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Ethics of non-therapeutic child circumcision

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|date=2017
|quote=As circumcision is irreversible and therefore a radical operation, we find the physical integrity of the child takes precedence over the belief system of the parents.
}}</ref> The process is irreversible, has no medical justification in most cases, and is performed on minors unable to give their own permission, according to the committee. Paul Schotsmans of the {{UNI|University of Leuven|UCLouvain}}, on behalf of the committee, noted "the child’s right to physical integrity, which is protected by the Convention on the Rights of the Child, and in particular its protection from physical injury."<ref name="bulletin2017"/> The Belgian minister of health replied that the federal institute Federal Institute for health insurance Health Insurance cannot check and know whether in (individual cases) a circumcision is medically justified or not and that she will continue to reimburse circumcision of minors as the safety of the child is her primary concern and she wants to avoid botched circumcisions by non-medical circumcisers.<!--<ref>{{REFweb |url=https://www.standaard.be/cnt/dmf20170920_03084394 |title=De Block blijft besnijdenis terugbetalen |last=Vergauwen |first=Eveline |website=De Standaard |language=nl-BE |access-date=2019-06-14}}</ref>--><!--==HIV in southern and eastern Africa=={{Main|Circumcision and HIV}} Rennie et al. (2007) remark that the results of three randomised controlled trials in sub-Saharan Africa, showing reduced risk of [[HIV]] among circumcised men, "alter the terms of the debate over the ethics of male circumcision."<ref name="rennie2007">{{REFjournal |last=Rennie |first=Stuart |init=S |authorlink= |last2=Muula |first2=Adamson S. |init2=AS |last3=Westreich |first3=Daniel |init3=D |date=2007-06 |title=Male circumcision and HIV prevention: ethical, medical and public health tradeoffs in low-income countries |journal=Journal of Medical Ethics |volume=33 |issue=6 |pages=357-361 |pubmedID=17526688 |url=http://jme.bmj.com/cgi/content/full/33/6/357 |accessdate= |pubmedCID=2598273 |quote= |DOI=10.1136/jme.2006.019901}}</ref> However, the methodology of the African RCTs has been severely criticised, thereby invalidating claims that circumcision reduces the sexual transmission of [[HIV]].<ref>{{REFbook |last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory Boyle |year=2013 |chapter=Critique of African RCTs into Male Circumcision and HIV Sexual Transmission. |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |title=Genital Cutting: Protecting Children from Medical, Cultural, and Religious Infringements |location=Dordrecht, The Netherlands |publisher=Springer Science+Business Media |DOI=10.1007/978-94-007-6407-1_15 |isbn=978-94-007-6406-4}}</ref> Supporters of circumcision argue that using circumcision and other available means to halt the spread of [[HIV]] is in the common good (but overlook the fact that [[HIV]] is transmitted in the seminal fluid). Rennie et al. argue that "it would be unethical to not seriously consider one of the most promising—although also one of the most controversial—new approaches to [[HIV]]-prevention in the 25-year history of the epidemic."<ref name="rennie"/> However, there clearly remains a risk of transmitting or acquiring [[HIV]] while engaging in unprotected sex and other high risk behaviors (circumcised or not). The [[World Health Organization]] (2007) states that provision of circumcision should be consistent with "medical ethics and [[human rights]] principles." They state that "[i]nformed consent, confidentiality and absence of coercion should be assured. ... Parents who are responsible for providing consent, including for the circumcision of male infants, should be given sufficient information regarding the benefits and risks of the procedure in order to determine what is in the best interests of the child."<ref>WHO/UNAIDS Technical Consultation. [http://www.who.int/entity/hiv/mediacentre/MCrecommendations_en.pdf Male Circumcision and [[HIV]] Prevention: Research Implications for Policy and Programming]. Montreux, 6–8 March 2007</ref> However, since babies and children are not sexually active, sexually-transmitted [[HIV]] infection is not a relevant concern. Critics of non-therapeutic circumcision argue that advocating circumcision to prevent [[HIV]] infection may detract from other efforts to prevent the spread of the virus such as using condoms. If the adult chooses to remain celibate or if a couple remain monogamous, or if [[HIV]] is eliminated by the time the child is an adult, the sexual reduction surgery would not have been needed. Moreover, they argue that circumcising a child purportedly to partially protect him from [[HIV]] infection in adulthood may be seen as granting permission to engage in dangerous sexual practices. Obviously baby boys do not need such protection and can choose for themselves as consenting adults if they want a circumcision.<ref name="Somerville"/> This stance, however, does not take into account the fact that adult men may already have contracted [[HIV]] before getting circumcised.<ref>{{REFjournal |last=Harmon |first=Katherine |init=K |title=Can male circumcision stem the AIDS epidemic in Africa? |url=http://www.nature.com/news/can-male-circumcision-stem-the-aids-epidemic-in-africa-1.9520 |journal=Nature News |language=en |DOI=10.1038/nature.2011.9520 |date=2011}}</ref> The UK National Health Service ([[NHS]]) has stated that the African studies have "important implications for the control of sexually transmitted infections in Africa", but that in the United Kingdom practising safe sex including condom use is the best way to prevent sexually-transmitted disease when having sex.<ref>{{REFweb |url=https://www.nhs.uk/news/lifestyle-and-exercise/circumcision-and-stis/ |title=Circumcision and STIs |date=2009-03-26}}</ref>-->
==Surrogate consent==
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