The first cut is the deepest for infants

The first cut is the deepest for infants

An Icelandic proposal to ban infant circumcision has provoked outrage among religious communities and renewed debate about the unkindest cut.

Five Icelandic political parties created an uproar by proposing a bill to criminalise circumcision of infant boys. What some may cherish as a cultural and religious right of passage, the politicians see as unnecessary genital mutilation – and they want their country to take a stand on it.

Public hospitals in Australia will not perform circumcisions, in accordance with guidance from the Royal Australasian College of Physicians, unless a specific medical condition is present that requires intervention. The NSW government guidelines say “it is rarely needed for medical reasons”.

Experts Hatch consulted disagreed  on the merits of Iceland’s move. Some argued in favour of what they say are clinical advantages to circumcision, others are adamant that the risks of performing unnecessary surgery outweigh the alleged benefits.

Dr Brian J. Morris of the University of Sydney’s physiology department strongly supports male infant circumcision and equates the procedure to vaccination. He has been a co-author of several papers recommending the procedure.

“The latest policies by the world’s top relevant medical bodies – American Academy of Paediatrics, Centres for Disease Control and Prevention, and World Health Organisation – recommend infant MC and later MC for those males who were not circumcised in infancy. Their policies are based on the strong scientific evidence showing enormous benefits and very low risk, thus making MC akin to vaccination.”

The AAP’s draft policy statement issued in 2012 is somewhat more complex than he suggests, reading: “Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it …

“Parents … ultimately should decide whether circumcision is in the best interests of their male child. They will need to weigh medical information in the context of their own religious, ethical, and cultural beliefs and practices. The medical benefits alone may not outweigh these other considerations for individual families.”

Dr George Williams, a neonatal paediatrician practising in Sydney, disagrees with Dr Morris, saying there are no medical benefits to the procedure which, he pointed out, can result in irreversible and fatal consequences.

There is no clinical need to remove the foreskin,” he told Hatch. “Every two or three years, children are admitted to the children’s hospital with significant damage to their penis. Every five years in Australia we have a death from circumcision.”

Recent studies suggest that male infant circumcision has preventative advantages against STIs and UTIs in young males, but Dr Williams believes their findings are inaccurate and do not justify the procedure.

“The UTI rate is 1 to 2 per cent – we have to circumcise ninety-eight babies or ninety-nine babies to protect one baby against UTI infection. Where is the economic benefit in that when you can treat the infection with antibiotics?” he asked.

The World Health Organisation’s advice on circumcision is also hedged: they emphasise “that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence”.

At the core of the debate is the question of the right of adherents to certain religions to circumcise according to their holy writ. Judaism calls for mandatory circumcision of infant boys; male circumcision is also commonly practiced by Muslims.

Rabbi Greenbaum, from the Kingston Synagogue in Melbourne, has spent the past 19 years performing ritual circumcisions – brit milah in Hebrew – on infant boys. He argues bans such as that imposed by Iceland will not deter Jewish people but will harm religious relations.

“The ban will only drive the practice underground and drive Muslims and Jewish people out of the country. If you cared about children you would make sure is done in a healthy safe way; you wouldn’t ban it.”

Rabbi Greenbaum pointed out that similar bans in the past have had dark implications: “I do know that throughout history that when antisemitism arises, [circumcision] is one of the first things they ban.”

Move away from the religious arena and human rights become a key issue for some campaigners.

Paul Mason, a former Tasmanian Children’s Commission, is an outspoken opponent of infant male circumcision and believes that ultimately a child’s right has to trump any religious consideration. He says children have the same rights under international law to freedom of conscience religion and belief as their parents.

But, he argues, infants are unable to express that right when parents are bent on cutting.

“What they don’t have is the power or the voice to prevent their parents cutting their most intimate and private parts.”

Mr Mason wryly points out that Australia is no stranger to banning similar procedures.

“Did you know that in NSW it is a crime to dock the tail of your dog?” – Eleanor Campbell, Penelope Burfitt and Naakaree Spero 

Photo by Yosef Silver used under Creative Commons Licence.

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