Canada: Difference between revisions
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==History== | ==History== | ||
The French-speaking people of Quebec and elsewhere generally do not favour circumcision. Male circumcision is not part of the native culture of indigenous Inuit, First Nations, and Métis populations (4.3% of the population). The Canadian Government established Residential Schools from about 1880 to assimilate the indigneous people into Euro-Canadian culture.<ref name="residential2021">{{REFweb | The French-speaking people of Quebec and elsewhere generally do not favour circumcision. Male circumcision is not part of the native culture of indigenous Inuit, First Nations, and Métis populations (4.3% of the population). The Canadian Government established Residential Schools from about 1880 to assimilate the indigneous people into Euro-Canadian culture.<ref name="residential2021">{{REFweb | ||
|title=Residential Schools in Canada | |title=Residential Schools in Canada | ||
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}}</ref> | }}</ref> | ||
</blockquote> | </blockquote> | ||
== Research into pain of circumcision == | == Research into pain of circumcision == | ||
Canada has been the the location of important research regarding the [[pain]] of circumcision. | Canada has been the the location of important research regarding the [[pain]] of circumcision. | ||
[[Janice Lander| Lander]] et al. (1997) conducted a comparison of neonatal non-therapeutic circumcision without anesthesia (current practice in 1997), ring block, dorsal penile nerve block, and a topical eutectic mixture of local anesthetics ([[EMLA]]) at the {{UNI|University of Alberta|UAlberta}}, Edmonton, AB.<ref name="lander1997">{{ | [[Janice Lander| Lander]] et al. (1997) conducted a comparison of neonatal non-therapeutic circumcision without anesthesia (current practice in 1997), ring block, dorsal penile nerve block, and a topical eutectic mixture of local anesthetics ([[EMLA]]) at the {{UNI|University of Alberta|UAlberta}}, Edmonton, AB.<ref name="lander1997">{{LanderJ etal 1997}}</ref> | ||
}}</ref> | |||
With no anaesthesia, the infants screamed continuously. Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high pitched cry throughout the [[circumcision]] and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). One experienced projectile vomiting.<ref name="lander1997" /> | With no anaesthesia, the infants screamed continuously. Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high pitched cry throughout the [[circumcision]] and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). One experienced projectile vomiting.<ref name="lander1997" /> | ||
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=== College of Physicians and Surgeons of British Columbia (CPSBC) === | === College of Physicians and Surgeons of British Columbia (CPSBC) === | ||
The [https://www.cpsbc.ca/ College of Physicians and Surgeons of British Columbia] has issued three guidances for its members regarding non-therapeutic male circumcision of children. The most recent (2009) says in part: | The [https://www.cpsbc.ca/ College of Physicians and Surgeons of British Columbia] has issued three guidances for its members regarding non-therapeutic male circumcision of children. The most recent (2009) says in part: | ||
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=== Canadian Urological Association (CUA) === | === Canadian Urological Association (CUA) === | ||
The [[Canadian Urological Association]] (CUA) considered the matter of circumcision and issued a statement in February 2018. The CUA concluded: | The [[Canadian Urological Association]] (CUA) considered the matter of circumcision and issued a statement in February 2018. The CUA concluded: | ||
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==Non-availability of third-party payment== | ==Non-availability of third-party payment== | ||
Canada has fourteen single-payer health insurance plans (HIPs) — one for each of the ten provinces and three territories and a 14th plan for government employees. The British Columbia HIP stopped paying for non-therapeutic [[circumcision]] in 1984. Ontario HIP stopped payment for non-therapeutic circumcision in July 1995; Saskatchewan stopped in 1996. One by one, all other HIPs have stopped paying for non-therapeutic circumcision. In 2006, Manitoba HIP was the last to stop, but only after the wrong boy was [[circumcised]] at [http://www.sbgh.mb.ca/ St. Boniface Hospital].<ref>{{REFnews | Canada has fourteen single-payer health insurance plans (HIPs) — one for each of the ten provinces and three territories and a 14th plan for government employees. The British Columbia HIP stopped paying for non-therapeutic [[circumcision]] in 1984. Ontario HIP stopped payment for non-therapeutic circumcision in July 1995; Saskatchewan stopped in 1996. One by one, all other HIPs have stopped paying for non-therapeutic circumcision. In 2006, Manitoba HIP was the last to stop, but only after the wrong boy was [[circumcised]] at [http://www.sbgh.mb.ca/ St. Boniface Hospital].<ref>{{REFnews | ||
|title=Circumcision mix-up | |title=Circumcision mix-up | ||
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|DOI= | |DOI= | ||
|accessdate=2019-11-10 | |accessdate=2019-11-10 | ||
}}</ref> <ref name="rediger-muller2013"/> | }}</ref><ref name="rediger-muller2013"/> | ||
With the decline in the incidence of [[circumcision]] in Canada that started decades ago, there are fewer and fewer [[circumcised]] fathers, so one would expect the incidence of circumcision in Canada to continue to decline. | With the decline in the incidence of [[circumcision]] in Canada that started decades ago, there are fewer and fewer [[circumcised]] fathers, so one would expect the incidence of circumcision in Canada to continue to decline. | ||
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===Canadian Medical Association Code of Ethics and Professionalism=== | ===Canadian Medical Association Code of Ethics and Professionalism=== | ||
The CMA code has two statements relevant to the non-therapeutic circumcision of male infants: | The CMA code has two statements relevant to the non-therapeutic circumcision of male infants: | ||
* Never participate in or support practices that violate basic [[human rights]]. | * Never participate in or support practices that violate basic [[human rights]]. | ||
* Never participate in or condone the practice of torture or any form of cruel, inhuman, or degrading procedure.<ref name="cma2018">{{REFdocument | * Never participate in or condone the practice of torture or any form of cruel, inhuman, or degrading procedure.<ref name="cma2018">{{REFdocument | ||
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|accessdate=2021-07-08 | |accessdate=2021-07-08 | ||
}}</ref> | }}</ref> | ||
It therefore appears that non-therapeutic circumcision of boys is unethical in Canada. | It therefore appears that non-therapeutic circumcision of boys is unethical in Canada. | ||
===Lawsuit=== | ===Lawsuit=== | ||
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|quote= | |quote= | ||
}}</ref> | }}</ref> | ||
===Third-party payment is not available=== | ===Third-party payment is not available=== | ||
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===The incidence of circumcision varies widely by region=== | ===The incidence of circumcision varies widely by region=== | ||
Saskatchewan had an incidence of circumcision in 2000 and 2001 of 27.6 percent. The Saskatchewan College of Physicians and Surgeons said in 2002 that was much too high and should be reduced substantially. The Registrar, Dr. Dennis Kimble, said, "they [doctors] aren't required to carry out a procedure simply because parents want it done."<ref>{{REFnews | Saskatchewan had an incidence of circumcision in 2000 and 2001 of 27.6 percent. The Saskatchewan College of Physicians and Surgeons said in 2002 that was much too high and should be reduced substantially. The Registrar, Dr. Dennis Kimble, said, "they [doctors] aren't required to carry out a procedure simply because parents want it done."<ref>{{REFnews | ||
|title=Sask. college wants circumcision rates reduced | |title=Sask. college wants circumcision rates reduced | ||
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|quote= | |quote= | ||
}}</ref> | }}</ref> | ||
===The most recent survey was done in 2006-7=== | ===The most recent survey was done in 2006-7=== | ||
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</blockquote> | </blockquote> | ||
In all provinces and territories, only a minority of boys are being [[circumcised]]. Sheldon (2008) reported an incidence of 13.9 percent.<ref name="skeldon2008" /> The incidence of circumcision in Labrador and Newfoundland is reported to be close to zero.<ref>{{REFweb | In all provinces and territories, only a minority of boys are being [[circumcised]]. Sheldon (2008) reported an incidence of 13.9 percent.<ref name="skeldon2008"/> The incidence of circumcision in Labrador and Newfoundland is reported to be close to zero.<ref>{{REFweb | ||
|url=https://momlovesbest.com/choosing-circumcision | |url=https://momlovesbest.com/choosing-circumcision | ||
|title=Circumcision: Pros and Cons | |title=Circumcision: Pros and Cons | ||
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{{Citation | {{Citation | ||
|Text=Our survey findings indicate that most physicians performing neonatal circumcisions in our community have received informal and unstructured training. This lack of formal instruction may explain the complications and unsatisfactory results witnessed in our pediatric urology practice. Many practitioners are not aware of the contraindications to neonatal circumcision and most non-surgeons perform the procedure without being able to handle common post-surgical complications. | |Text=Our survey findings indicate that most physicians performing neonatal circumcisions in our community have received informal and unstructured training. This lack of formal instruction may explain the complications and unsatisfactory results witnessed in our pediatric urology practice. Many practitioners are not aware of the contraindications to neonatal circumcision and most non-surgeons perform the procedure without being able to handle common post-surgical complications. | ||
|ref=<ref name="demaria2013"> | |ref=<ref name="demaria2013">{{REFjournal | ||
{{REFjournal | |||
|last=De Maria | |last=De Maria | ||
|first= | |first= | ||
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|quote= | |quote= | ||
}}</ref> The CBC reported: | }}</ref> The CBC reported: | ||
<blockquote> | <blockquote> | ||
Among the complications, two boys were rushed to hospital with potentially life-threatening bleeds, one after a portion of his penis was amputated and the other with arterial bleeding. | Among the complications, two boys were rushed to hospital with potentially life-threatening bleeds, one after a portion of his penis was amputated and the other with arterial bleeding. | ||
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The circumcisions performed by Dr. Ahmad were performed for cultural reasons, not medical reasons, so they were not insured by Manitoba Health. The CBC reported: | The circumcisions performed by Dr. Ahmad were performed for cultural reasons, not medical reasons, so they were not insured by Manitoba Health. The CBC reported: | ||
<blockquote> | <blockquote> | ||
Along with malpractice, the college found Ahmad displayed several "multi-dimensional" professional shortcomings. | Along with malpractice, the college found Ahmad displayed several "multi-dimensional" professional shortcomings. | ||
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==Video== | ==Video== | ||
[[Christopher Guest]], {{MD}}, {{FRCPC}}, of Barrie, {{CAPTC|ON}}, discusses circumcision in Canada: | [[Christopher Guest]], {{MD}}, {{FRCPC}}, of Barrie, {{CAPTC|ON}}, discusses circumcision in Canada: | ||
<youtube>7-vbutOy4X8</youtube> | <youtube>7-vbutOy4X8</youtube> | ||
A news report on circumcision in Canada. | A news report on circumcision in Canada. | ||
<youtube>Yf06OSHcZc8</youtube> | <youtube>Yf06OSHcZc8</youtube> | ||
{{SEEALSO}} | {{SEEALSO}} | ||
* [[Canadian Children's Rights Council]] | * [[Canadian Children's Rights Council]] | ||