AAP Circumcision Policy 'Seriously Flawed', Condemned by Canadian Children's Rights Group
AUG 27, 2012 - 03:01 ET
FOR: CHILDREN'S HEALTH & HUMAN RIGHTS PARTNERSHIP
VICTORIA, BRITISH COLUMBIA--(Marketwire - Aug. 27, 2012) - A recently released policy on infant male circumcision by the American Academy of Pediatrics (AAP) was condemned today by the Children's Health & Human Rights Partnership (CHHRP) as being 'seriously flawed'.
CHHRP co-founder Christopher Guest, M.D. said the new policy makes claims that international paediatric associations reject and he encouraged the Canadian Paediatric Society (CPS) to maintain its policy of deterrence with regard to circumcising otherwise normal, healthy boys.
Citing a continued failure of the AAP to recognize the unique sensory functions of the male foreskin, Guest asserted that, "A growing number of medical associations now recognize that an intact penis with a foreskin enhances sexual pleasure for the male and his partner." According to Guest, in 2010 the Royal Dutch Medical Association concluded "the foreskin is a complex erotogenic structure that plays an important role in the mechanical function of the penis during sexual acts."
"Circumcision alters the structure of the penis, which inevitably alters function. Long term harm to men from infant circumcision has never been studied," Guest said. He referred to a growing body of anecdotal evidence collected by the Canadian-based Global Survey of Circumcision Harm. Guest said that in the past 12 months over 900 men have answered the online survey to document their harm.
Guest also faults the AAP for relying on methodologically weak African trials claiming HIV is lower in circumcised men. He says the studies also contradict global HIV trends, citing the United States, with a high circumcision rate, yet a significantly higher rate of HIV infection than Sweden and Japan where circumcision is rare. "Even if the African trials are scientifically valid, they cannot be used to justify infant circumcision in North America where the incidence of heterosexual HIV transmission is low."
Guest cautioned that infant circumcision could never be justified based on the ethical principle of proportionality, because there are more effective and less destructive methods to improve hygiene and prevent or treat disease that don't involve removing healthy genital tissue. "Soap and water and safer sex practices, including condoms, can prevent disease. New vaccines against penile and cervical cancer can prevent human papillomavirus (HPV) infection."
Guest harshly criticized the AAP's failure to note the conflict between contemporary medical ethics and infant circumcision, which he says violates the fundamental ethical principles of autonomy, beneficence and primum non nocere (First, Do No Harm). According to Guest, "Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany and other countries confirm there's no justification for circumcising infants in the absence of medical urgency. Those medical associations are urging an end to the practice due to ethical and human rights concerns."
He notes that the College of Physicians and Surgeons of British Columbia stated in 2009 that "… routine removal of normal tissue in a healthy infant, is not recommended... [P]roxy consent by parents is now being questioned. ... Under the Canadian Charter of Rights and Freedoms and the United Nations Universal Declaration of Human Rights, an infant has rights that include security of person, life, freedom and bodily integrity. Routine male circumcision is an unnecessary and irreversible procedure. Therefore many consider it to be 'unwarranted mutilating surgery'."
According to Guest, the AAP has exercised poor judgment in the past. In 1989, the AAP Task Force on Circumcision declared circumcision was "necessary", but in 1999 reversed its position to declare, "There is no valid medical indication for circumcision." In 2010, the AAP released a statement defending female genital nicking for cultural reasons, only to retract it under pressure from children's rights groups opposed to circumcision of girls and boys.
"Preservation of bodily integrity is a basic and universal human right that the AAP doesn't seem to value when it comes to male children" he said. "In spite of the new U.S. policy, we Canadians, as well as our institutions and government, have an obligation to preserve that right for all of our citizens, regardless of gender or age."
The Children's Health & Human Rights Partnership was established in 2012 as a partnership of professionals in the fields of medicine, ethics and law, and concerned citizens, to further public education and social advocacy to end non-therapeutic genital surgery on Canadian children.
Children's Health & Human Rights Partnership