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Informed consent

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For some reason this information is not making it to parents. Studies have shown that doctors provide parents with almost no accurate or useful information about circumcision.  One study showed that 40% of parents believed that their doctors failed to provide enough information, 46% reported that their doctors failed to give them any medical information at all, and 82.8% of parents regretted their decision they made within the first six months of their son’s life.<ref>Adler R, Ottaway S, Gould S. circumcision: We have heard from the experts; now let’s hear from the parents. ''Pediatrics '' 2001 Feb;107(2):E20</ref> Another study found that physicians were less likely to circumcise their own sons.<ref>Topp, S. (1978, January). Why not to circumcise your baby boy. ''Mothering, '. 6, 69-77.</ref>This suggests that doctors are very well aware that circumcision is a non-therapeutic surgery (in short, a ritual); but they do not appear to share this knowledge with parents.  A busy physician can supplement their income by as much as $60,000 per year from circumcision surgeries alone.<ref>Fleiss, Paul M.D. ''What your Doctor May Not Tell You About Circumcision''. Warner books. New York. Sept 2002.</ref>This incentive can cloud a physician’s judgment when it comes to providing parents with information about circumcision.
[[Image:circumcision_screaming_baby.jpg|right|thumb|Horror of Circumcision.]]
Many parents are surprised to hear that anesthetics are used in only a minority of cases.<ref>Stang , M.J., & Snellman, L.W. (1998). Circumcision practice patterns in the United States. ''Pediatrics, ''. 101(6)</ref> 
The use of local anesthetics significantly drives up the costs of surgery. When anesthetics are used, they can only reduce the pain. Infants can not be given general anesthesia because of the medical risks involved. In the recent past, anesthesia was rarely used, if ever. Because of this, circumcision has always been an extremely traumatizing experience causing an array of short and long term behavioral and developmental problems
<ref>Gunnar MR, Fisch RO, Korsvik S, Donhowe JM. The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology ''Psychoneuroendocrinolog'' 1981; 6(3):269-75.</ref><ref>Porter FL, Miller RH, and Marshal RE. Neonatal pain cries: effect of circumcision on acoustic features and perceived urgency. Child Dev 11Child Dev11 1986;57:790-802.</ref><ref>Porter, FL, Porges SW, Marshall RE. Newborn pain cries and vagal tone: parallel changes in response to circumcision. ''Child Dev '' 1988;59:495-505.</ref><ref>Emde RN, Harmon RJ, Metcalf D, ''et al''. Stress and neonatal sleep. ''Psychosom Med ''. 1971;33(6):491-7.</ref><ref>Gunnar MR, Connors J, Isensee, Wall L. Adrenocortical activity and behavioral distress in human newborns. ''Dev Psychobiol ''. 1988;21(4):297-310.</ref><ref>Anders TF, Chalemian RJ. The effects of circumcision on sleep-wake states in human neonates. ''Psychosom Med ''. 1974;36(2):174-9.</ref><ref>Marshall RE, Stratton WC, Moore JA, et al. Circumcision I: effects upon newborn behavior. ''Infant Behavior and Development ''. 1980;3:1-14.</ref><ref>Marshall RE, Porter FL, Rogers AG, ''et al''. Circumcision: II : effects upon mother-infant interaction. ''Early Hum Dev '' 1982; 7(4):367-74.</ref><ref>Lee N. Circumcision and breastfeeding. ''J Hum Lact '' 2000;16(4):295.</ref><ref>Anand KJS, Hickey PR. [http://www.cirp.org/library/pain/anand/ Pain and its effects in the human neonate and fetus]. ''New Engl J Med '', 1987;317(21):1321-9. http://www.cirp.org/library/pain/anand/ Retrieved 3/21/11</ref><ref>Anand KJS, Frank M. Scalzo. Can Adverse Neonatal Experiences Alter Brain Development and Subsequent Behavior? ''BIOLOGY OF THE NEONATE'', Volume 77, Number 2: Pages 69-82,
February 2000.http://www.cirp.org/library/pain/anand4/ Retried 3/21/11</ref>
, including altered perceptions of pain
<ref>Taddio A, Goldbach M, Ipp E, et al. Effect of neonatal circumcision on pain responses during vaccination in boys. ''Lancet '' 1995;345:291-2.http://www.cirp.org/library/pain/taddio/ Retrieved 3/21/11</ref><ref>Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet ''Lance''t 1997;349(9052):599-603.http://www.cirp.org/library/pain/taddio2/ Retrieved 3/21/11</ref>
<ref>LaPrairie Jamie L. Murphy Anne Z. Neonatal Injury Alters Adult Pain Sensitivity by Increasing Opioid Tone in the Periaqueductal Gray. Front Behav Neurosci 30 September 2009. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766783/ Retrieved 3/21/11</ref>
, post traumatic stress disorder (PTSD)
<ref>Boyle GJ, Goldman R, Svoboda JS, Fernandez E. Male circumcision: pain, trauma and psychosexual sequelae. ''J Health Psychol '' 2002;7(3):329-43.</ref><ref>Rhinehart J. Neonatal circumcision reconsidered. ''Transactional Analysis J '' 1999;29(3):215-21.</ref>
<ref>Ramos S, Boyle GJ. Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GC, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem. New York: Kluwer Academic/Plenum Publishers, 2001: pp. 253-70.</ref>
<ref>Menage J. Post-traumatic stress disorder in women who have undergone obstetric and/or gynaecological procedures. ''J Reprod Infant Psychol '' 1993;11:221-28.</ref>
, and a possibly of adult self destructive behavior.
<ref>Van der Kolk BA, Perry JC, Herman JL. Childhood origins of self-destructive behavior. ''Am J Psychiatry ''. 1991; 148;1665-71.</ref><ref>Jacobson B, Bygdeman M. Obstetric care and proneness of offspring to suicide. ''BMJ ''. 1998; 317:1346-49.</ref><ref>Salk L, Lipsitt LP, Sturner WQ, et al. Relationship of maternal and perinatal conditions to eventual adolescent suicide. ''Lancet '' 1985;i:624-7.</ref> 
Many circumcised men, some of whom are doctors, experience a strong denial of loss which in turn fuels an emotional compulsion to repeat the trauma to normalize their loss.
<ref>Van der Kolk BA. The compulsion to repeat the trauma: re-enactment, revictimization, and masochism. ''Psychiatr Clin North Am ''. 1989;12(2):389-411.</ref><ref>Goldman R. The psychological impact of circumcision. ''BJU Int '' 1999;83 Suppl. 1:93-103.</ref><ref>Maguire P, Parks CM. Coping with loss: surgery and loss of body parts. ''BMJ ''. 1998;316(7137):1086-8. http://www.cirp.org/library/psych/maguire/ retrieved 3/18/11</ref><ref>Hill G. The [https://d1wqtxts1xzle7.cloudfront.net/33967758/2007-09_Hill.pdf?1402982200=&response-content-disposition=inline%3B+filename%3D2007-09_Hill.pdf&Expires=1593048723&Signature=Is4Hq0eW0qQcHC2oM-K0d7oVPjsOpA~W8SQ62Sp--8ycfA7Zyk82a4XzuLWjuw5elXVmYzdBo47MjEdR7vZ-yqXVBpGbmH7c1iSeKmvmwPL5r6KSFER~0Sf4cgQsPFOH5rN35sG1MAHYE3M7atzGIear38oyvqq6~B3dCgyk05xD93-E7oZlLvZ-YkNhgdlJv0~7EkRJdV4Pr7vK40xJCY0bxN375KhP8n~edvQYvTNSGrApWqveLKirt7I4UF1opKcESa4Hx4jgiRftrUVjQKTb9Imcw7NjmPaV-QJvGqySxwWtw0UpYVpsy3pKiAYaWmNm2IBGhyTS2WJthJoHmQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZAThe case against circumcision]. ''J Mens Health Gend ''. 2007;4(3):318-23.</ref><ref>Goldman R. Circumcision policy: a psychosocial perspective. ''Paediatr Child Health '' 2004;9(9):630-3.</ref>
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