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2013-03-01 Pediatrics - Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision

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  • 2013-03-01 Pediatrics - Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision


    PDF Version http://pediatrics.aappublications.or...-2896.full.pdf (attached)

    ^^ The AAP’s extensive report was based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious. The conclusions of the AAP Technical Report and Policy Statement are far from those reached by physicians in most other Western countries.

    As mentioned, only 1 of the aforementioned arguments has some theoretical relevance in relation to infant male circumcision; namely, the questionable argument of UTI prevention in infant boys. The other claimed health benefits are also questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves. Circumcision fails to meet the commonly accepted criteria for the justification of preventive medical procedures in children.

    The cardinal medical question should not be whether circumcision can prevent disease, but how disease can best be prevented.

    The AAP report lacks a serious discussion of the central ethical dilemma with, on 1 side, parents’ right to act in the best interest of the child on the basis of cultural, religious, and health related beliefs and wishes and, on the other side, infant boys’ basic right to physical integrity in the absence of compelling reasons for surgery. Physical integrity is 1 of the most fundamental and inalienable rights a child has. Physicians and their professional organizations have a professional duty to protect this right, irrespective of the gender of the child.

    There is growing consensus among physicians, including those in the United States, that physicians should discourage parents from circumcising their healthy infant boys because nontherapeutic circumcision of underage boys in Western societies has no compelling health benefits, causes postoperative pain, can have serious long-term consequences, constitutes a violation of the United Nations’ Declaration of the Rights of the Child, and conflicts with the Hippocratic oath: primum non nocere: First, do no harm. ^^
    Attached Files
    -Ron Low
    [email protected]
    847 414-1692 Chicago