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wikify EMLA
|date=2020-09-21
|accessdate=2020-09-21
}}</ref> against the knee-jerk reaction to religious pressure that the [https://en.stps.dk/en/about-us/# Danish Agency for Patient Safety ] has shown in the issue of the boy [[circumcision ]] problem.
This is the original text of the open letter which was published on politiken.dk on {{date|2020-09-21}} [Google auto-translated]:
== Jewish law should not dictate the rules for boy circumcision in [[circumcisionDenmark]] in Denmark ==
As doctors, we see with the greatest concern the kneeling to religious pressure in the case of circumcision of boys.
If the politicians at Christiansborg decide that healthy boys must continue to be able to be [[circumcised ]] before they come of age, which we as doctors strongly advise against, then the minimum requirement must be to ensure the boys competent surgery and pain relief during the operation. It can only be achieved by having trained surgeons perform the procedure and postpone it until after the age of 2, where it can take place under full anesthesia, as recommended by the country's surgeons and anaesthesiologists.
However, the Jewish community is not to be slammed or stabbed when it comes to ensuring medically sound surgery and pain relief. It shows recently published minutes from meetings between the Jewish Community and the Danish Agency for Patient Safety on the boy [[circumcision ]] problem.
In [[Brit Milah| Jewish boy circumcisions ]] in [[Denmark]], the operation is performed by a [[Mohel| religious circumciser]] who is not a doctor, and only [[EMLA|Emla ]] (popularly called magic cream) is used, which provides insufficient, superficial pain relief. [[EMLA|Emla ]] is the least effective form of local anesthetic; the pain relief is significantly worse than with local anesthesia with injection of anesthetic at the root of the penis and significantly less than that obtained with full anesthesia. In addition, [[EMLA|Emla ]] is not at all approved by the Danish Medicines Agency for use on the genitals of children under 12 years of age.
For ritual circumcisions performed by doctors in private surgical clinics, local anesthesia with injection of anesthetic at the root of the penis and possibly prior [[EMLA|Emla ]] is used. It gives the boys significantly better pain relief than at the ritual Jewish circumcisions. Unfortunately, this type of local anesthesia fails in up to every 10-20. cases and therefore does not ensure all boys pain relief. The boys also risk circulatory problems and possibly cardiac arrest if the anesthetic is accidentally injected directly into the bloodstream or into the swelling bodies of the penis.
From the minutes of the meetings between the Jewish Community and the Danish Agency for Patient Safety, it appears that the former "has significant reservations" about local anesthesia with injection of anesthetic at the root of the penis, and that a requirement for full anesthesia would be contrary to "Jewish law".
The situation is now that all the invited medical companies have emigrated in protest from the working group under the Danish Agency for Patient Safety, which is to prepare a new clinical guide on non-therapeutic boy circumcision. The reason is that the Danish Agency for Patient Safety has not listened to and taken the medical recommendations seriously. On the other hand, it is safe to say that it has listened extremely attentively to the Jewish community, indeed, it has listened to such an extent that the Jewish community has in fact - with reference to 'Jewish law' - made the board deny the medical professionals companies' key recommendations.
According to the Danish Agency for Patient Safety, approximately 2,000 non-therapeutic boy circumcisions take place each year, which is a low estimate, as this does not include the circumcision of sons of descendants from Muslim countries. The real number of boy circumcisions in [[Denmark ]] can therefore very well be over 3,000 a year.
Of these, Jewish boy circumcisions performed by the ritual circumcision account for in the order of 5-10 per year, corresponding to 0.2-0.5 percent of all boy circumcisions in [[Denmark]].
When the Jewish Society turns its back on the Danish Agency for Patient Safety and trumps the demand to be able to continue with the same medically indefensible circumcision practice as before, it will not only make the beginning of life painful for the 5-10 boys with Jewish parents who leave them circumcised ritually. With the agency's compliance with 'Jewish law', the Jewish community effectively prevents all the 2,000-3,000 other boys from predominantly Muslim families from being effectively relieved of their pain.
As physicians, we look with the greatest concern at the kneeling to religious pressure, at the denial of the expertise of medical societies, and at the failure of the weak in this game, namely, the boys. Not least the thousands of boys with Muslim family backgrounds who, due to the veto of religious Jews, will be denied access to effective pain relief.
When Prime Minister Mette Frederiksen claims to want to fight [[Anti-Semitism|anti-Semitism ]] in [[Denmark]], it does not benefit the case that she and her government almost equate circumcision resistance and anti-Semitism, let a painful and destructive ritual like boy circumcision continue at the request of religious Danish Jews and at the same time let consideration to 'Jewish law' make it impossible to ensure proper surgery and optimal pain relief for the - predominantly Muslim - boys, who in future come under the knife, as long as the ritual is legal in [[Denmark]].
<!-- == Jødisk lov skal ikke diktere reglerne for drengeomskæring i Danmark ==
Det Jødiske Samfund er imidlertid ikke til at hugge eller stikke i, når det handler om at sikre lægeligt forsvarlig kirurgi og smertelindring. Det viser netop offentliggjorte referater fra møder mellem Det Jødiske Samfund og Styrelsen for Patientsikkerhed om drengeomskæringsproblemet.
Ved jødiske drengeomskæringer i Danmark udføres operationen af en religiøs omskærer, som ikke er læge, og der benyttes kun [[EMLA|Emla ]] (populært kaldet tryllecreme), der yder utilstrækkelig, overfladisk smertelindring. [[EMLA|Emla ]] er den mindst effektive form for lokalbedøvelse; smertelindringen er væsentligt ringere end ved lokalbedøvelse med injektion af bedøvelsesmiddel ved penisroden og markant ringere end den, der opnås ved fuld bedøvelse. Desuden er [[EMLA|Emla ]] slet ikke godkendt af Lægemiddelstyrelsen til anvendelse på kønsorganerne på børn under 12 år.
Ved [[Brit Milah| rituelle omskæringer ]] udført af læger i kirurgiske privatklinikker benyttes lokalbedøvelse med injektion af bedøvelsesmiddel ved penisroden og eventuelt forudgående [[EMLA|Emla]]. Det giver drengene væsentligt bedre smertelindring end ved de rituelle jødiske omskæringer. Desværre svigter denne form for lokalbedøvelse i op mod hvert 10.-20. tilfælde og sikrer derfor ikke alle drenge smertefrihed. Drengene risikerer også kredsløbsproblemer og evt. hjertestop, hvis bedøvelsesmidlet ved et hændeligt uheld sprøjtes direkte i blodbanen eller i svulmelegemerne i penis.
Af referaterne fra møderne mellem Det Jødiske Samfund og Styrelsen for Patientsikkerhed fremgår det, at førstnævnte »har betydelige forbehold« over for lokalbedøvelse med injektion af bedøvelsesmiddel ved penisroden, og at et krav om fuld bedøvelse vil stride mod »jødisk lov«.
Når statsminister Mette Frederiksen hævder at ville bekæmpe antisemitisme i Danmark, så gavner det ikke sagen, at hun og hendes regering nærmest sætter lighedstegn mellem omskæringsmodstand og antisemitisme, lader et smertefuldt og destruktivt ritual som drengeomskæring fortsætte efter krav fra religiøse danske jøder og samtidig lader hensynet til ’jødisk lov’ gøre det umuligt at sikre forsvarlig kirurgi og optimal smertelindring til de – altovervejende muslimske – drenge, som fremover kommer under kniven, så længe ritualet er lovligt i Danmark.-->
=== Co-signatories ===
* [[Morten Frisch]], overlæge, dr.med., ph.d.{{PhD}}, adj. professor* Arash Afshari, overlæge, ph.d. {{PhD}} (børneanæstesiologi og intensiv medicin)* Kasper Linde Ankjærgaard, læge, ph.d.{{PhD}}
* Lisbeth Asserhøj, speciallæge (almen medicin)
* Niels Bentzon, overlæge (kirurgi)
* Sven Felsby, overlæge (anæstesiologi og intensiv medicin)
* Sarah Grunnet, afdelingslæge (pædiatri)
* Jamal Abed Hanash, overlæge, ph.d. {{PhD}} (kardiologi)
* Joachim Hoffmann-Petersen, overlæge (anæstesiologi og intensiv medicin)
* Morten Holm, speciallæge (almen medicin)
* Peter Jensen-Gadegaard, overlæge (anæstesiologi og intensiv medicin)
* Katrine Staudt Jeppesen, speciallæge (pædiatri)
* Trine Maria Mejnert Jørgensen, afdelingslæge, ph.d. {{PhD}} (karkirurgi)
* Anas Al Kahwa, læge
* Preben Kirkegaard, professor emeritus, dr.med. (kirurgi)
* Juri Lindy Pedersen, overlæge, dr.med. (pædiatri)
* Hadi Riazi, overlæge (karkirurgi)
* Frederik Schaltz-Buchholzer, læge, ph.d.{{PhD}}
* Anne Mette Skjødt-Jensen, overlæge (anæstesiologi og intensiv medicin)
* Anders Peter Gerholt Skovsen, afdelingslæge (kirurgi)
{{SEEALSO}}
* [[Denmark]]
* [[Dansk Folkeparti]]
* [[Intact Denmark]]
* [[Pain]]
* [[Resolution_by_the_Parliamentary_Assembly_of_the_Council_of_Europe#Resolution_1952| Resolution 1952]]
{{LINKS}}
* [http://circumwatch.dk/omsk/2019/20191121_referat_moede_STPS_DJS.pdf Møde den 21. november 2019]
{{ABBR}}
{{REF}}
[[Category:Denmark]]
[[Category:Pain]]