hinchley, a consultant at Barnet & Chase Farm NHS Trust. The law and principles pertaining to child protection should apply equally to both sexes, so why do society and the medical profession collude with this unnecessary mutilating practise, he asks" In addition to religious justification, there have been many spurious and now unsupported claims for circumcision including the prevention of penile cancer, masturbation, blindness, and insanity, most of which relate to adult sexual behaviour and not to the genital anatomy or best interest of a child, he adds. There may be a case that male circumcision reduces HIV risk in sexually active adults, however the decision on whether an individual wishes to have this procedure should be left until they are old enough to make their own informed health care choices. Male genital mutilation is not a risk-free procedure, he adds. Far from being a harmless traditional practice, circumcision damages young boys. And in terms of legal protection, he argues that both the US and the UK legal systems discriminate between the sexes when it comes to protecting boys and girls from damaging ritual genital mutilation. The unpalatable truth is that logic and the rights of the child play little part in determining the acceptability of male genital mutilation in our society, he writes. The profession needs to recognise this and champion the argument on behalf of boys that was so successful for girls. But Kirsten Patrick of the BMJ argues that, if competently performed, circumcision carries little risk and cannot be compared with female circumcision. Although any surgical operation can be painful and do harm, the pain of circumcision, if done under local anaesthesia, is comparable to that from an injection for immunisation, she writes. In terms of evidence of benefit, male circumcision has been associated with a reduced risk of sexually transmitted infections, such as human papilloma virus, chancroid and syphilis. Robust research has also shown that circumcision can reduce the spread of HIV. And although the complication rate for infant circumcision is essentially unknown (because most operations are unregistered) data suggest that it is between 0.2% and 3%, with most complications being minor. Furthermore, she says, no robust research exists examining the long term psychological effects of male infant circumcision. Despite the fact that no medical body advocates routine male infant circumcision, most agree that it is safe and acceptable and recommend that the procedure is carried out by a competent operator using adequate anaesthesia. Male circumcision is not illegal anywhere in the world. It is a choice that parents will make on behalf of their male children, for cultural or other reasons, and regulating its provision is the wisest course of action, she concludes. An accompanying clinical review concludes that medical indications for male circumcision in both childhood and adulthood are rare, but that complications can be drastic. BMJ-British Medical Journal |
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| Related Circumcision Current Events and Circumcision News Articles Music played to premature babies may lessen pain and improve feeding habits Music played to premature babies may help to reduce their pain and encourage better oral feeding, suggests research published ahead of print in the Archives of Disease in Childhood. Adult circumcision reduces risk of HIV transmission without reducing sexual pleasure Two studies presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA) show that adult circumcision reduces the risk of contracting the human immunodeficiency virus (HIV) and the risk of coital injury¬¬--without reducing pleasure or causing sexual dysfunction. UAB researchers report breakthrough in HPV research UAB (University of Alabama at Birmingham) researchers have developed a new, inexpensive and efficient method for producing and studying a type of human papillomavirus (HPV) that causes cervical cancer. The process could speed understanding of how the virus functions and causes diseases, and lead to new prevention or treatment options. Circumcision rates lower in states where Medicaid does not cover procedure Hospitals in states where Medicaid does not pay for routine male circumcision are only about half as likely to perform the procedure, and this disparity could lead to an increased risk of HIV infection among lower-income children later in life, according to a UCLA AIDS Institute study. Male Circumcision May Decrease Risk of HPV Infection and Cervical Cancer Two new studies suggest that male circumcision may assist in the prevention of human papillomavirus (HPV) infection, particularly infection with the high-risk subtypes associated with cervical, penile, and other cancers. Circumcision Reduces the Risk of HIV Infection in Heterosexual U.S. Men A new U.S. study has found that being circumcised significantly reduced the risk of HIV infection in heterosexual African American men known to have been exposed to the virus. Male circumcision efforts lag in Africa despite evidence of dramatic impact in preventing HIV With millions of lives at stake over the next two decades, researchers and advocates at the AIDS 2008 Conference today called on the global health community to ramp up male circumcision to significantly reduce risk of HIV infection in Africa, and to move quickly to integrate the life-saving procedure into other comprehensive efforts to prevent transmission of the disease in the vulnerable nations of eastern and southern Africa. New Male Circumcision Device for HIV Prevention Studied by NewYork-Presbyterian/Weill Cornell With the recent endorsement by the World Health Organization (WHO) and scientists worldwide of adult male circumcision as an important strategy for HIV prevention, there is increased urgency to develop safe and cost-effective circumcision services. This is especially the case in Africa where HIV/AIDS continues to spread at an epidemic rate. The release of new data from the HVTN 502 HIV vaccine study The new analyses revealed today from the STEP HIV vaccine clinical trial are both disappointing and puzzling. At this time, the data offer no clear explanations as to why the vaccine showed no measurable efficacy or why among individuals with background immunity to the adenovirus vector, there were more HIV infections in the vaccinees as compared to those in the placebo group. Male circumcision for HIV prevention and more Three clinical trials in Africa found that adult male circumcision reduced the risk of men acquiring HIV infection from heterosexual sex by 51-60%. More Circumcision Current Events and Circumcision News Articles |
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