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Text Bioethicists Myers & Earp (2020) exhaustively reviewed the evidence for and against the alleged health benefits to be addeda healthy person claimed for non-therapeutic circumcision of a neonate, infant or child. They balanced this against the [[pain]], [[trauma]], and loss of body tissue and function. They concluded the claimed health benefits are insufficient to support surrogate consent for non-therapeutic circumcision. Given this, only the subject can grant consent for a non-therapeutic circumcision, after he reaches the right age for circumcision, which does not occurs until a male reaches the age of consent in his jurisdiction which may vary from 16 to 18 years of age. The present practice in the [[United States]] and elsewhere of parental consent for non-therapeutic circumcision is entirely unethical.<ref name="myers2020">{{REFjournal
* {{REFjournal
|last=Freeman
|init=MD
|authorlink=
|date=1999
|title=A child's right to circumcision
|journal=BJU Int
|volume=83
|issue=Suppl. 1
|pages=74-78
|pubmedID=10349417
|DOI=10.1046/j.1464-410x.1999.0830s1074.x
}}
→The emerging consensus on surrogate consent for non-therapeutic newborn, infant, and child circumcision: Update URL.
# unjustified differential treatment of children of the same sex,<br>
# unjustified differential treatment of children of different sexes,<br>
# problems with child safeguarding, and (8) # problems with regulation and training. ,<br># an unjustified presumption of lawfulness of NPC of minors , and<br> #) failure adequately to address recent case law.<ref name="lempert2022">{{REFjournal
|last=Lempert
|first=Antony
== Journal of Medical Ethics ==
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===JME symposium on circumcision, June 2004===
The ''Journal of Medical Ethics'' published a "symposium on circumcision" in its June 2004 issue.<ref name="symposium2004">{{REFjournal
|pubmedCID=1733850
}}</ref>
-->
===Journal of Medical Ethics circumcision issue, July 2013===
The ''Journal of Medical Ethics'' devoted the entire July 2013 issue to the controversial issue of non-therapeutic circumcision of male children.<ref>{{REFjournal
|publisher=New York: {{UNI|Oxford University|Oxon}} Press
|date=2001
}}</ref> Some believe that consent Consent for a non-therapeutic operation offends the principle of autonomy, when granted by a surrogate.
Since children, and especially infants, are legally incompetent to grant [[informed consent]] for medical or surgical treatment, that consent must be granted by a surrogate — someone designated to act on behalf of the child-patient, if treatment is to occur.<ref name="conundrum">{{REFjournal
The Committee on Bioethics of the AAP (1995) states that parents may only grant surrogate informed permission for diagnosis and treatment with the assent of the child whenever appropriate.<ref name="bioethics"/>
There is was an unresolved question whether surrogates may grant effective consent for non-therapeutic child circumcision.<ref name="povenmire">{{REFjournal
|last=Povenmire
|init=R
|url=http://www.cirp.org/library/legal/povenmire/
|accessdate=2013-11-25
}}</ref> <ref name="conundrum"/><ref name="Adler">{{REFjournal |last=Adler |first=Peter W. |init=PW |author-link=Peter W. Adler |url=http://rjolpi.richmond.edu/archive/Adler_Formatted.pdf |title=Is Circumcision Legal? |volume=16 |issue=3 |journal=Richmond J. L. & Pub. Int. |page=439 |date=2013}}</ref> Richards (1996) argues that parents may only consent to medical care, so are not empowered to grant consent for non-therapeutic circumcision of a child because it is not medical care.<ref name="richards">{{REFjournal
|last=Richards
|init=D
}}</ref> The Canadian Paediatric Society (2015) recommends that circumcisions done in the absence of a [[medical indication]] or for personal reasons "should be deferred until the individual concerned is able to make their own choices."<ref name="CPS2015" />
Regardless of these issues, the unethical general practice of the medical community in the United States is to receive surrogate informed consent or permission from parents or legal guardians for non-therapeutic circumcision of children.<ref name="bma2006"/><ref name="povenmire"/> ==Observations== The non-therapeutic circumcision industry in the United States produces more than $2 billion annually.<ref name="bollinger2012conundrum">{{REFweb |url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually |title=High Cost of Circumcision: $3.6 Billion Annually |last=Bollinger |first=Dan |author-link=Dan Bollinger |publisher=Academia |website=https://www.academia.edu |date=2012 |accessdate=2021-11-12 |format= |quote=As the saying goes, follow the money. Now you know why neither the [[American Academy of Pediatrics]], American Medical Association, [[American Academy of Family Physicians]], or the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] haven’t condemned this unnecessary surgery, and why their physician members are quick to recommend the procedure to expectant parents.}}</ref> [[Third-party payment]] is a major support to the performance of this medically-unnecessary surgery. If parents could not grant consent for non-therapeutic circumcision, then no one could grant consent for the non-therapeutic circumcision of a child, so the $2 billion annual business would collapse. The American [[Medical trade association| medical trade associations]], more than those of other nations, have been unwilling to recognize the child's right to [[physical integrity]], to security of the person, and the right to personal autonomy.
== The emerging consensus on surrogate consent for non-therapeutic newborn, infant, and child circumcision ==
|issue=2
|pages=16-8
|url=https://musewww.jhuresearchgate.edunet/articleprofile/44133George-Hill-3/publication/371599857_Can_Anyone_Authorize_the_Nontherapeutic_Permanent_Alteration_of_a_Child's_Body/links/648b8819c41fb852dd0949be/Can-Anyone-Authorize-the-Nontherapeutic-Permanent-Alteration-of-a-Childs-Body.pdf
|quote=
|pubmedID=14635628
|pubmedCID=
|DOI=10.1162/152651603766436342
|format=PDF |accessdate=2023-0507-2711
}}</ref>
|last=Myers
|first=
|issue=7
|pages=645-63
|url=https://d1wqtxts1xzle7www.cloudfrontresearchgate.net/64630392profile/bioe.12714Brian-Earp-2/publication/337720859_What_Is_the_Best_Age_to_Circumcise_A_Medical_and_Ethical_Analysis/links/5f815f61a6fdccfd7b555395/What-Is-the-libre.pdf?1602188733=&responseBest-contentAge-disposition=inline%3B+filename%3DWhat_is_the_best_age_to_circumcise_A_med.pdf&Expires=1685229951&Signature=A6JCU8ZBH6f1fFjanf7NB7BspXqd80s5KeHmHcIBEuXsPGvrJc0HgD~BVseIT~sSto-d2UiVYjbX6VIMjDhGCojnzerer7esXTypLaN6XLiUrV1UEKUs7jOxYoV7832KeUzQ4iQoTtlPRHCaY1ly2yMZLJLAEsHsSXn1iIWMcsdORDjW8CiBon0rp7ZSUx28gIK7gLUgHB1FjcjOVhpyXlmBbXHPfwFzCa2UP8Qin~MwDBzND1hMxKSpjVOoc~3Circumcise-q5xGvrIQK8QQA-gw2WVL1szzoMedical-KcfacbJeMbqXdUCzEVO5zPIY~mMWJ0rNINn9Yd4Li5VsFkyR~tp5Juu2elgxZpA__&Keyand-PairEthical-Id=APKAJLOHF5GGSLRBV4ZAAnalysis.pdf
|archived=
|quote=Based on a careful consideration of the relevant evidence, arguments and counterarguments, we conclude that medically unnecessary penile circumcision-like other medically unnecessary genital procedures, such as 'cosmetic' labiaplasty-should not be performed on individuals who are too young (or otherwise unable) to provide meaningful consent to the procedure.
|accessdate=2020-05-27
}}</ref>
Moreover, non-therapeutic circumcision of boys may also be unlawful,<ref name="Adler">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|url=http://rjolpi.richmond.edu/archive/Adler_Formatted.pdf
|title=Is Circumcision Legal?
|volume=16
|issue=3
|journal=Richmond J. L. & Pub. Int.
|page=439
|date=2013
}}</ref> if a court should accept Adler's arguments.
== Observations ==
The non-therapeutic circumcision industry in the United States produces more than $2 billion annually.<ref name="bollinger2012">{{REFweb
|url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually
|title=High Cost of Circumcision: $3.6 Billion Annually
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|website=https://www.academia.edu
|date=2012
|accessdate=2021-11-12
|format=
|quote=As the saying goes, follow the money. Now you know why neither the [[American Academy of Pediatrics]], American Medical Association, [[American Academy of Family Physicians]], or the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] haven’t condemned this unnecessary surgery, and why their physician members are quick to recommend the procedure to expectant parents.
}}</ref> [[Third-party payment]] is a major support to the performance of this medically-unnecessary surgery. If parents could not grant consent for non-therapeutic circumcision, then no one could grant consent for the non-therapeutic circumcision of a child, so the $2 billion annual business would collapse. The American [[Medical trade association| medical trade associations]], more than those of other nations, have been unwilling to recognize the child's right to [[physical integrity]], to security of the person, and the right to personal autonomy.
{{SEEALSO}}
{{LINKS}}
* {{REFjournal
|last=Goodman