Quite an interesting ethics debate, really. An 8-year-old boy is caught in the middle of his parent's court battle over whether he should be circumcised or not, and groups opposed to the procedure are keeping a keen eye on the case. The mother wants him to undergo circumcision in order to prevent a recurring inflammation she says he's experiencing, but the father is opposed to what he considers an unnecessary and psychologically (and physically) scarring procedure.
"The child is absolutely healthy," the father said during a break in a court hearing on the matter Wednesday. "I do not want any doctor to butcher my son."
(from CNN)
"My child was in the bathroom crying. He asked me to come in because his penis did not look normal," [the mother] said, describing one of the episodes.
A tough situation, and surely not improved by their 2003 divorce. But, during the divorce, the father was given the right to offer input on medical decisions for the child, and in early 2006 sued to block the surgery. A judge granted the stay until he could hear from both parents.
The case reflects America's conflicted feelings over circumcision. Once considered medically necessary for improved hygiene, in 1999 the American Academy of Pediatrics reversed its support for the procedure citing questionable benefits. In America, most newborn boys are circumcised before leaving the hospital, although a growing number of parents are opting against the surgery; this is reflected in a fall from 90% in 1970 to about 60% today that are circumcised.
Advocates allege that the procedure lowers risk of STDs, urinary tract infections, and promotes hygiene. The "genital integrity" movement, on the other hand, says that circumcision is a human rights violation and sexual assault resulting in pain, physical scars, and possible psychological trauma.
But, what of what the 8-year-old wants? He's not an infant and, as the procedure is irreversible, should have some amount of say in the matter. While he cannot fully comprehend what/why circumcision is an issue, he is also not completely ignorant either. To me, although the question of whether circumcision should be practiced is important, another interesting issue is whether minor children should be able to have a say in medical procedures that they will undergo. Obviously parents and caregivers are responsible (and better judges) in these matters, but does that negate the child playing a legal role in their well-being? This especially seems relevant in matters of contentious medical necessity.
As a child who underwent numerous surgical procedures (no, not circumcisions lol), my parents were conscientious enough to ask my opinion and consider what i wanted with some weight. But many other parents are not so considerate. What happens when the parent's religious beliefs prevent their child from getting help? Or perhaps they want their child to have a nose job, tonsils out, wisdom teeth out, or other elective/preventative procedure?
So, readers, weigh in, if you like:
Should minor children have any say in their medical procedures?
Are there any true benefits to circumcision?
(Shout out to Kyle for the heads-up on this story!)
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I was not circ'd as a child. I had repeated UTIs for years, which my parents dismissed. Can you imagine peeing razor blades? I asked for circumcision, got none. Well, until I grew up. It also got caught in my zipper, and the foreskin ballooned and sprayed all over. My 3 sons are circ'd. Also, I always thought of circumcision as yes or no, but there is a middle ground. My youngest nephew got a minimal circ (tip clip). With local anesthesia it did not hurt and healed quickly. A mini circ removes just the floppy tip of the foreskin, enough to prevent all the problems I grew up with and more. I would have been quite happy for a childhood mini circ. I suggest that a mini circ is a great idea if need a compromise about circumcision, are doing it only for religious reasons or simply want your son to keep his foreskin. If you live where circumcision is less common, a mini circ will give your son worthwhile protection without his being the odd man out. If your eight year old is having problems after you said no to circumcision, a mini circ might be the solution you want and he needs. My 3rd son sports a mini circ. Any son can have some real benefits of circumcision and look, feel, still be intact.
This story shows how complicated we make things with issues that are not relevant. This problem was partly about divorce, partly about the courts and only partly about an 8 year old boy. It doesn't seem to be about medicince at all, though that might have at least been the main focus. If the boy was having UTIs, which are very painful (I know from my childhood), medicine needed to be first and foremost. The boy could have been given a minimal circumcision, which removes only the floppy tip of the foreskin, leaving the look and function nearly the same, but a tiny opening that usually prevents UTIs and other infections(It worked for me). Apparently the well being of the boy was not the main thing when it should have been the only thing.
Its worth discussing with them why the are getting surgery in general - but only to tell them why they are getting it.
As far as circumcision goes... are there really any downsides to it?
I mean besides the occasional slip of the knife. It's pretty "normal" and I think its worth it to have most things about your kid normal so they don't have other kids looking at them in the locker room and asking "what's wrong with your weener johnnie!?"
p.s. I like your bird :)
Upon arrival to the USA I was astonished that Americans have a positive attitude towards circumsision, think it is normal, believe it is healthier than the alternative, and even have a bias against NOT doing it (including bias by women against non-circumsized men, as in, "yeeeew, yuk!"). I guess some tribes in Africa think that way about female circumsision as well - never really giving it a thought, just taking the tradition for granted - if my tribe is doing it, tat must be the best way to go.
I absolutely think an eight year old should be asked about it, for the following reason - I was circumcised at eight without being asked, and I have had interminable problems ever since. And I had opinions, but in those days kids weren't asked, they were told. By the doctors. It is one thing I have never forgiven my parents (there are other things, of course). And don't even ask me about the medical profession's tendency to dictate to patients.
As it happens I just had a tight foreskin that would have corrected itself after a while. But that's no consolation when I suffer from the irritation it causes me daily. My mother liked the "clean" look (it's almost always mothers who make these decisions).
thats why kids should always have it at birth ;)
can 8 year olds really make appropriate decisions anyway?
Wow thanks for all your comments guys. I can see this is an issue where emotions run deep, and thanks for sharing.
I do sympathesize with the "looking normal in the locker room" argument, although with less and less parents electing to have it, uncircumsices may soon be the "norm." It is also interesting to note that this is something peculiar to Americans (leaving out religious reasons). We truly are a culture obsessed with aesthetics.
If kids have it at birth, a strong argument could be made that you are depriving the child of its ability to weigh in on the matter (if such things count.) Or, you could argue that if you wait, it may be too late. If the procedure is performed on an infant, chances are no anesthesia is used, but it is on an 8-year-old. But, as far as I am aware, there is no difference in what an infant or and 8-year-old can feel.
Hm. I imagine most men's opinions on this are going to be colored by personal experience: from "I had one and it's scarred me for life" to "I had one and I just don't see what the big deal is," and from "I wasn't circumcised and got picked on in the locker room/bedroom" to "Thank god I'm still all there." For this reason, I'm not sure how persuasive personal anecdote is. I think we have to rely on evidence about health benefits and costs, the frequency of cases like John Wilkins', etc.
I do think the relevant arguments ought to be health-related--I'm not really compelled by the aesthetic or cultural considerations. After all, we don't, in most situations, run around with our johnsons hanging out; thus, the social stigma that non-circumcision might bring is somewhat limited. As to a specific situation brought up above: people are going to get picked on the locker room for all sorts of things, and it really has very little to do with the feature the pickers-on choose to target; if they can't pick on a kid becuase of his foreskin, they'll pick on him because he doesn't have any hair, or because he has too much, or because he's scrawny. The point is, these sorts of things are arbitrary enough that I can't see it as a rationale for childhood circumcision. I think similar reasoning applies to the aesthetic preferences of romantic partners (male or female).
Should the eight-year-old be consulted? Well, he should certainly be involved in the discussion, but I don't think most kids that age are really equipped to make such decisions. Just think about what path most kids would take if you handed them control of, say, their dental decisions. Now add the "You're going to do what?!?" factor of circumcision. It's hard for me to believe an eight-year-old is really going to be able to reliably weigh the (possible) long-term benefits against the immediate costs.
(Sorry this comment was so long--there are many interesting issues in this post.)
Penn & Teller did a show in this a while back. See, you can also find professionals with "modern" research, not stuff from 50 years ago, that suggest "some" types of infections, if not STDs are actually decreased by leaving things well enough alone. More important, the promotion of the idea was based on a hand full of proponents of two crazy ideas, a) masterbation is bad and b) the human body can only produce so much sperm, because each time it drains some of your "life force". Both ideas are alive today among some nuts. However, these two things should clue you in to two key factors:
1. There is no point in using circumcision to help prevent masterbation *unless* it on some level reduces pleasure and sensitivity. Yep, that little bit of skin has millions of receptors in them that "help" in sex.
2. That skin also acts as a second layer of lubrication, i.e. it helps the penis slide better during sex, since part of it moves under the skin, not in and out. This makes it better for "both" partners.
As for the medical benefits.. Check who is saying so. I bet you will find that most of them are a) using 50 year old studies that where showed little benefit, b) members of the various abstinence only type crowds who lie through their teeth about anything dealing with sex, or c) promoted by intentional misreading of "huge" benefits from what are minor, contradictory and about 50-50 for and against it helping to protect against "anything".
The health benefits are practically alternative medicine in their "real" provable results and the entire idea was only promoted as a health benefit after people like Walter Kellog realized that people didn't go for the whole, "Sex is evil and masterbation will kill you!", gibberish.
Put simply, it hurts you as a sex partner, which I would call a medical problem itself, and "if" any benefit exists medically at all, its *maybe* decreases the odds of getting "some", though not all, STDs by at most perhaps 5%? Gosh! I am so glad the doctors saved me from that extra 5% risk, if I was ever stupid enough to sleep with someone with an STD in the first place. The trade off for poorer self stimulation and worse sex is made up for so much by that slight protection... lol
Josh, I think men should always run around with their johnsons hanging out. But thats just me. :P
Kagehi, I agree very much with what your saying, that the procedure of circumcision was championed in the "sex is bad and materbation will (at the very least) land you in hell)" movement. The flag was then carried on by dubious health benefits and aesthetic preferences. I'm honestly surprised its gone on as long as it has, but the culture has been persistent. Why change bu surgical intervention what evolution has deemed well and good?
mutilation (circumcision) of a minor should be a crime and punished like what it is.
Alas, the neighbors complain, and the police tend to take a dim view of it--at least around here. The only place I've been able to get away with it was a spa in Austria; but there it was practically required.
If Kagehi and you are right about the dubious health benefits, then there seems to be a good argument for foregoing circumcision generally. But the case that sparked this discussion sounds atypical, in that circumcision is being pushed as a remedy to a specific condition. So maybe circumcision should be a bit like having your tonsils or appendix out: not done as a matter of course, but only when the need arises.
If this were to become the standard approach to circumcision it would have an added benefit: most of us American men would fit in at those European spas a bit better.
The "fitting in" argument is ridiculous. Any surgical procedure on a 1 month old baby ought to have serious medical necessity behind it, and this simply doesn't have that. No honest doctor would tell you it's medically necessary--how can it be when 80% of the world's males don't have it and are fine?
Semitic peoples (Jews, Arabs, etc) may have culturalized it early in history because of the problem of sand getting under the foreskin. But for most places this isn't an issue.
God, men are so obsessed with the mass of their members anyway, why are we removing like 30% of the surface area at birth? Why are doctors and hospitals profitting from this? This hurts like a bastard, stuff can go wrong. What's there to love?
I live in the U.K. where the incidence of circumcision is much lower. (I'm uncut :-)
Recently there was a very interesting documentary on this subject.
A few salient points:
1) as mentioned above the 'movement' began with ideas of stoping masturbation.
2) Even for Jews and Muslims there is no actual requirement to be circumcised, it is still the wish to be like ones peers that is the driving force (although I'm sure that it is stronger).
3) There are other parts of the body which could be removed in order to reduce the risk of certain diseases. However they are left alone!
4. The head of the British Medical Association said that, as far as he could see, the primary motivator for doctors to carry out circumcision in the US is that they make a lots of money doing it.
One thing I regret in my life is letting my wife have our son circumsized...it's just that you do not argue with a woman who just spent hours in pain, so you go along with whatever she says.
Has anyone ever argued for mass decapitation as a prevention against mental diseases?
>>Has anyone ever argued for mass decapitation as a prevention against mental diseases?<<
I did read a post once, long ago, taking the 'circumcision to prevent disease' (specifically penile cancer) argument a step further to demonstrate its absurdity -- the risk of developing breast cancer is obscenely high these days, MUCH higher than any risk of penile cancer or that big 5% inflation of STD risk. So, the argument goes, for the sake of our health all women should have double mascectomies. Perhaps society will come to like the "clean look" in women's chests.
Oh, no! Don't take away the boobs!!!
Don't worry, I think that society has made its wishes loud and clear that we what MORE boobs, not less!
If the kid is old enough to remember it when they are older, they should have a say. As for whether babies should be circumsized... well.. there's not much reason not to, but on the other hand there's not much reason to do it.
My only thought is if it's done at birth then it will under no circumstwances ever have to be done later in life (and I don't buy that it reduces the pleasure you get from sex, it seems pretty pleasureable to me)
Male circumcision is truly an ancient ritual and is poorly understood as is evident by the ignorant comments on this board (30% of the surface area is lopped off? If it weren't necessary evolution would have removed it? Sand getting stuck? Preventing masturbation? Please.).
According to scripture, Abraham was commanded by God to circumcise all of his male descendants as a symbol of the covenant between man and the One God. Oh, and Jesus was circumcised too.
People on this board are confusing the act of circumcising with being circumcised. The religious ceremony is supposed to be performed during 8 days after birth with the vast majority recovering very quickly from the "trauma". Whether done religiously or in a surgical suite the little guy cries for a minute, then he gets Mum's boob and quiets down. Fifteen minutes later, he's sleeping. Where's the trauma?
Being circumcised is no different than being au naturel but I wouldn't know because I've always been the way I am and you've always been the way you are.
Now doing this to an 8 year old is not smart. Freud would have a field-day with the psychosexual implications of having part of his penis removed during his "latent phase." The parents are clearly using this child to hurt each other as is the case in many divorces. IMO, it's too late to cut this kid until he's 18 and can decide for himself whether to wear a turtleneck or a crewneck.
Cricumcision was written into the Bible because it was already a custom in various local goatherders tribes that wrote it at the time.
Despite the fact that close to 90% of men his age will report that they are circumcised, I'll bet anything that the father in this article is uncircumcised.
Medically speaking, or at the very least corporeally speaking, I've always been in favor of the "you can always get it removed, but you can never put it back on--so you'd better be sure of what you're doing" philosophy. That is why if my eyes ever do go bad, I would opt to have glasses or contacts over "starwars" on my eyes which would undoubtedly leave me with fewer options should the future hold better alternatives or, god forbid, "the dark side" wins and I'm rendered blind by the operation.
This also is why if I had Parkinsons Disease (and I've thought about this as one who had studied Parkinson's disease for some time), I'd be VERY hesitant to have a pallidotomy (a surgery aimed at excising a part of the brain which controls inhibition of movement, thus having ameliorative affects over the paucity of movement commonly observed in PD patients). Science has already shown that these poor people who elected pallidotomies in the 90's wish they would have waited for the deep-brain stimulation therapies which have gained popularity as of late.
Now I'm not trying to equate the decision to have part of my brain removed to the decision to have a seemingly useless flap of skin on my "johnson" removed, but I stand by my original "you can always get it removed, but you can never put it back on--so you'd better be sure of what you're doing" philosophy.
That being said, I think I would still elect to have my son circumcised at birth. At the end of the day, and for the reason I stated at the beginning of this post that "I'll bet anything that the father in this article is uncircumcised", I believe it is in human nature to stick with what we are familiar with.
And especially when it comes to the Johnson :)
My brothers are in their late-20s and have intact penises. When I found out I was having a son, I asked younger brother #1 about dealing with locker room showers.
His reply? "If they are staring hard enough at my dick to know whether or not I have a foreskin, we have other problems to deal with." He was 17 at the time.
IMNSHO, aethetics is never a good reason for the surgical modification an infant. As for the 8-year-old in question, I think he should have a say, but with the acrimonious relationship between his parents, he's in a real no-win situation. He may feel unduly pressured to conform with the wishes of his primary caregiver.
This popped up as my random quote on Pharyngula:
You know, the more I think about it, the more I come to realize that circumcision really just has all the trappings of sexual repression and dogmatic religious practice. Considering a cost-benefit analysis of the situation reveals several things:
1. Its not a good reason to do it just because YOU prefer how it looks. You're not going to be looking at your son's johnson for any significant period of time (hopefully). He is. And I do believe he'll love it no matter what (probably TOO much lol).
2. From a survery of the literature, there isn't any conclusive, convincing health benefits.
3. Surgical modifications as religious ritual infers that the act will have any religious meaning to the child. You can't know that as fact.
4. With any surgery there comes risk of infection, bleeding, loss of feeling, even death. These are not appropriate risks to take if there are no conclusive benefits.
5. The execution of the procedure largely involves no anesthesia, which seems cruel.
Any more to add?
> Alas, the neighbors complain, and the police tend to take a dim view of it--at least around here. The only
> place I've been able to get away with it was a spa in Austria; but there it was practically required.
Sadly, it has a dim view in most of the US, but... While the "adult" nudism clubs have caught on, this is actually due to the rise of acceptance of "family" type places. Heck, there is even one group in the US that is based on Christian religious scripture and promotes nudism as healthier than being clothed. A fact that seems to be the case, since the statistics imply few if any cases of eating disorders, almost no cases of sexual predation, at least not from "inside" the communities and their kids tend to wait 2-3 years longer before having sex. By contrast, a recent study done on some religious schools, where the "asssuption" is that clothes + abstinence = no sex, they tended to lose their virginity 2-3 years "earlier" than the national average and with something like 80-90% of them doing so, where the average in the same age groups is like 60-70% or something. lol Note, my numbers are probably not accurate, but there was at least a 10% or more difference, in favor of "non-religious" rates.
I am continually amazed how those that want to control everyone else's bodies can't *see* how the very protestant gibberish that promotes that idea actually contributes to or even causes the conditions that make possible and encourage the very things they are trying to prevent. Then again, the vast majority of them also have no clue "when" the ideas became popular, no clue that nudity wasn't a problem 2000 years ago and even less clue that baptisms where once traditionally done "in the nude". I know this and I am most certainly not Christian. Why the heck are Christians so clueless?!?
As for someone else's comment:
> The religious ceremony is supposed to be performed during 8 days after birth with
> the vast majority recovering very quickly from the "trauma".
Ok, one.. The "falling asleep" that happens to babies is ***shock***, you know the same thing people warn you about when injured and can kill you without warmth to make up for your bodies partial shutdown... Babies are a) not yet developed enough for safeguards and limiters to be in place, which means the level of sensativity, as has been tested (don't ask me how exactly), is Significantly higher than an adult. It would be comparable to how some people read brail, while others like me can't even tell how many bumps are there, never mind how they are grouped. You are basically causing pain to the child that, due to their sentitivity, is probably the worst they will "ever" experience in their entier life times and they collapse from the shot of it. However, the "good news", if you can still call it that knowing the truth, is that we also don't have very good memory formation skills that early. We are still trying to work or grose motor control and what input needs to be remembered, so the pain and the experience is pretty much lost and not ever remembered. It would be a major life altering psychological trauma if it was remembered. But by that same excuse you could break and reset the childs arm, on the grounds that it was "tradition", they "recover quickly", and "won't remember anyway" as well. If you don't like the analogy, tough, its still more accurate than the assumptions you are repeating about how bad it is and what "recovery" really means in the context of this surgery. An assumption held by people that heard it from other people, not one of which in the entire time that this has been preformed has, until this century, ever been "able" to make an accurate assessment of what was really happening.
Oh, and they know its shock because someone thought to hook up the same sort of monitoring stuff they do for other medical procedures during a circumcision and got "identical" readings to a shock patient. Something that would, if it happened in any other context, get the person arrested or fired if done intentionally, or at minimun send out a hospital alert for specialists to stabalize the patient if accidental. I am sure in the early days they had some babies die from it by not keeping them warm enough after. Most societies also "never" do it on babie, but reserve it for ceremonies to become official adults, though imho, that doesn't make it better, just mildly less insane than doing it to a baby.
And yes, as someone else pointed out, doctors get a thousand of more for each procedure "and" often can then use the tissue for some other things, so make a few thousand more off it. There isn't much incentive for doctors, most of whom have never tried to check the vital stats of a baby under those conditions and thus have no clue what its really doing to them, have no real incentive to stop the practice, which tradition and ignorance promote as safe and harmless.
Oh, and the surgery "can" produce the very infections in a small number of cases, do to increased exposure to feces and urine, as the clowns in the original article where arguing about doing it to stop. That is one of the reasons "for" a forskin, to prevent exposure to things that cause infections. You think that is actually going to "improve" due to removal when the first 1-2 years are in a diaper?
This from a recent BBC article:
Researchers found evidence that the HIV virus targets specific cells from the inner surface of the foreskin.
These cells possess HIV receptors, making this area particularly susceptible to infection.
The researchers suggest that male circumcision provides significant protection against HIV infection by removing most of the receptors.
Circumcision also reduces the likelihood of contracting other sexually transmitted diseases, such as gonorrhoea and syphilis, which make a person more vulnerable to HIV infection.
The most dramatic evidence of this protective effect comes from a new study of couples in Uganda, where each woman was HIV positive and her male partner was not.
Over a period of 30 months, no new infections occurred among 50 circumcised men, whereas 40 of 137 uncircumcised men became infected - even though all couples were given advice about preventing infection and free condoms were available to them.