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'''Informed consent''' is a legal and ethical prerequisite for surgery and other procedures in the [[United States]] and many most other nations.
It is defined as:
The name for a fundamental principle of law that a physician has a duty to reveal what a reasonably prudent physician in the medical community employing reasonable care would reveal to a patient as to whatever reasonably foreseeable risks of harm might result from a proposed course of treatment. This disclosure must be afforded so that a patient—exercising ordinary care for his or her own welfare and confronted with a choice of undergoing the proposed treatment, alternative treatment, or none at all—can intelligently exercise judgment by reasonably balancing the probable risks against the probable benefits.<ref>{{REFweb
|url=https://legal-dictionary.thefreedictionary.com/Informed+Consent
|title=Informed conesntconsent
|last=
|first=
This section is for all parents of boys, but is addressed primarily to parents of boys who are located in the [[United States of America]], who appear to be most uninformed or misinformed about the [[foreskin]] and [[circumcision]]. Information is not making it to parents. Studies have shown that doctors provide parents with almost no accurate or useful information about circumcision. After several generations of promotion of and near universal neonatal circumcision in the United States, most Americans are profoundly ignorant of a normal body part and its valuable functions.
=== Surrogate consent ===
Parents act as surrogates for their minor children who are too young to personally grant consent. Surrogate consent ethically is limited to the granting of consent for diagnosis and treatment of disease.<ref name="aap1995">{{REFjournal
|last=Committee on Bioethics
|etal=no
|title=Informed consent, parental permission, and assent in pediatric practice
|trans-title=
|language=
|journal=Pediatrics
|location=
|date=1995-02
|volume=95
|issue=2
|article=
|page=
|pages=314-7
|url=http://www.cirp.org/library/ethics/AAP/
|archived=
|quote=
|pubmedID=7838658
|pubmedCID=
|DOI=
|accessdate=2023-09-14
}}</ref> <ref name="aviva2016">{{REFjournal
|last=Committee on Bioethics
|etal-no
|title=Informed Consent in Decision-Making in Pediatric Practice
|trans-title=
|language=
|journal=Pediatrics
|location=
|date=2016-08
|volume=138
|issue=2
|article=
|page=e20161484.
|pages=
|url=https://publications.aap.org/pediatrics/article/138/2/e20161484/52512/Informed-Consent-in-Decision-Making-in-Pediatric?autologincheck=redirected
|archived=
|quote=
|pubmedID=27456514
|pubmedCID=
|DOI=
|doi=10.1542/peds.2016-1484
|accessdate=2023-09-14
}}</ref>
===Provision of relevant information===
|issue=3
|pages=318-323
}}</ref><ref>{{REFjournal
|last=Goldman
|init=R
|date=2009-09-30
|accessdate=2011-03-21
}}</ref>, [[posttraumatic post-traumatic stress disorder]] (PTSD)<ref>{{BoyleGJ GoldmanR SvobodaJS FernandezE 2002}}</ref><ref>{{REFjournal
|last=Rhinehart
|init=J
|pages=624-627
}}</ref>
It appears that the major reason to administer analgesia to infants undergoing circumcision may be to minimize parents' feeling of guilt and to get their consent for a profitable [[amputation]].
==Video==
However, the vast and overwhelming majority of circumcisions of children are performed to excise healthy, functional tissue from the body of a child who is too immature to grant consent.
The Bioethics Committee of the [[American Academy of Pediatrics]] (1995) considered the power granted to parents to grant surrogate consent for diagnosis and treatment of a child. The Committee says that a parent may give "informed permission" for investigation and treatment of disease. The difference between informed consent and informed permission is unclear. When a child is ill, it is the practice to allow a parent to grant informed permission for diagnostic tests and appropriate treatment.<ref name="aap1995">{{REFjournal |last=Bioethics Committee, American Academy of Pediatrics. |first= |author-link= |etal=no |title=Informed consent, parental permission, and assent in pediatric practice |trans-title= |language= |journal=Pediatrics |location= |date=1995-02 |volume=95 |issue=2 |pages=314-7 |url=http://www.cirp.org/library/ethics/AAP/ |archived= |quote= |pubmedID=7838658 |pubmedCID= |DOI= |accessdate=2020-07-23}}</ref>
Infant boys are born with a healthy [[foreskin]]. No disease or deformity is present to be diagnosed or treated. [[Circumcision]] of an infant boy is neither a diagnostic procedure nor a treatment for disease. The limited parental surrogate powers to grant informed permission recognized by the Bioethics Committee do not extend to the granting of permission or consent for the non-therapeutic circumcision of a minor child.<ref name="aap1995" />
At the present time, ethics and law notwithstanding, non-therapeutic circumcisions of boys are performed with parental consent. Parents will be offered medically-unnecessary, non-therapeutic circumcision and encouraged to grant consent, the sole beneficiary being the bank accounts of the hospital and the doctor. The information supplied below is intended to inform and assist parents of boys.
The Bioethics Committee (2016) of the [[American Academy of Pediatrics]] updated its guidance on informed consent in pediatric practice, <ref name="aap1995" /> however it still does not recognize the child as a human being with rights under domestic and international law.<ref>{{REFjournal
|last=Katz
|first=Aviva L.
|url=https://publications.aap.org/pediatrics/article/138/2/e20161484/52512/Informed-Consent-in-Decision-Making-in-Pediatric
|archived=
|quote=A parent’s authority is not absolute but constrained by respect for the child.
|pubmedID=27456510
|pubmedCID=
Although this may be an advance, Wasserman et al., speaking for the [[AAP]], still do not recognize the [[human rights]] of children.
== Correct age for circumcision ==
Hill (2003) asked if anyone can grant consent for medically not indicated, non-therapeutic circumcision of infants.<ref>{{REFjournal
|last=Hill
|first=George
|init=G
|author-link=George Hill
|title=Can anyone authorize the nontherapeutic permanent alteration of a child's body?
|journal=The American Journal of Bioethics
|date=2003
|season=Spring
|volume=3
|issue=2
|pages=16-8
|url=https://muse.jhu.edu/article/44133
|quote=The question is whether anyone, parents included, has the right to remove the extremely sensitive genital tissue from an infant for any reason other than unquestionably urgent medical necessity.
|pubmedID=14635628
|pubmedCID=
|DOI=10.1162/152651603766436342
|accessdate=2023-05-24
}}</ref>
Bioethicists Myers & Earp (2020) answered Hill's question. They exhaustively reviewed the evidence for and against the alleged health benefits to a 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, and then ''only'' 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. No other person may grant consent for the non-therapeutic circumcision of a minor boy. The present practice in the [[United States]] and elsewhere of allowing parental surrogate consent for non-therapeutic circumcision is entirely unethical because it exceeds the powers granted to surrogates.<ref name="myers2020">{{REFjournal
|last=Myers
|first=
|init=A
|author-link=Alex Myers
|last2=Earp
|first2=
|init2=BD
|author2-link=Brian D. Earp
|etal=no
|title=What is the best age to circumcise? A medical and ethical analysis
|trans-title=
|language=
|journal= Bioethics
|location=
|date=2020
|volume=34
|issue=7
|pages=645-63
|url=https://www.researchgate.net/profile/Brian-Earp-2/publication/337720859_What_Is_the_Best_Age_to_Circumcise_A_Medical_and_Ethical_Analysis/links/5f815f61a6fdccfd7b555395/What-Is-the-Best-Age-to-Circumcise-A-Medical-and-Ethical-Analysis.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.
|pubmedID=32068898
|pubmedCID=
|DOI=
|doi=10.1111/bioe.12714
|format=PDF
|accessdate=2023-09-17
}}</ref>
{{SEEALSO}}
{{REF}}
[[Category:Parental information]]
[[Category:Medical ethics]]