Citation

Svoboda JS, Adler PW, Van Howe RS. J. Law Med. Ethics 2016; 44(2): 263-282.

Affiliation

J. Steven Svoboda, M.S., J.D., is Executive Director of Attorneys for the Rights of the Child, graduated with honors from Harvard Law School and has a B.S. (Physics and English, summa cum laude) from the University of California at Los Angeles and a Master's Degree in Physics from the University of California at Berkeley. He presented to the United Nations on male circumcision as a human rights violation. He has published numerous articles regarding male circumcision in publications such as the Journal of Law, Medicine & Ethics, the American Journal of Bioethics, the Journal of the Royal Society of Medicine, and, most recently, the Journal of Medical Ethics. Peter W. Adler, J.D., M.A., is Legal Advisor to Attorney For the Rights of the Child. He holds a B.A. degree in Philosophy from Dartmouth College (magna cum laude, Phi Beta Kappa), an M.A. degree with Honours in Philosophy from Cambridge University, and a J.D. degree from University of Virginia School of Law, where he was an editor of the Virginia Law Review and the Virginia Journal of International Law. Robert S. Van Howe, M.D., M.S., is Professor and Interim Chairman of Pediatrics at Central Michigan University College of Medicine. His research interests include primary care issues, evidence-based medicine, and the efficacy of teaching bioethics to medical students. He has been an invited presenter to the American Academy of Pediatrics Task Force on Circumcision and to Centers for Disease Control and Prevention and is currently working on a book on the ethics of genital alteration.

Copyright

(Copyright © 2016, American Society of Law, Medicine and Ethics, Publisher John Wiley and Sons)

DOI

10.1177/1073110516654120

PMID

27338602

Abstract

The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision-the removal of this structure-is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.

Circumcision is usually performed for religious, cultural and personal reasons. Early claims about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.

Circumcision violates the cardinal principles of medical ethics, to respect autonomy (self-determination), to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent. In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys' absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision.

© 2016 American Society of Law, Medicine & Ethics.

Language: en