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Their slogan is: "Dedicated The addition of a member to represent the Health board of All Children," however directors and an insurance specialist was most unusual and illustrates the importance that the protection administration of the income AAP placed on preservation and protection of its members ("fellows") is also an important consideration[[third-party payment]].
The AAP policy regarding its statements is * Charles LeBaron, {{MD}}, representing the [[Centers for Disease Control and Prevention]], where [[Bias| biased]] doctors had been working to give each statement produce a fivepro-year lifecircumcision policy since 2008* Sabrina Craigo, after which {{MD}}, representing the statement expires unless it is reaffirmed[[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 2012 Circumcision Policy Statement has not been reaffirmed* Lesley Atwood, so it expired in 2017. As of 2019{{MD}}, representing the AAP has no official [[American Academy of Family Physicians]]. whose fellows also make extra money by performing non-therapeutic circumcision policy.
<p>After the release of the position statement, Shorty thereafter a debate appeared in the journal ''Pediatrics'' and the ''Journal of Medical Ethics'' between the AAP and an ad-hoc group of Western doctors, ethicists and lawyers, who questioned the evidence and ethics of the AAP position statement, and accused the AAP of "cultural bias". The AAP received further criticism from activist groups that oppose [[circumcision]]."<ref>https://en.wikipedia.org/wiki/American_Academy_of_Pediatrics</ref></p></blockquote>
The AAP asserted in their 1999 Circumcision Policy Statement It is now self-evident that parents have many, perhaps most, of America's child care doctors, including pediatricians and family doctors, do not know how to care of a right boy's intact penis. The foreskin an an infant boy is non-retractable by design. An attempt to decide forcibly retract a non-retractable foreskin of a boy can only lead to circumcise their children based on cultural or religious factors (although they removed any mention of esthetics as a possible parental motivation, despite previous inclusion in their 1989 statement)painful injury to the boy. No further substantiation There are frequent reports of this right was offered. Whether or not attempts by ignorant physicians to retract a medical benefit was required for parents to make this choice was also not addressedboy's non-retractile foreskin. <brref>{{REFjournal |last=Geisheker |first=John V. |init=JV |author-link=John V. Geisheker |url=https:The following statement appeared in its <b>1999 Policy Statement//www.psychologytoday.com/us/blog/moral-landscapes/201110/doctor-ignorance-male-anatomy-harms-boys |title=Doctor ignorance of male anatomy harms boys:What you can do to protect boys from medical interference |journal=Psychology Today |date=2011-10-20 |accessdate=2021-07-18}}</bref>
{{Citation |Text=In the pluralistic society of The AAP is the United States in which parents are afforded wide authority for determining what constitutes appropriate nation's leading child-rearing and child welfarecare organization, but it is legitimate for the parents has taken no action to take into account cultural, religious, educate its pediatrician members and ethnic traditionsother doctors on the [https://en.intactiwiki.org/wiki/Foreskin_Care_for_Boys proper care of the infant foreskin], in addition so as to medical factors, when making this choiceavoid [[iatrogenic]] injury of boys.<small>(119)</small> |Author=Committee on Bioethics |Source=1999 AAP Circumcision Policy Statement (re-affirmed 2005)}}
:The above sentence cited <u>Caring for Gravely Ill Children</u>== American Academy of Pediatrics Lawsuit ==A major lawsuit<ref name="Fleischmann 1994delaney2021">{{REFjournalREFweb |lasturl=Fleischman |first=Ahttps://www.Lcircumcisionisafraud. |last2=Nolan |first2=K. |last3=Dubler |first3=N..N. |etal=yes |date=1994com/docket-mer-l-000272-21 |title=Caring for gravely ill children |journal=American Academy of PediatricsLawsuit |volumewebsite=Circumcision is a Fraud |issue= |pages=7 |url=http://pediatrics.aappublications.org/content/94/4/433 |quotedate=2021-02-05 |accessdate=20112021-1005-0901}}</ref> as its source. The Fleishman article addresses was filed on February 5th, 2021 against the ethics American Academy of caring for gravely ill Pediatrics and dying children. It is totally irrelevant to the care Princeton Medical Group alleging constructive and non-therapeutic intentional fraud around a botched circumcision of well-babies. <!--While this document focuses primarily on sick children and not infants, it does go into much detail on the ethics surrounding autonomy and consent, particularly with respect to patient-centered vs. parent-centered medicine.--> That document says the following, which the AAP's "hands-off" position on circumcision might contradict:
{{Citation* The AAP had a number of undisclosed biases, including a financial bias, and made false claims in their 1989 Report of the Task Force on Circumcision Guidance. |Text=* This patient-centered "best interest" standardGuidance induced the Plaintiffs to provide consent for circumcisions without all of the necessary medical facts and information to make an informed decision, which the AAP has been accepted by a broad spectrum of groups and commentatorsfiduciary obligation to provide.* The AAP owes a duty to the general public, [n9including the Plaintiffs,n10] emphasizes that children ought to be valued as individuals tell the truth, the whole truth and protects children in situations involving conflict between what is best for nothing but the child truth when issuing reports, policy statements, and what is best guidelines for the family or societymedical care and procedures. |Author= |Source=Caring for Gravely Ill Children (1994)}}
:The AAP <b>1999 Policy Statement</b> also includes this statement on informed consent:{{Citation |Text=The process of informed consent obligates the physician ==Removal to explain any procedure or treatment and to enumerate the risks, benefits, and alternatives for the patient to make an informed choice. For infants and young children who lack the capacity to decide for themselves, a surrogate, generally a parent must make such choice.<small>(118)</small> |AuthorFederal Court== |Source=1999 AAP Circumcision Policy Statement (re-affirmed 2005)}}
: That document also says:{{Citation |Text=A patient's reluctance or refusal to assent should also carry considerable weight when the proposed intervention is not essential to his or her welfare and/or can be deferred without substantial risk. |Author= |SourceComment==AAP Committee on Bioethics - Informed Consent, Parental Permission, and Assent in Pediatric Practice}}
The AAP has no official position on whether a baby can refuse a procedure, nor does it specify if crying Giannetti (2000) argues that scientific misconduct in pain counts as reluctance or refusal. However, they do write that a patient's discomfort should be taken into account, and that children the American Academy of Pediatrics circumcision policy statements should have expose the necessity of a procedure communicated AAP to themtrade association liability.<ref name="Fleischmann 1994giannetti2000"/> (It might follow that inability to do so means that proceeding with an intervention that could be harmlessly deferred constitutes needless violation of autonomy, or inadequate consent):{{CitationREFjournal |Textlast=Although very young children may be unable to envision the future benefits of treatment that may justify its associated burdens (eg, pain, discomfort, Giannetti |first=Matthew |init=M |author-link= |title=Circumcision and hospitalization), their perceptions of those burdens should not be ignored. [...] Regardless of the child's level American Academy of participation Pediatrics: Should Scientific Misconduct Result in planning care, he or she should be given as much control over the actual treatment as possible.Trade Association Liability |journal=Iowa Law Rev |date=2000 |volume=85 |issue=4 |pages=1507-68 |Authorurl=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2018/01/Gianetti-AAP-Misconduct-Trade-Assn-Iowa-Law-Rev-2000.pdf |Sourceaccessdate=Caring for Gravely Ill Children (1994)2020-05-09}}</ref>
== AAP‘s pamphlet on intact care ==* 1984 - The Although the AAP's pamphlet on intact care stated:<blockquote>The function speaks very highly of the foreskin and the glans at birth is delicate and easily irritated by urine and feces. The foreskin shields the glans. With non-therapeutic circumcision this protection is lost. In such cases, the glans and especially the urinary opening (meatus) may become irritated or infecteda close reading indicates that it has never made an actual overt recommendation for [[circumcision]], causing ulcersprobably because its lawyers forbid it. Nevertheless, meatitis (inflammation of the meatus) and meatal stenosis (a narrowing of suit has been filed against the urinary opening.) Such problems virtually never occur [[AAP]] that alleges fraud in uncircumcised penises. The foreskin protects the glans throughout lifeits circumcision statements.<ref name="delaney2021" /blockquote>*1990 - The AAP removed the above with no explanation.
{{LINKS}}==Video==* [http<youtube>https://wwwyoutu.aap.orgbe/ AAP.org] SB- American Academy of Pediatrics (Official Website)2aQoTQeA</youtube>
[[Category:Organizations]]
[[Category:American Academy of Pediatrics]]
Add link in SEEALSO section.
[[Image:Aap.jpg|right|thumb|Emblem of the American Academy of Pediatrics]]
{{Notebox|'''The AAP does not recommend non-therapeutic infant circumcision.''' The AAP is regularly cited with its 2012 circumcision policy as a major US medical organization recommending non-therapeutic infant circumcision. The 2012 policy expired in 2017 and has not been renewed or re-affirmed since.<ref>{{REFjournal |last=AAP Task Force on Circumcision |url=https://publications.aap.org/pediatrics/article/130/3/585/30235/Circumcision-Policy-Statement |title=Circumcision Policy Statement |date=2012-09 |accessdate=2022-11-15 |journal=Pediatrics |volume=130 |issue=3 |pages=585–6 |DOI=10.1542/peds.2012-1989}}</ref>}} The '''American Academy of Pediatrics''' (AAP) is an American a [[medical 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. Almost all US 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), nor has it recognized the legal right of children to [[physical integrity]]. The AAP publishes [https://publications.aap.org/pediatrics/ Pediatrics]. == History of AAP circumcision policy ===== Introduction === The AAP evidently has an apparent long standing policy of appointing members of its various circumcision task forces who are believed by reason of published statements and/or ethnicity to be [[Bias| biased]] in favor of non-therapeutic male [[circumcision]]. Some such members are: * [[Susan Blank]]* [[Michael Brady]]* [[Douglas Diekema]]* [[Andrew Freedman]]* [[Edgar J. Schoen]] 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. === First policy (1971) ===The first policy was a one-sentence statement in a book on care of the newborn that stated:{{Citation |Text='''There are no valid medical indications for circumcision in the neonatal period.''' |ref=<ref name="aap1971">{{REFweb |url=http://www.cirp.org/library/statements/aap/#a1971 |title=Standards and Recommendation for Hospital Care of Newborn infants. 5th ed. |last= |first= |date=1971 |accessdate=2020-03-31}}</ref>}} The policy cited the 1970 landmark paper by E. Noel Preston as its authority.<ref name="preston1970">{{REFjournal |last=Preston |first=E. Noel |init= |author-link= |etal=no |title=Whither the foreskin? |trans-title= |language= |journal=JAMA |location= |date=1970-09 |volume=213 |issue=11 |article= |page= |pages=1853-8 |url=http://www.cirp.org/library/general/preston/ |quote=Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine. |pubmedID=5468911 |pubmedCID= |DOI=10.1001/jama.213.11.1853 |accessdate=2021-07-23}}</ref> === Second policy (1975) ===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.<ref name="aap1975">{{REFjournal |last=Thompson |first= |init=HR |author-link= |last2=King |first2= |init2=LR |author2-link= |last3=Knox |first3= |init3=E |author3-link= |etal=yes |title=Report of the ad hoc task force on circumcision |trans-title= |language= |journal=Pediatrics |location= |date=1975-10 |volume=56 |issue=4 |article= |pages=610-1 |url=https://www.cirp.org/library/statements/aap/#a1975 |archived= |quote= |pubmedID=1174384 |pubmedCID= |accessdate=2023-06-13}}</ref> 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 [[physical integrity| 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. === Third policy (1989) ===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 membersof the task force, or 83 percent, were Jewish and none had an [[intact]] [[foreskin]]. This statement claimed for the first time that "potential" medical benefits exist.<ref name="aap1989">{{REFjournal |last=Schoen |first=Edgar J. |init=EJ |author-link=Edgar J. Schoen |last2=Anderson |first2=Glenn |init2=G |author2-link= |last3=Bohon |first3=Constance |init3=C |author3-link= |last4=Hinman |first4=Frank |init4=F |author4-link= |last5=Poland |first5=Ronald |init5=R |author5-link= |last6=Wakeman |first6=E. Maurice |init6=EM |etal=no |title=Report of the Task Force of Circumcision |journal=Pediatrics |location= |date=1989-11 |volume=84 |issue=4 |pages=388-91 |url=http://www.cirp.org/library/statements/aap/#a1989 |pubmedID=2664697 |pubmedCID= |DOI= |accessdate=2020-03-31}}</ref> One should understand that ''potential'' means to be '''[c]apable of being but not yet in existence; latent or undeveloped''',<ref>{{REFweb |url=https://www.thefreedictionary.com/potential |title=Potential |last= |first= |accessdate=2020-03-31}}</ref> therefore the use of the word ''potential'' means the medical benefits discussed do not actually exist. The use of the word ''potential'' may be misleading to parents. This statement acknowledged that infants feel [[pain]] but minimized the effects of pain and declined to recommend the use of analgesia or anesthesia for foreskin [[amputation]].<ref name="aap1989"/> Based on methodologically flawed studies by circumcision promoter [[Thomas E. Wiswell]], the statement falsely claimed a reduction in the incidence of urinary tract infection (UTI) could be obtained by non-therapeutic infant circumcision.<ref name="aap1989"/> The statement does not recognize baby boys as human beings with rights that should be respected.<ref name="aap1989"/> Although the 1989 statement speaks favorably about non-therapeutic circumcision of infant boys, a careful reading shows that it does not actually recommend [[circumcision]],<ref name="aap1989"/> perhaps for avoidance of legal liability. The statement was not well received. Professor [[Ronald L. Poland]], a member of the task force, published a dissent in the ''New England Journal of Medicine''.<ref name="poland1990">{{REFjournal |last=Poland |first=Ronald L. |init=RL |author-link= |etal=no |title=The question of routine neonatal circumcision |journal=N Eng J Med |location= |date=1990-05-03 |volume=322 |issue= |pages=1312-5 |url=http://www.cirp.org/library/general/poland/ |pubmedID=2183058 |pubmedCID= |DOI=10.1056/NEJM199005033221811 |accessdate=2020-03-31}}</ref> === Statement on medical ethics === The Committee on Bioethics of the AAP issued a statement on bioethics and consent in 1995 that has caused great difficulty for the promoters of male non-therapeutic circumcision of non-consenting infants at the AAP. The statement provides in part:{{Citation |Text=We now realize that the doctrine of "[[informed consent]]" has only limited direct application in pediatrics. Only patients who have appropriate decisional capacity and legal empowerment can give their [[informed consent]] to medical care. In all other situations, parents or other surrogates provide informed permission for diagnosis and treatment of children with the assent of the child whenever appropriate. |ref=<ref>{{REFjournal |last=Kohnman |first=Arthur |init= |author-link= |last2=Clayton |first2=Ellen Wright |init2= |author2-link= |last3=Frader |first3=Joel E. |init3= |author3-link= |etal=yes |title=Informed consent, parental permission, and assent in pediatric practice. |journal=Pediatrics |location= |date=1995-02 |volume=95 |issue=2 |article= |page= |pages=314-7 |url=http://www.cirp.org/library/ethics/AAP/ |pubmedID=7838658 |pubmedCID= |DOI= |accessdate=2021-07-23}}</ref>}} Non-therapeutic circumcision of children is neither diagnosis nor treatment, so the statement means that parents do ''not'' have a 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 |last=Fleischman |first= |init=AL |author-link= |last2=Nolan |first2= |init2=K |author2-link= |last3=Dubler |first3= |init3=NN |author3-link= |etal=yes |title=Caring for gravely ill children |trans-title= |language= |journal=Pediatrics |location= |date=1994-10 |volume=94 |issue= |article= |page= |pages=433-9 |url=https://pediatrics.aappublications.org/content/94/4/433.long |pubmedID=7936849 |pubmedCID= |DOI= |accessdate=2021-07-24}}</ref> Non-therapeutic [[circumcision]] of children, however, is performed only on healthy children who can withstand the [[pain]], [[trauma]], and stress of the [[amputation]]. === Fourth policy (1999) ===The American Academy of Pediatrics had been acutely embarrassed by the faults of [[Edgar J. Schoen| Edgar Schoen]]'s horrific circumcision policy statement, so a new task force was convened under the direction of Carole Marie Lannon, {{MD}}, {{MPH}}, to produce a new, more appropriate, and less embarrassing policy statement on non-therapeutic child circumcision which was published in Pediatrics in September 1999.<ref name="aap1999">{{REFjournal |last=Lannon |first=Carole Marie |init=CM |last2=Bailey |first2=Ann Geryl Doll |init2=AGD |last3=Fleishman |first3=Alan R. |init3=AR |last4=Kaplan |first4=George W. |init4=GW |author4-link=George W. Kaplan |last5=Shoemaker |first5=Craig T. |init5=CT |last6=Swanson |first6=Jack T. |init6=JT |last7=Coustan |first7=Donald |init7=D |etal=no |title=Circumcision Policy Statement |journal=Pediatrics |date=1999-09 |volume=103 |issue=3 |pages=686-93 |url=http://www.cirp.org/library/statements/aap1999/ |pubmedID=22926180 |DOI=10.1542/peds.2012-1989 |accessdate=2021-10-10}}</ref> The AAP asserted in their 1999 Circumcision Policy Statement that parents have a right to decide to circumcise their children based on cultural or religious factors (although they removed any mention of esthetics as a possible parental motivation, despite previous inclusion in their 1989 statement). No further substantiation of this right was offered. Whether or not a medical benefit was required for parents to make this choice was also not addressed.<br>:The following statement appeared in its <b>1999 Policy Statement:</b> {{Citation |Text=In the pluralistic society of the United States in which parents are afforded wide authority for determining what constitutes appropriate child-rearing and child welfare, it is legitimate for the parents to take into account cultural, religious, and ethnic traditions, in addition to medical factors, when making this choice.<small>(119)</small> |Author=Committee on Bioethics |Source=1999 AAP Circumcision Policy Statement (re-affirmed 2005)}} :The above sentence cited <u>Caring for Gravely Ill Children</u><ref name="Fleischmann 1994">{{REFjournal |last=Fleischman |init=AL |last2=Nolan |init2=K |last3=Dubler |init3=NN |etal=yes |date=1994 |title=Caring for gravely ill children |journal=Pediatrics |volume= |issue= |pages=7 |url=http://pediatrics.aappublications.org/content/94/4/433 |quote= |accessdate=2011-10-09}}</ref> as its source. The Fleishman article addresses the ethics of caring for gravely ill and dying children. The pain of circumcision is very stressful, so it is performed only on babies who are stable and healthy. It is totally irrelevant to the care and non-therapeutic circumcision of well-babies. <!--While this document focuses primarily on sick children and not infants, it does go into much detail on the ethics surrounding autonomy and consent, particularly with respect to patient-centered vs. parent-centered medicine.--> That document says the following, which the AAP's "hands-off" position on circumcision might contradict: {{Citation |Text=This patient-centered "best interest" standard, which has been accepted by a broad spectrum of groups and commentators, [n9,n10] emphasizes that children ought to be valued as individuals and protects children in situations involving conflict between what is best for the child and what is best for the family or society. |Author= |Source=Caring for Gravely Ill Children (1994)}} :The AAP <b>1999 Policy Statement</b> also includes this statement on [[informed consent]]:{{Citation |Text=The process of [[informed consent]] obligates the physician to explain any procedure or treatment and to enumerate the risks, benefits, and alternatives for the patient to make an informed choice. For infants and young children who lack the capacity to decide for themselves, a surrogate, generally a parent, must make such choice.<small>(118)</small> |Author= |Source=1999 AAP Circumcision Policy Statement (re-affirmed 2005)}} :The above sentences cited <u>[[informed consent]], Parental Permission, and Assent in Pediatric Practice</u>, a policy guide by AAP's Bio-ethics Committee.<ref>{{REFweb |last=Committee on Bioethics |first= |date=1995-02 |title=Informed Consent, Parental Permission, and Assent in Pediatric Practice |url=http://www.cirp.org/library/ethics/AAP/ |publisher=Pediatrics |accessdate=2011-10-09}}</ref> However, those sentences appear to contradict the document they cited, which says:{{Citation |Text=Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. [...] the pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent. |Author= |Source=AAP Committee on Bioethics - Informed Consent, Parental Permission, and Assent in Pediatric Practice}} : That document also says:{{Citation |Text=A patient's reluctance or refusal to assent should also carry considerable weight when the proposed intervention is not essential to his or her welfare and/or can be deferred without substantial risk. |Author= |Source=AAP Committee on Bioethics - Informed Consent, Parental Permission, and Assent in Pediatric Practice}} The AAP has no official position on whether a baby can refuse a procedure, nor does it specify if crying in pain counts as reluctance or refusal. However, they do write that a patient's discomfort should be taken into account, and that children should have the necessity of a procedure communicated to them.<ref name="Fleischmann 1994"/> (It would follow that inability to do so means that proceeding with an intervention that could be harmlessly deferred constitutes needless violation of patient autonomy, or inadequate consent):{{Citation |Text=Although very young children may be unable to envision the future benefits of treatment that may justify its associated burdens (eg, pain, discomfort, and hospitalization), their perceptions of those burdens should not be ignored. [...] Regardless of the child's level of participation in planning care, he or she should be given as much control over the actual treatment as possible. |Author= |Source=Caring for Gravely Ill Children (1994)}} === Fifth policy (2012) ======= Genesis ====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, falsely claimed that male [[circumcision]] would reduce [[infection]] with human immunodeficiency virus ([[HIV]]).<ref name="who2007">{{REFweb |quote= |url=http://www.who.int/hiv/topics/malecircumcision/en/ |title=Male circumcision for HIV prevention |last= |first= |publisher=World Health Organization |work= |date=2007 |accessdate=2020-04-16}}</ref> The AAP saw this as an opportunity to protect third-party payment for non-therapeutic circumcision.<ref name="jones2022">{{REFweb |url=https://www.circumcisionisafraud.com/foia-request-sheds-new-light-on-aaps-motivations |title=FOIA request sheds new light on AAP's motivations |last=Jones |first=Ryan |init= |author-link=Ryan Jones |website=Circumcision is a Fraud |date=2022-02-07 |accessdate=2022-08-27}}</ref> 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 Jewish doctor with pro-[[circumcision]] credentials, as chairwoman. The task force was an unusually large eight-member task force with an unusual constitution. It included: * Ellen Buerk, {{MD}}, representing the board of directors of the AAP. * [[Michael Brady]], {{MD}}, an [[HIV]] specialist with pro-circumcision views.* Waldemar Carlo, {{MD}}, a specialist in the care of the newborn.* [[Andrew Freedman]], a Jewish urologist from Los Angeles who [[circumcised]] his own son on the kitchen table.* [[Douglas Diekema]], a pediatric medical ethicist.* Lynne Maxwell, {{MD}}, a [[pain]] control specialist.* Steven Wegner, {{MD}}, {{JD}}, a medical insurance specialist, who evidently was appointed to the task force to preserve and protect [[third-party payment]].
The AAP, in association with [[ACOG]] and [[AAFP]], issued a circumcision policy statement in 2012. That statement was heavily criticized by many due to its obvious bias toward obtaining and preserving [[third-party payment]] for nontask force also included representatives from other pro-therapeutic child circumcision. organizations:
==== Discussion ==== The AAP, in association with [[ACOG]] and [[AAFP]], issued a circumcision policy statement in 2012. That statement was heavily criticized by many due to its obvious [[bias]] toward obtaining and preserving [[third-party payment]] for non-therapeutic child circumcision.<ref name="doc2013">{{REFweb |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf |title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement |trans-title= |language= |last= |first= |author-link= |publisher=[[Doctors Opposing Circumcision (D.O.C.)]] |website= |date=2013-04 |accessdate=2020-02-15 |format=PDF |quote=}}</ref> {{Box|Boxtext=<big><b>'''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 2023, the AAP has had ''no'' official circumcision policy for six years, although it misleadingly continues to publish its long expired policy on its website.'''</b></big>}} Although the patients of the fellows of the AAP are children, the AAP consistently has failed to acknowledge the [[human rights]] of its child patients.<ref name="doc2013" />
From the Wikipedia:
<blockquote><p>"In a 2012 position statement, the academy Academy stated that a systematic evaluation of the medical literature shows that the "preventive health benefits of elective [[circumcision]] of male newborns outweigh the risks of the procedure" and that the health benefits "are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns," but "are not great enough to recommend routine circumcision for all male newborns". The Academy takes the position that parents should make the final decision about circumcision, after appropriate information is gathered about the risks and benefits of the procedure. By doing this, the AAP attempts to shift the liability for the certain injury of child non-therapeutic circumcision from the doctor to the parents. </blockquote> The 2012 statement is a shift in the Academy's position from its [https://www.cirp.org/library/statements/aap1999/ 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> ==== Criticism ====After the release of the position statement, there was a substantial immediate critical comment by Brian Earp.
* {{REFjournal |last=Earp |first=Brian D. |init=BD |author-link=Brian D. Earp |etal=no |title=The AAP report on circumcision: bad science + bad ethics = bad medicine |journal=Practical Ethics |location= |date=2012 statement is a shift in the Academy's position from its 1999 statement in that the academy says the health benefits of the procedure outweigh the risks, and supports having the procedure covered by insurance |volume= |issue= |article= |page= |pages= |url=https://www. academia.edu/15617255/The_AAP_report_on_circumcision_bad_science_bad_ethics_bad_medicine The 2012 position statement is an obvious effort to preserve [[third|accessdate=2020-party payment]] to physicians, without which most non12-therapeutic circumcisions would not be done.</p>25}}
* {{REFjournal |last=Svoboda |first=J. Steven |init=JS |author-link=J. Steven Svoboda |last2=Van Howe |first2=Robert S. |init2= International protests RS |author2-link=Robert S. Van Howe |etal=noIn 2013, international physicians protest against American Academy |title=Out of Pediatrics’ step: fatal flaws in the latest AAP policy report on infant male neonatal circumcision. This protest was organized by [[Morten Frisch]] and led to an article in ''Pediatics today''<ref>[http |journal=J Med Eth |location=Published online first |date=2013-03-13 |volume=39 |issue=7 |pages=434-41 |url=https://knmgarclaw.artsennetorg.nlcustomers.tigertech.net/wp-content/webuploads/file?uuid=62e174e8Svoboda-613eVan-4d79Howe-910fOut-747708dbf27a&owner=a8a9ce0eof-f42bStep-47a5Fatal-960eFlaws-be08025b7b04&contentid=129611 Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision-AAP... Pediatrics -JME-2013 131 (4) (PDF)]<.pdf |pubmedID=23508208 |pubmedCID= |DOI=10.1136/ref>, signed by an international group of 38 physicians from medethics-2013-101346 |accessdate=2020-04-16 European countries.}}
* {{REFdocument |title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statemeni |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf |contribution= |last=Hill |first=George |author-link=George Hill |publisher= From [[IntactWikiDoctors Opposing Circumcision (D.O.C.)]] |format=PDF |date=2013-04-01 |accessdate=2020-04-16}} * In 2013, international physicians protested against American Academy of Pediatrics’ policy on infant male circumcision. This protest was organized by [[Morten Frisch]] and led to an article in ''Pediatics''<ref name="frisch2013">{{FromIntactWikiREFjournal |last=Frisch |first=Morten |init=M |author-link=Morten Frisch |last2=Aigrain |first2=Yves |init2=Y |author2-link= |last3=Barauskas |first3=Vidmontas |init3=V |author3-link= |etal=yes |title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision |journal=Pediatrics |location= |date=2013-04-01 |volume=131 |URL issue= http4 |pages= |url=https://intactwikipediatrics.aappublications.org/wikicontent/131/4/796.long |quote= |pubmedID=23509170 |pubmedCID= |DOI=10.1542/American_Academy_of_Pediatricspeds.2012-2896 |Title accessdate= 2020-04-04}}</ref>, signed by an international group of 38 physicians from 16 European countries. The AAP received further criticism from activist groups that oppose [[circumcision]]."<ref>{{URLwikipedia|American_Academy_of_Pediatrics|American Academy of Pediatrics|2020-03-31}}</ref></p> * {{REFjournal |last=Darby |first=Robert |init=R |author-link=Robert Darby |etal=no |title=Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non-Therapeutic Circumcision |journal=Kennedy Institute of Ethics Journal |location= |date=2015-04 |volume=25 |issue=1 |pages=1-34 |url=https://kiej.georgetown.edu/wordpress/wp-content/uploads/2015/03/03_25.1darby.pdf |pubmedID=25843118 |pubmedCID= |DOI=10.1353/ken.2015.0004 |accessdate=2020-04-16
}}
== From [[IntactWiki]] ==<blockquote>The American Academy of Pediatrics (AAP) currently advises parents on its "Healthy Children" website that "The existing scientific evidence is not sufficient to recommend routine (non-therapeutic) circumcision.<ref>{{REFweb
|last=
|first=
|accessdate=
}}</ref> Be that as it may, they still say that they "...recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician." While not recommending circumcision, the AAP shirks responsibility by refusing to take a clear stand and state anything more directly negative than saying "the scientific evidence is not sufficient to recommend." The evidence, of which there is not enough for the AAP to come to a concrete conclusion, must apparently still be considered by parents, placing them in the awkward position of doing what the AAP could not do. Many view the AAP's policy as a "cover your ass" move: an awkward attempt shield itself and its members (doctors), from possible future legal repercussions, by distancing them as far as possible from any ethical considerations in the decision of parents to circumcise (while allowing its members to continue profiting from the procedure).
</blockquote>
''The current text was drafted in 2014. It is based on the 2012 Circumcision Policy Statement which is discredited and has now expired.''
An annotated version is now available.<ref>{{REFweb
|url=http://www.circumstitions.com/Docs/aap-bro-12.pdf
|title=Circumcision (annotated}
|last=Young
|first=Hugh
|author-link=Hugh Young
|publisher=
|website=Circumstitions
|date=2014
|accessdate=2020-04-17
|format=
|quote=
}}</ref>
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== The AAP briefly endorses female genital cutting ==
On April 26, 2010, the AAP changed its long-held stance against female genital cutting.
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|pages=15
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext
|quote=The authors suggested that a “ritual nick,” in which the clitoral [[skin ]] is pricked or incised, might satisfy these symbolic requirements, and “is no more of an alteration than ear piercing”.
|DOI=10.1016/S0140-6736(10)61042-2
|accessdate=2011-09-27
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|quote=...a ritual nick as a possible compromise to avoid greater harm...
|accessdate=2011-09-27
}}</ref> The AAP had deviated from a much more forceful statement published in 1998, which unequivocally condemned [[FGC ]] in any form.<ref>{{REFjournal
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|pages=15
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61042-2/fulltext
|quote=...the AAP revised a much more forceful statement published in 1998, which unequivocally condemned [[FGC ]] in any form.
|DOI=10.1016/S0140-6736(10)61042-2
|accessdate=2011-09-27
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
|last=MacReady
|first=Norra
|init=N
|date=2010-07-03
|title=AAP retracts statement on controversial procedure
}}</ref>
The AAP wrote the following in their 2010 [[FGC ]] Policy:
{{Citation
|Text=The American Academy of Pediatrics policy statement on newborn male circumcision expresses respect for parental decision-making and acknowledges the legitimacy of including cultural, religious, and ethnic traditions when making the choice of whether to surgically alter a male infant's genitals.<small>(119)</small>
This was a segue into the following sentence:
{{Citation
|Text=But [[parental rights ]] have limits -- [[FGC ]] is damaging so it should be disallowed. But maybe we should change the law for the mild alterations.<small>(119)</small>
|Author=Committee on Bioethics
|Source=AAP Policy Statement on Ritual Genital Cutting of Female Minors (April, 2010).
In other words, they were using the fact that MGM is accepted as an argument in favor of "milder" FGM.
-->
== AAP‘s pamphlet on intact care ==
* 1984 - The AAP's pamphlet on intact care stated:
<blockquote>The function of the foreskin and the glans at birth is delicate and easily irritated by [[urine]] and feces. The foreskin shields the glans. With circumcision this protection is lost. In such cases, the glans and especially the urinary opening (meatus) may become irritated or infected, causing ulcers, [[meatitis]] (inflammation of the meatus) and [[meatal stenosis]] (a narrowing of the urinary opening.) Such problems virtually never occur in [[uncircumcised]] penises. The foreskin protects the glans throughout life.</blockquote>
*1990 - The AAP removed the above with no explanation.
== The AAP's 1999 Circumcision Policy Statement <small>(and its apparent contradictions with other AAP positions on bioethics)</small> premature forcible retraction of the foreskin==
This lawsuit by the Lavine family, which alleges fraud, has been removed from the New Jersey state court to the United States District for New Jersey based on "diversity of citizenship". The case number is 3:21-CV-17099. The above sentences cited <u>Informed Consent, Parental Permission, and Assent in Pediatric Practice<presiding judge is [https://en.wikipedia.org/wiki/u>, a policy guide by AAP's Bio-ethics CommitteeZahid_Quraishi Zahid N. Quraishi].<ref>{{REFweb |url=https://unicourt.com/case/pc-db5-lavine-et-al-v-american-academy-of-pediatrics-et-al-1022393 |title=Lavine et al. v. American Academy of Pediatrics et al. |last=Committee on Bioethics
|first=
|date=19952021-02 |title=Informed Consent, Parental Permission, and Assent in Pediatric Practice |url=http://www.cirp.org/library/ethics/AAP/ |publisher=Pediatrics11-29 |accessdate=20112021-1012-0901}}</ref> However, those sentences appear to contradict the document they cited, which says:{{Citation |Text=Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. [...] the pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent. |Author= |Source=AAP Committee on Bioethics - Informed Consent, Parental Permission, and Assent in Pediatric Practice}}
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]].
{{SEEALSO}}
* [[AAP Circumcision Task Force 2012]]
* [[AAFP]]
* [[ACOG]]
* [[Circumcision study flaws]]
* [[Financial incentive]]
* [[Penis]]
* [[Position statements on infant circumcision]]
* [[United States of America]]
{{LINKS}}
* {{REFweb
|url=https://www.circinfo.org/AAP_in_retreat.html
|accessdate=2019-12-31
}}
* {{REFweb
|url=https://intactamerica.org/dear-dr-remley/
|title=Calling the American Academy of Pediatrics to Account
|last=Chapin
|first=Georgeanne
|author-link=
|publisher=Intact America
|website=
|date=2017-03-07
|accessdate=2021-04-02
}}
* [http://www.aap.org/ AAP.org] - American Academy of Pediatrics (Official Website)
{{ABBR}}
{{REF}}
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[[Category:USA]]
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