A Human rights issue

By Dr. Kenneth Zatz, Pediatrician 

In a post on my office page two years ago, I expressed my hope that patients in my practice would take the time to thoughtfully consider whether they should have their infant boys circumcised. I was unprepared for the outpouring of opinions on both sides of this discussion that reached far beyond my little town. All I asked of those families I care for was to weigh the arguments for and against, and make a thoughtful, informed decision going forward.

Since then, I have taken great care in continuing to review the literature on circumcision. I was recently at the American Academy of Pediatrics annual convention in Washington, D.C. where pro-intact demonstrators greeted us daily which led me to again consider my position. There was no information presented at these meetings about circumcision despite it touching the lives of so many. During a break, I asked my two 20-something servers at a restaurant what they thought about circumcision. Answer #1: “You have to do it to prevent disease.” Answer #2: “It’s so dirty if you don’t. How are you supposed to clean it?” These answers have become the default in our cultural consciousness.

There are a lot of medical arguments attempting to justify circumcising our newborn boys. There are many statistics touting the benefits for urinary infections, HIV transmission, penile cancer, and other entities. These benefits are often marginal, debatable, or irrelevant to an infant. Websites, such as that of the American Academy of Pediatrics, can provide the most positive view of this procedure.

Even if some of the arguments supporting routine circumcision were valid, this debate for me is a human rights issue. I am not a lawyer or an ethicist, but I rely on my internal compass to tell me how far we can impose our will on another who has no say in the discussion. This is a debate about how far do parents’ rights extend over onto the body of their child. Whatever one thinks about the benefits of this procedure, it is a procedure. It is a surgery performed with little or no anesthesia on a helpless, restrained infant. It hurts…a lot. It takes the better part of a week to heal. It alters the appearance of the baby’s penis forever. It removes countless nerve endings altering sexual pleasure forever. It has a complication rate. The penis cannot be returned to its original state. All of this is done without the benefit of informed consent from the recipient of the procedure. I am not comfortable that we impose this choice on our children.

The culture of circumcision is not going to change from the top down. This change can only come from the bottom up. There will be fewer circumcisions only if parents request fewer circumcisions. I believe they will request fewer circumcisions if the fact that this is a choice is brought into their consciousness and if they are given proper information. I do my best to counsel families when I have the opportunity to see them prior to delivery. I would ask those who have thought about this to raise the circumcision question with those who are soon to have children. In my experience, many, if not most parents have never actually truly thought about it. Ask questions. Provide information. Direct them to organizations that can provide more information.

Some surgeries are necessary. Routine infant circumcision is one that is not. If we aspire to be a compassionate society, it is our obligation to extend that compassion to the most helpless. We can all help break this painful chain…one foreskin at a time.

Dr. Kenneth Zatz is a practicing pediatrician in New York.