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Ethics of non-therapeutic child circumcision

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|issue=
|pages=301–310
}}</ref><ref name="RACPSumm">{{REFweb
|url=http://www.racp.edu.au/download.cfm?DownloadFile=A453CFA1-2A57-5487-DF36DF59A1BAF527
|title=Policy Statement On Circumcision
The medical ethics committee of the [https://www.bma.org.uk/ British Medical Association] also reviewed the ethics behind circumcision. Since circumcision has associated medical and psychological risks with no unequivocally proven medical benefits, they advise physicians to keep up with clinical evidence and only perform this procedure if it's in the child best interest.<ref name="bma2006">Committee on Medical Ethics. [www.bma.org.uk/-/media/Files/PDFs/Practical advice at work/Ethics/Circumcision.pdf The law & ethics of male circumcision: guidance for doctors]; June 2006 [Retrieved 3 November 2019.].</ref> However, they acknowledge the procedure as a cultural and religious practice, which may be an important ritual for the child's incorporation into the group.<ref name="bma2006"/> They recognize that parents have the authority to make choices for their child, and they emphasize it is important for parents to act in their child's best interest.<ref name="bma2006"/> They ultimately report that views vary in their community about the benefits and risks of the procedure, and there is no clear policy for this situation.<ref name="bma2006"/>
 
 
====Adult circumcision====
In a paper published June 2006, the [https://www.bma.org.uk/ British Medical Association] Committee on Medical Ethics does not consider circumcision of an adult male to be controversial, provided that the adult is of sound mind and grants his personal consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.<ref name="bma2006">{{REFweb
|last=Committee on Medical Ethics
|title=The law & ethics of male circumcision: guidance for doctors
|url=http://bma.org.uk/-/media/Files/PDFs/Practical%20advice%20at%20work/Ethics/Circumcision.pdf
|date=2006-06
|accessdate=2019-11-03
}}</ref>
 
====Child circumcision====
 
In the same British Medical Association paper, circumcision of a child to treat a clear and present medical indication after a trial of conservative treatment also is not considered to be ethically questionable, provided that a suitable surrogate has granted surrogate consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.<ref name="bma2006"/>
 
====Criticism and revision of BMA statement====
Commenting on the development of the 2003 British Medical Association guidance on circumcision, Mussell (2004) reports that debate in society is highly polarized, and he attributes it to the different faiths and cultures that make up BMA.<ref name="mussell2004">{{REFjournal
}}</ref> He identifies this as a difficulty in achieving consensus within the medical ethics committee. Arguments put forward in discussions, according to Mussell, included the social and cultural benefits of circumcision, the violation of the child's rights, and the violation of the child's autonomy.<ref name="mussell2004"/>
====Adult circumcision====
In a paper published June 2006, the [https://www.bma.org.uk/ British Medical Association] Committee on Medical Ethics does not consider circumcision of an adult male to be controversial, provided that the adult is of sound mind and grants his personal consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.<ref name="bma2006">{{REFweb
|last=Committee on Medical Ethics
|title=The law & ethics of male circumcision: guidance for doctors
|url=http://bma.org.uk/-/media/Files/PDFs/Practical%20advice%20at%20work/Ethics/Circumcision.pdf
|date=2006-06
|accessdate=2019-11-03
}}</ref>
 
====Child circumcision====
In the same British Medical Association paper, circumcision of a child to treat a clear and present medical indication after a trial of conservative treatment also is not considered to be ethically questionable, provided that a suitable surrogate has granted surrogate consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.<ref name="bma2006"/>
 
====Criticism and revision of BMA statement====
The BMA statement of 2003 took the position that non-therapeutic circumcision of children is lawful in the United Kingdom.<ref name="BMA2003"/> British law professors Fox & Thomson (2005), citing the House of Lords case of R v Brown, challenged this statement. They argued that consent cannot make an unlawful act lawful.<ref name="fox-thomson">{{REFjournal
|last=Fox
}}</ref> They state that if physicians outline all the currently known risks and benefits of the procedure to the parents and believes the procedure is indeed medically indicated, they cannot be held accountable for any harm from the procedure.<ref name="reis-reis2017"/> However, they still advise against physicians recommending unnecessary, irreversible surgeries, which is a category circumcision falls in frequently.<ref name="reis-reis2017"/>
== Other views Journal of Medical Ethics ==
===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
|title=Symposium on Circumcision
|journal=J Med Ethics
}}</ref>
===Other views===
Povenmire (1988) argues that parents should not have the power to consent to neonatal non-therapeutic circumcision.<ref name="povenmire"/>
Richards (1996) argues that parents only have power to consent to therapeutic procedures.<ref name="richards"/>
Somerville (2000) argues that the nature of the medical benefits cited as a justification for infant circumcision are such that the potential medical problems can be avoided or, if they occur, treated in far less invasive ways than circumcision. She states that the removal of healthy genital tissue from a minor should not be subject to parental discretion, or that physicians who perform the procedure are not acting in accordance with their ethical duties to the patient, regardless of parental consent.<ref name="SomervilleSomerville2000">{{REFbook
|last=Somerville
|first=Margaret
|accessdate=2007-02-12
|date=2000-11
|publisher=[[Viking Press|Viking Penguin Canada]] |location=[[New York, NY]]
|isbn=0-670-89302-1
|pages=202–219
}}</ref>
Somerville argues that because of a lack of credible information about male circumcision in some societies, the ability for the caregiver to grant informed consent on behalf of their child is compromised. This may be especially true of caregivers from a religious or cultural tradition that is particularly biased towards or against circumcising infants.<ref name="somervillesomerville2000">Somerville M. ''The Ethical Canary: Science, Society and the Human Spirit.'' Toronto: Penguin, 2000: pp. 202-19. (ISBN 0-670-89971-2)</ref>
Canning (2002) commented that "[i]f circumcision becomes less commonly performed in North America [...] the legal system may no longer be able to ignore the conflict between the practice of circumcision and the legal and ethical duties of medical specialists."<ref name="Canning">{{REFjournal
|last=Canning
|first=D.A.
|language=nl-BE
|access-date=2019-06-14
}}</ref>
<!--
==HIV in southern and eastern Africa==
|url=http://www.cirp.org/library/legal/richards/
|accessdate=2008-04-11
}}</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">{{REFjournal
|last=Sorakan
|first=S.T.
|pubmedID=26435672
|pubmedCID=4578472
}}</ref>-->
Regardless of these issues, the 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"/>
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