American Academy of Pediatrics: Difference between revisions

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|'''Notice:''' '''The AAP does not recommend routine infant circumcision.''' The AAP is regularly cited with its 2012 circumcision policy as a major US medical organization recommending routine infant circumcision. The 2012 policy expired in 2017 and has not been renewed since.<ref>{{REFjournal

|}

The '''American Academy of Pediatrics''' (AAP) is a  trade association of American pediatricians, headquartered in Elk Grove Village, Illinois. Almost all U.S. pediatricians are members.  

The AAP advances the financial and business interests of its members.  Hundreds of millions of dollars are paid out by [[Third-party payment| third-parties]] to physicians, including pediatricians, obstetricians, and family physicians to provide medically unnecessary non-therapeutic [[circumcision]] of minor boys. Their slogan is: "Dedicated to the Health of All Children," however the protection of the income of its fellows ("members") overrides their duties to children. Preservation of that income stream has always been a fundamental policy of the AAP.

The AAP has not recognized the [[human rights]] of children that were granted by the ''International Covenant on Civil and Political Rights'' (1966) and the ''Convention on the Rights of the Child'' (1989).

It is thought that the AAP chooses [[circumcised doctors]] who don't have a [[foreskin]] to its various task forces on circumcision, so personal knowledge and understanding of a normal body part has been lacking on its various task forces. Perhaps the AAP believes that such doctors will be [[Bias| biased]] in favor of circumcision. The AAP apparently hopes to continue to produce statements in favor of [[circumcision]] so that the collection of revenue, usually by [[third-party payment]], from circumcision can continue.

The simple 1971 statement that dismissed non-therapeutic circumcision as a medical procedure did not sit well with the AAP, so efforts were made to walk back that statement. An "ad hoc" task force of four male physicians was formed to develop a new statement that was released in 1975. The new statement attempted to shift responsibility and legal liability from the physician to the parents. The statement claimed that "traditional, cultural, and religious factors" could be considered in making a decision to perform non-therapeutic circumcision upon a boy. The statement did not recognize the boy as a person with human and legal rights to bodily integrity and security of the person, nor did it consider [[pain]] control. There was no mention of the numerous [[Foreskin#Physiological_functions| functions of the foreskin]] or of [[Risks and complications| risks and complications]] of [[circumcision]]. The statement contained not a single reference. The result was that medically-unnecessary, non-therapeutic [[circumcision]] could still be performed and doctors could continue to [[Financial incentive| profit thereby]] and anesthesia for surgical [[pain]] was not required.

The 1975 policy was considered outmoded so a new "task force on circumcision" with circumcision promoter [[Edgar J. Schoen]] as chairman was formed. It is believed that five of the six members of the task force, or 83 percent, were Jewish.

This statement claimed for the first time that "potential medical benefits exist.<ref name="aap1989">{{REFjournal

Non-therapeutic circumcision of children is neither diagnosis nor treatment, so the statement means that parents do ''not'' have right to consent to non-therapeutic circumcision of children. This has caused problems for future advocates of male non-therapeutic circumcision at the AAP, so they have adopted a work-around policy. Future statements regarding male non-therapeutic circumcision resorted to citing a non-germane statement on the medical ethics of sick and dying children.<ref>{{REFjournal

Several state Medicaid organizations had delisted medically-unnecessary, non-therapeutic male circumcision as a covered procedure, which caused alarm at the AAP. The corrupt [[World Health Organization]] (WHO), in a very poor and misguided decision in 2007, claimed that male circumcision would reduce infection with human immunodeficiency virus ([[HIV]]).<ref name="who2007">{{REFweb

The AAP allied itself with the [[American College of Obstetricians and Gynecologists]] (ACOG) and the [[American Academy of Family Physicians]] (AAFP) to produce a new circumcision policy that would claim a medical benefit. A new task force was named with [[Susan Blank]], a doctor with pro-circumcision credentials as chairwoman. The task force was an unusually large eight-member task force with an unusual constitution. It included:

* [[Andrew Freedman]], a Jewish urologist from Los Angeles who circumcised his own son on the kitchen table.

* Sabrina Craigo, {{MD}}, representing the [[American College of Obstetricians and Gynecologists]], whose fellows make extra money by performing non-therapeutic circumcision on newborn baby boys, although males are outside of their practice area.

 

'''The AAP policy regarding its statements is to give each statement a five-year life, after which the statement expires unless it is reaffirmed. The 2012 Circumcision Policy Statement has not been reaffirmed, so it expired in 2017. As of 2020, the AAP has had ''no'' official circumcision policy for three years.'''

The 2012 statement is a shift in the Academy's position from its 1999 statement in that the Academy now says the health benefits of the procedure outweigh the risks, and supports having the procedure covered by insurance. The 2012 position statement is an obvious effort to preserve [[third-party payment]] to physicians, without which most non-therapeutic circumcisions would not be done.</p>

The AAP's difficulties with a child circumcision policy are largely of its own doing. The AAP continues to put its members' financial well-being ahead of the [[human rights]] and well-being of its child patients, which it does by omission of significant information and distortion of the medical facts in its numerous circumcision policy statements. Medical societies outside of the [[United States]] are in near total disagreement with the AAP and its American allies with regard to non-therapeutic child [[circumcision]].

Although the AAP speaks very highly of non-therapeutic circumcision, a close reading indicates that it has never made an actual overt recommendation for circumcision, probably because its lawyers forbid it. Nevertheless, a suit has been filed against the AAP that alleges fraud in its circumcision statements.<ref name="delaney2021" />