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→Guidance from the Bioethics Committee of the American Academy of Pediatrics
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The statements Committee on Bioethics seeks to modify surrogate consent in pediatric medicine to granting of "informed permission" with assent by the child when appropriate. Thesestatements address consent for treatment of disease in pediatric patients, however they have relatively little to say about non-therapeutic procedures such as [[circumcision of the newborn]]. The 1995 statement did say:
<blockquote>
Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. Although impasses regarding the interests of minors and the expressed wishes of their parents or guardians are rare, the pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent.<ref name="bioethics1995" />
</blockquote>
This statement would cover doctors who refuse to perform harmful non-therapeutic circumcision on boys, however it is not clear if that it ever has been applied to refusal to perform injurious [[circumcision]].
The 2016 statement identifies the harm principle and states:
The harm principle may be seen as a more realistic standard to apply in pediatric surrogate medical decision-making. The intent of the harm principle is not to identify a single course of action that is in the minor’s best interest or is the physician’s preferred approach, but to identify a harm threshold below which parental decisions will not be tolerated and outside intervention is indicated to protect the child.<ref name="bioethics2016" />
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The harmful, injurious effect wounding of child [[circumcision ]] brings harm, not only to the child, but also to a societyfilled with wounded males, however circumcision brings in huge amounts of money, so the Bioethics Committee is effectively muzzled with regard to [[circumcision]].<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
}}</ref>
The perceived need desire to protect physician income derived from non-therapeutic [[circumcision ]] induces an element of [[bias]] into the statements of the Bioethics Committee. One should note that these guidances from the Bioethics Committee of the American Academy of Pediatrics apply to the granting of "informed permission" by surrogates for the treatment of disease, and do <i>NOT</i> apply to non-therapeutic procedures.
==Consent for circumcision of minors==