Australia

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Australia, like other English-speaking countries, once had a rather high rate of non-therapeutic neonatal circumcision of male infants, however Australia now (2019) has a very low rate of non-therapeutic neonatal circumcision.

Contents

History

The indigeous people of Australia, the Aborigines, have variously practiced subincision and circumcision since before the first contact with Europeans.

The incidence of non-therapeutic neonatal circumcision in Australia approached that of the United States in the 1930s through 1960s.

Douglas Gairdner's famous, classic 1949 paper, The Fate of the Foreskin: A Study of Circumcision,[1] seems to have had no effect in Australia.

Morgan (1967) criticised non-therapeutic circumcision in a letter published in the Medical Journal of Australia.[2]

Wright (1967) slammed the practice of non-therapeutic circumcision.[3]

The Australian Paediatric Journal issue of June 1970, published three articles critical of non-therapeutic infant circumcision.[4][5][6]

Position statements of medical societies

After considering the three papers published in the Australian Paediatric Journal, the Australian Paediatric Society adopted a resolution on April 24, 1971 that the circumcision of male infants should not be performed as a routine measure. That resolution subsequently was reported in a letter by Belmaine published in the Medical Journal of Australia on May 22, 1971.[7]

The incidence of non-therapeutic child circumcision in Australia started to decline after the publication of the Belmaine (1971) letter. By 1978, only 50 percent of newborn boys were being circumcised.

The incidence of circumcision continued to decline, so that by 1996, when the Australian College of Paediatrics issued a statement, it reported that the incidence of "routine" (i.e. non-therapeutic) circumcision was estimated at ten percent of newborn boys.[8]

Non-therapeutic circumcision and Australian law

Australia is a state-party to the United Nations Covenant on Civil and Political Rights (1966) and to the United Nations Convention on the Rights of the Child (1989, both of which provide various rights to children, which are violated by non-therapeutic child circumcision.

The legality of non-therapeutic circumcision of boys has been considered several times.

The Queensland Law Reform Commission (1993) researched the legality of non-therapeutic circumcision of children. The commission concluded:

The common law operating in Queensland appears to be that if the young person is unable, through lack of maturity or other disability, to give effective consent to a proposed procedure and if the nature of the proposed treatment is invasive, irreversible and major surgery and for non-therapeutic purposes, then court approval is required before such treatment can proceed. The court will not approve the treatment unless it is necessary and in the young person's best interests. The basis of this attitude is the respect which must be paid to an individual's bodily integrity.[9]

Richards (1996) discussed non-therapeutic circumcision of boys. He concluded:

Ritual male circumcision is non-therapeutic and is not warranted or justified by medical evidence. This form of mutilation should not be legally distinguished from female circumcision which is a form of female genital mutilation presently in the process of being prohibited throughout Australia and the Western world. As ritual male circumcision is non-therapeutic, may be against public policy, and clearly is not in the best interests of the child, a parent's consent may be vitiated, leaving persons involved in the procedure liable in negligence, notwithstanding parental religious beliefs. Alternatively, if a medical practitioner fails to give the parent reasonable information on the risks of and alternatives to ritual circumcision, the practitioner may also be liable in negligence.[10]

Professor Neville Turner (1996) reported that circumcised boys may sue their circumciser.[11]


Circumcision in the 21st Century

The several Australian states operate public hospitals. By 2008 all public hospitals in all states no longer offer non-therapeutic circumcision to patients.

As the incidence of non-therapeutic circumcision has declined, the incidence of infant deaths and SIDS deaths has also declined, while the overall health of Australia's children has improved.[12]

The Australian College of Paediatrics was merged into the Royal Australasian College of Physicians (RACP), which has issued a statement on non-therapeutic child circumcision. The statement (2010) states:

After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.

But the statement also says:

The option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered. This option has recently been recommended by the Royal Dutch Medical Association. The ethical merit of this option is that it seeks to respect the child’s physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future. However, deferring the decision may not always be the best option. As noted earlier, the psychosocial benefits of circumcision (e.g. full inclusion in a religious community) may only be obtained if circumcision is done in infancy. Waiting until the boy is twelve years old or more (i.e. old enough to make his own decision) may mean losing benefits that circumcision was intended to produce.[13]

Na et al. (2015) considered whether Australian boys should be circumcised. They concluded:

In conclusion, although there is a benefit of circumcision in those with urogenital tract anomalies, in a healthy newborn,the disease in the foreskin is non-existent. There is insufficient scientific evidence to support routine newborn circumcision in Australia done for UTI risk and HIV transmission issues alone. Therefore, any surgical complication and financial cost of routine newborn circumcision for these reasons in Australia currently cannot be justified. From a medical point of view, the‘price’ is still too high.[14]

The incidence of non-therapeutic circumcision of children in Australia has continued to diminish. Circumcision Information Australia (2017) reported an incidence of infant circumcision of 9.66 percent in fiscal 2015.[15]

See also

External links

References

  1. ↑   Gairdner, Douglas M.. The fate of the foreskin: a study of circumcision. British Medical Journal. 1949; 2(4642): 1433-1437. PMID. PMC. DOI. Retrieved 28 October 2019.
  2. ↑   Morgan, WKC. Penile plunder. Med J Aust. 1967; 1: 1102-3. PMID. Retrieved 31 October 2019.
  3. ↑   Wright, JE. Non-therapeutic circumcision. Med J Aust location=. 27 May 1967; 1: 1083-7. PMID. Retrieved 28 October 2019.
  4. ↑   Leitch, I.O., et al. Circumcision: the continuing enigma. Aust Paediatr J. March 1970; 6(1): 59-65. PMID. Retrieved 27 October 2019.
  5. ↑   Birrell, R.G.. Circumcision. Aust Paediatr J. June 1960; 6(2): 66-7. PMID. Retrieved 27 October 2019.
  6. ↑   Smith, E.D.. Another view of circumcision. Aust Paediatr J. June 1970; 6(2): 67-9. PMID. Retrieved 27 October 2019.
  7. ↑   Belmaine, SP. Circumcision. Medical Journal of Australia. 22 May 1971; 1: 1148. Retrieved 28 October 2019.
  8. ↑   Statement (27 May 1996). Routine circumcision of normal male infants and boys, Australian College of Paediatrics. Retrieved 28 October 2019.
  9. ↑   Circumcision of Male Infants Research Paper, Queenland Law Reform Commission. (1993). Retrieved 31 October 2019.
  10. ↑   Richards, David. Male Circumcision: Medical or Ritual?. J Law Med. 1996; 3: 371. Retrieved 31 October 2019.
  11. ↑   Turner, Neville. Circumcised boys may sue. The Health Law Update (Australia). 23 February 1996; 1(4): 1-2. Retrieved 31 October 2019.
  12. ↑   Eldridge, Deanna, Macdonald, Malcolm (2009): 4, in: A Picture of Australia's Children 2009. Canberra: Australian Institute of Health and Welfare. Pp. 12-16. ISBN SBN 978 1 74024 929 4. Retrieved 19 October 2019.
  13. ↑   Circumcision of Infant Males  , The Royal Australasian College of Physicians. (1 September 2010). Retrieved 28 October 2019.
  14. ↑   Na, Angelika F, Tanny, Sharman PT, Hutson, John M. Circumcision: Is it worth it for 21st-century Australian boys?. J Paediatr Child Health. 2015; 51: 580-3. PMID. DOI. Retrieved 29 October 2019.
  15. ↑   Cozijn, John. Incidence and prevalence of circumcision in Australia. Retrieved 28 October 2019.
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