2005 Essay Contest
First Place
Yuri Tertilus Jadotte, Sophomore
Montclair State University
Montclair, New Jersey
Circumcision of Newborn Males: An Ethical Violation
America is the only country in the world in which the medical establishment circumcises the majority of newborn boys, even though the surgery is not recommended by any national or international medical organization. Not only does this practice violate all the four basic principles necessary to achieve and maintain an ethical relationship between two individuals, it also seriously disregards the best interests of the individual being affected, that is, of the newborn male.
Circumcision, strictly speaking, is the amputation of the foreskin of the penis of a human individual. Medically speaking, circumcision has no relevant health benefits that can be objectively used to justify its practice, although many members of the medical establishment speculate. For example, it is often said that circumcised males have a much lower chance of contracting sexually transmitted diseases such as gonorrhea or AIDS. The fact of the matter is that these speculations have never been objectively proven, and therefore amount to no more than the medical establishment's attempt to justify this unethical practice. One must be careful, however, not to assign too much blame to the members of the medical community because, although they are the ones who actually can legally perform this procedure, the newborn's parents and close family are the ones who request that a circumcision be performed. This is where the ethical violations of circumcision become clear: circumcision is simply a choice that negatively impacts the life of an individual in several ways.
Circumcision, although many disagree, is a medically useless practice and thus can be viewed for what it really is: the willful amputation and mutilation of a perfectly healthy, normal part of a human body. And as such, it violates one of the most crucial principles of ethics: the principle of justice. The foreskin of a healthy newborn penis is an integral part of the body: he, and all other males before him, came into the world with this body part intact and untouched. Either human evolution, Mother Nature or perhaps the Creator has brought him into the world with this part of his body intact. Who are we to justify removing it from his body? Who are we to justify undoing what nature itself has done, to destroy that which has been naturally created? Only in the cases where keeping the foreskin intact poses a clear threat to the health of the newborn male should it be removed through circumcision. But systematic circumcision for any other reason is a violation of the newborn's right to justice.
A newborn's parents, however, often argue that it would be unfair or unjust to deny them their inherent right to opt for the performance of a circumcision on their newborn son. After all, are they not the ones that brought him into the world and will care for him until he is able to care for himself? Are they not in the best position to know what's in their child's best interest, more than anyone else who may disagree? Under most circumstances, parents' "ownership rights" over their child should be completely respected. However, the law should protect their complete "ownership" of their child only to the extent where all their decisions are in the child's best interests, and not in their own best interests. In most cases, parents will solely have a child's best interest in mind: they feed their children, they nurture them and protect them from harm, and they educate them and give them the tools to eventually survive on their own. However, it is well known that, in many instances, a parent may not have the child's best interest as his or her first priority. No, I'm not talking about abortion, where, biologically speaking, the embryo is not really a child yet and its best interests are never completely separate from that of its mother. I'm talking about when a parent subjects a child to his or her own whims, desires, and cultural or religious preferences that actually affect the child's body, such as beating the child severely to the point of bruising and declaring it to be a way of reprimanding him or her, and, of course, circumcising him because of their beliefs. I'm not saying that parents cannot inculcate a particular religion and its practices into their children. What I'm saying is that, viewed objectively and taken in the ethical context of the principle of justice, the violation of a newborn male's right to the maintenance of the integrity of his body is much more unjust than the denial of his parents request for a circumcision.
Furthermore, circumcision violates the principle of beneficence, which, in a nutshell, states: "when dealing with an individual, you should only do what is good." Does circumcision do the newborn's body any type of proven good? Is it really in his benefit to have the foreskin of his penis amputated? Many argue that it serves several useful purposes, some of which are allowing for an easier cleaning of the penis and reducing the male's chances of contracting an STD in his lifetime. But have these justifications ever been experimentally proven? Can those who argue that circumcision serves a hygienic purpose really say that an uncircumcised penis is not just as easy to keep clean as a circumcised one is? Can those who argue that circumcision significantly reduces an individual's chance of contracting an STD seriously show that it does so? As far as cleaning is concerned, people should focus more on teaching males to care for their penises or, in the case of newborns, parents themselves need to show more care when it comes to hygiene. Besides, by using the "better hygiene excuse" as their sole defense for performing a circumcision, parents are actively ridding themselves of the responsibility to teach their sons proper hygiene, which would be a more beneficent thing to do for their sons. Also, isn't it true that boys, in general, are not taught how to properly care for their genitals, whereas girls are? Why is that? I guess that, in our society, teaching boys how to properly care for their genitals must not be the "manly" thing to do. It must be so much easier to just cut off the foreskin, the supposed source of the problem, from the outset and call it a day! As far as STDs are concerned, most scientific literature agree that circumcision is not a significant method of reducing one's chances of contracting an STD. It is also well known that only healthy sexual practices, such as always wearing condoms during intercourse and being monogamous, truly help reduce one's chances of becoming infected with an STD. Therefore, these reasons should not be used to conclude that circumcision of a newborn male is "good" for him.
As a matter of fact, there is reason to believe that circumcision may be "bad" for newborn males. These reasons show that the principle of non-maleficence, another ethical principle, is violated when circumcision is performed. This principle requires one to "do no harm" when making choices that will affect another individual. Well, even though anesthetic methods are sometimes used when performing the surgery, how do we know that a newborn male is not in significant pain afterward? What about those on whom no anesthetic methods are used? How do we know that the pain is bearable or non-traumatic? We do not understand the psyche of newborns enough to make such ethically dangerous assumptions. For example, although many think of crying as a significant measure of a child's pain, some newborns tend to react the other way: they do not cry under possibly significant pain. What then? Do we simply disregard this segment of the circumcised male population? The point is that we do not know the psychological impacts of the surgery on newborn males and we therefore should not simply assume that nothing happens to them. Doing so is like blatantly disregarding the newborn's human rights and violating the principle of non-maleficence.
Furthermore, circumcision, by virtue of its aftermath, negatively impacts the sexual life of the man that the newborn male will become. What happens after a newborn is circumcised? Progressively, the head of the penis "dries up" so to speak because it no longer has the protective, lubricating cover that the foreskin provided, thereby decreasing the natural sensitivity of the head of the penis. What gives anyone the right to take that away from a human being, to reduce his ability to achieve a maximal sexual sensation that he inherited and has a right to naturally enjoy? Isn't circumcising a newborn male willfully harming his future sexual potentiality and decreasing his ability for complete sexual fulfillment as an adult? Yes, circumcision clearly does harm the sexual potentiality of a newborn male and significantly reduces his ability to fully enjoy sex later on in life by virtue of its effects on the penis. Moreover, there's evidence that the practice of circumcision, no matter what veil it currently possesses, may have originally been devised as a means to curtail young men's sexual appetites, something that should clearly be considered unethical.
Also, from a biological point of view, it is well known that an uncircumcised
penis much more easily penetrates a woman's vagina than a circumcised one
during natural intercourse without barriers, and that there is a lesser
need for artificial lubrication. Women's preferences undoubtedly vary for
their own personal reasons, but the fact itself remains true. The bottom
line is that circumcision causes unnecessary harm to a newborn male's body
and subsequently harms the sexual potentiality of the man he is bound to
become, all of which are serious ethical violations. Circumcision also violates
another ethical principle: the principle of autonomy. Even though a newborn
male has no legal autonomy, shouldn't the law protect him from having healthy
parts of his body amputated, just as the law protects him from having his
arms, legs, head, or testicles amputated? Why should foreskin amputation
be considered different? All human individuals must have legal protection
of the integrity of their body, and newborns should not be any different.
Why shouldn't the autonomy of the newborn male over his penis' foreskin
be respected? The fact that he is not yet able to make a choice in the matter
does not justify the making of that choice for him. His autonomy should
be respected in this matter. Circumcision is a procedure that can be performed
at almost any age, however, it creates serious ethical considerations when
being performed on a newborn male who has no say in what is being done to
him and its imminent and distant implications. Therefore, if parents and
everyone else who thinks that circumcision is beneficial want him to be
circumcised, they should wait until he is of legal age to decide whether
or not their arguments in favor of circumcision are valid. He may then opt
to have the procedure performed or not. This would be a much more ethically
correct way of making sure that he is circumcised, because it involves mutual
respect for both his autonomy and his parents' partial autonomy over him.
It is true that circumcision of newborn males is widely practiced in America.
And, although the justifications for its practice may vary from religious
and cultural beliefs to assumed yet unproven medical benefits, it cannot
be considered an ethical practice since it violates all the four principles
necessary to the maintenance of a moral relationship between two or more
individuals. Circumcision, by virtue of the unethical justifications used
to practice it and its inherent nature as a choice by one or more individuals
that negatively impacts the life of another, is therefore not an ethical
practice.
Second Place
Gregory William Esteven, Freshman
Southeastern Louisiana University
Amite, Louisiana
Is Circumcision Ethical?
I. Introduction
Ethical standards are the products of societies and develop to meet the needs of societies. Consequently, they vary from society to society and within societies over time. Not only are ethical standards far from standard among societies around the world, but even individuals within particular societies differ from one another in regard to their ethics and values. Therefore, it is extremely unlikely that governments could pass legislation that would satisfy the ethical demands of all persons within their respective societies. Nevertheless, a society wishing to promote equality and the greatest possible freedom for its members is in a unique position: it can ensure protection to all its members by protecting the rights of individuals--no matter how marginal or powerless they may be. I propose, therefore, that the main purpose of ethics from a legislative standpoint is in ensuring the rights of individuals, and, I will argue: the excision or other alteration of the healthy genitals of a child is inherently antithetical to this aim. It is unethical. When a circumcision occurs, society has failed to protect the rights of an individual who is incapable of protecting himself, and the entire society suffers.
Parents make medical decisions for their children all the time. Naturally, an infant is incapable of seeking medical aid on his own, even if he requires it. Parents must make medical decisions for their children, though, there are and should be limits to that power. Procedures that are not beneficial to the child are unethical. If circumcision or any other medical practice does not benefit the child, or is carried out even when more conservative alternatives are available, it is unethical.
II. History
The practice of male circumcision involves the partial or total removal of the prepuce (foreskin) of the penis, and has a long history spanning many cultures. There is archaeological evidence suggesting circumcision being performed as far back as 2200 BCE in Egypt, for instance. Other groups in the Near East, Africa, and Australia, and other areas of the world, have also practiced circumcision.1 However, non-religious, routine infant circumcision in the English-speaking countries began during the latter part of the 19th century. Early proponents of non-religious circumcision, such as John Harvey Kellogg, MD, cited myriad benefits of the practice, including deterring masturbation--an activity that was seen by many of the day as highly immoral and even physically and psychologically dangerous.2 Indeed, by removing a significant amount of penile skin, nerve fibres, and nerve endings, circumcision does make masturbation and all other sexual activities more difficult to accomplish and less rewarding. It is not difficult to imagine why circumcision appealed to those who were already suspicious of sexuality.3
The terminal decades of the 19th century and the early decades of the 20th century saw a proliferation of routine infant circumcision in English-speaking lands. Today, however, the United States is the only country in the world that circumcises the majority of its newborn males for non-religious reasons. The U.S. takes the lead of other English-speaking countries, with a rate of roughly 57.2%-60% of all newborn males being circumcised yearly, while our former Western circumcising peers, Canada, Australia, and Great Britain circumcise only 17%, 12.1%, and 0.5%, respectively. However, even the comparatively high U.S. rate indicates that the prevalence of the practice is decreasing: the rate once ranged between 80% and 90%.4 We must ask ourselves, what continuing relevance, if any, does circumcision have? What are the justifications of the continuance of the practice?
III. Concerning Some Supposed Benefits of Circumcision
No health organization in the world currently advocates circumcision. Even the American Academy of Pediatrics states that the supposed benefits of the procedure "are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised."5
One of the most common misconceptions surrounding intact male anatomy is that the natural penis is difficult to clean: this is simply not the case. The natural penis is no more difficult to clean than any other body part, and can easily be washed with fresh water or a gentle cleansing product. Therefore, hygiene provides no compelling justification for the practice.
Another oft-cited excuse is that circumcision wards off urinary tract infection. There is little evidence to support this claim--besides, urinary tract infections can be treated with antibiotics like any other infection.
Contrary to another common misconception, intact men are not at greater risk of contracting penile cancer. Penile cancer is an extremely rare condition affecting only about 1 in 1437 men in the United States. Interestingly enough, only about 1 in every 1694 men in Denmark (where only 1.6% of the male population are circumcised) are expected to be affected by the disease.6 Some early studies suggested that circumcised men were less likely to develop penile cancer, but when the data is readjusted to account for the respondents' ages, the correlation disappears. In fact, more recent studies indicate the exact opposite: circumcised men are more likely to develop penile cancer at some time during their lives than are their intact peers, especially if they were circumcised after the neonatal period.
The debate about the effectiveness of circumcision in reducing the risk of contracting HIV/AIDS also continues. Many of the studies rely on information taken from African populations, and have many inherent research flaws, including lack of control groups. Strangely enough, the United States has both a high circumcision rate and a high rate of HIV infection compared to other industrialized countries.7
IV. Functions of the Foreskin and Dysfunctions Caused by Circumcision
Many people are unaware of the dysfunctions caused by all circumcisions--they are even less aware of the more rare, though still too common, complications caused by circumcision, including hemorrhaging, amputation of the glans penis (often "remedied" with sex-reassignment surgery), and even death.
For a society that circumcises the majority of its males, the dysfunctions caused by circumcision actually constitute the norm. This is why most circumcised men are not aware that their functioning has been impaired. Misconceptions also stem from a profound ignorance concerning the intact penis.
The glans penis and inner foreskin consist of mucosal tissue, such as that found in the inner lining of the eyelids and inside the mouth. This type of tissue is not intended to be continually exposed to the elements, and should remain moist. The foreskin of the intact penis folds in on itself and covers the glans and inner foreskin mucosa: this provides needed protection. Circumcision, which permanently removes the protective covering, exposes the glans and remaining inner foreskin to air and abrasive clothing. Over time, a process of keratinization occurs, by which the once sensitive mucosal tissue becomes toughened and desensitized. Quite literally, a layer of dead cells builds up around the tissue. This reduces the capacity for erogenous sensation. Any circumcised male who has undergone non-surgical foreskin restoration (a skin expansion technique) can attest to the fact of keratinization. After keeping the glans and inner foreskin covered for some time, the layers of dead skin will fall away and a significant amount of sensation will return.
The foreskin makes the sliding movements of intercourse possible. Without it, the penis must be used as if it were a battering ram during intercourse. Also, because of the process of keratinization, the organ is less sensitive and many males are inclined to thrust more violently during intercourse to compensate for decreased sensation.
Finally, the foreskin itself is one of the chief erogenous zones of the penis. The average foreskin contains more than 240 feet of nerves and over 1,000 nerve endings. In an important study conducted by J.R. Taylor, A.P. Lockwood, and A.J. Taylor, specialized nerves and nerve endings were found in the "ridged bands,"--the area where the mucosal tissue meets true skin.8 Clearly, the removal of the foreskin is the removal of highly erogenous tissue that is integral to the normal functioning of the penis, including sensory response.
Circumcision is incontrovertibly damaging physically. However, many males also suffer psychological symptoms because they have lost their foreskins, including depression, resentment, frustration, and a profound sense of loss.
Again, I must ask, is circumcision justified?
V. Conclusion
As I stated earlier, parents absolutely must make medical decisions of behalf of their children. Children, especially infants, are simply incapable of making those decisions themselves. However, if the child does not benefit from the procedure in question, or is even harmed by it, then it is unethical. Parents do not have absolute freedom to do as they wish with their children. Children are not property. When parents abuse their children, society, through the criminal justice system, intervenes. When parents recklessly endanger their children, society intervenes. Circumcision is by definition a mutilation and an abuse. Why should we regard it differently than any other form of abuse?
Circumcision has long been institutionalized, and we have a tendency to reify such long-standing institutions. However, as we learn more, it becomes apparent that some of the things that we have done for a long time, and have accepted, are in fact harmful. Circumcision is one of those practices. The main aim of ethics, as far as legislation is concerned, is to protect individuals. It is time we pass legislation protecting those in need of it most--our children.
Works Cited
1. Jonas, Udo, MD, Schultheiss, Dirk, MD, Stief, Christian G, MD, and Truss, Michael C, MD. "Uncircumcision: A Historical Review of Preputial Restoration." Plastic and Reconstructive Surgery 101(1998):1990-1998.
2. Kellogg, John Harvey, MD. Treatment for Self-Abuse and Its Effects, Plain Facts for Old and Young. Burlington, Iowa: F. Segner & Co., 1888.
3. Hodges, Frederick and Warner, Jerry W. "The Right to Our Own Bodies: The History of Male Circumcision in the U.S." MEN Magazine Nov. 1995.
4. Richards, David. "Male Circumcision: Medical or Ritual?," Journal of Law and Medicine 3(1996):371-76.
5. "Circumcision Information for Parents." The Medem Network: Connecting Physicians and Patients Online. 2001. American Academy of Pediatrics. http://www.medem.com/medlb/article_detaillb_for_printer.cfm?article_ID=ZZZJZMEMH4C&sub_cat=1
6. Cold, Christopher J, MD, Storms, Michelle R, MD, and Van Howe, Robert S, MD. "Carcinoma in Situ of the Penis in a 76-Year-Old Circumcised Man." The Journal of Family Practice 44(1997):407-9.
7. "Circumcision and HIV Infection." Circumcision Information and Resource Pages. 2004 http://www.cirp.org/library/disease/HIV/
8. Lockwood, AP, Taylor, AJ, Taylor, JR. "The prepuce: Specialized mucosa of the penis and its loss to circumcision." British Journal of Urology 77(1996):291-95.
Third Place
Kelly Millard, Freshman
University of Scranton
Long Pond, Pennsylvania
Mere hours after birth, a newborn baby boy is taken from his mother's arms and the peaceful reverie of sleep. He is taken to a room, usually sound-proof to prevent others from hearing the tortured screams, and placed in a cold, hard plastic seat. His arms and legs are strapped down in a posture most likely uncomfortable for a baby used to spending time in the fetal position. A sterile cloth is placed over his body, leaving only the tiny penis exposed. Then, usually without any anesthetizing agent, his foreskin is forcibly ripped from the glans of his penis, tearing the tiny pieces of skin designed to prevent such an occurrence. The chilling sharpness of metal cutting flesh removes over fifty percent of the heavily innervated tissue from his penis, leaving the child's body part red, raw, and exposed. Finally, the infant lapses into a trauma-induced sleep, awaking later to extreme pain at every movement, diaper change, and loving caress of his mother. Oftentimes, the infant's behavior is disturbed for many days, causing breastfeeding problems and abnormal sleep patterns. Over half of male babies born in the United States go through this rite of passage for absolutely no reason.
The question of the ethics of circumcision would seem to be a simple one. No other developed nation in the world still regularly practices circumcision, and many medical ethics committees have come out strongly against the practice. Therefore, it is a wonder that this is such a highly debated topic within American medicine. This could be attributed to the fact that circumcision is seen by some as a religious issue and by others as a health issue. Certainly, with the sexual freedom in this country, circumcision cannot be justified by fear of masturbation, as it once was, so many people rely on outdated medical studies and tradition to support the perpetuation of myths surrounding circumcision.
There are two different ethical issues at stake--the considerations of the parents and the responsibility of the physicians. Without the collusion of both of these parties, circumcision could not be performed. Fortunately, most new parents today are aware that they have a choice to circumcise or not, but this does not seem to be influencing at least fifty percent of parents to fully research the topic. An analogy that may be helpful would be to compare circumcision to any other form of cosmetic surgery. Would it be ethical to have an elective cosmetic procedure performed on a child too young to consent? The American Academy of Pediatrics has published a statement on the rights of parents to consent to any medical procedure for their child. It states that parents have only the authority to provide "informed permission" to diagnosis and treatment of a child too young to provide consent. The distinction here is important because it shows that the permission of the parents is not the same as the consent of the patient, and the wording obviously limits the parental powers to issues that are illness and injury related. The only "diagnosis" made prior to non-medically indicated circumcision is as to the presence of a foreskin, which is not an illness. The policy statement goes on to list practical applications of this interaction, stating that children should be consulted even before administering medications or doing diagnostic testing whenever appropriate. It also states that anything that is not immediately necessary should be deferred until such a time as the patient can provide consent. This is contradictory to the AAP's statement on circumcision which acknowledges that circumcision is not generally medically necessary, but still leaves the decision in the hands of the parents for "religious and cultural reasons." The policy statement on religious objections to medical care states, "Constitutional guarantees of freedom of religion do not permit children to be harmed through religious practices, nor do they allow religion to be a valid legal defense when an individual harms or neglects a child." Although this statement is issued specifically regarding the denial of necessary medical care, how is the purposeful injury to a newborn boy's genitals not applicable?
This brings up another area of conflict in the policy regarding female genital mutilation. Of course, most men do not suffer pain during intercourse for the rest of their lives, but certainly there is not much else that is different between the two practices other than the timing. Most of the world has realized the harm being done to women--to the point that it is illegal to perform female circumcision. Why then the discrepancy? Is it because we cannot look at the rituals in our own culture with the same scrutiny? The fact that most men do not suffer pain for the rest of their lives is not an excuse to continue this practice. There is evidence that shows that sexual pleasure is diminished in men who have had their foreskins removed, and the basic premise of both practices at the outset was to that effect.
Another consideration, which is often downplayed, is the complications and risks of circumcision, many of which the AAP conveniently leaves out of their brochure targeted at new parents regarding circumcision. For example, some baby boys have been irreparably harmed by the procedure. In at least one case, the penis itself had to be removed after a botched circumcision. Nowhere in the pamphlet on circumcision does it mention that your son could actually lose his penis. The wording throughout the informational brochure encourages parents to research the topic, but nowhere does it provide a clear picture of the procedure or the risks associated with it. It also does not address the issue of anesthetic use at the time of circumcision, the need of which has been established by the AAP's policy statement on neonatal anesthesia, but the use of which is still uncommon. Supposedly, concern for the baby's ability to metabolize any anesthetic agent have prompted medical professionals to deny the use of injectable anesthetics, but many physicians do not use even topical pain relievers, their ineffectiveness not withstanding. They acknowledge the newborn's vulnerability, but then subject them to such excruciating pain as to cause a state very similar to shock. It is a conundrum beyond comprehension for most compassionate people.
That brings us to the ethical responsibilities of the physician. The previously mentioned policy statement on informed consent and parental rights establishes that physicians have a responsibility to the child as their patient, over and above the wishes of the parents. This is unmistakably violated in routine newborn circumcision. The AAP acknowledges that not all parents have the best interests of the child at heart, and even that some parents desire to harm their children, and so leaves the physician as the sole interpreter of the necessity and urgency of any medical procedure. Using this model of care, how is it ethical to perform an unnecessary, cosmetic procedure on a newborn infant--even if the parents want it? Certainly, a doctor would not remove any other body part unless it was medically indicated. Unfortunately, the situation is not even as hopeful as having reluctant physicians performing circumcisions. Often, a parent who is seeking guidance in that area is likely to be swayed by outdated and inaccurate medical studies showing supposed benefits to circumcision. Considering the fact that many of those studies have been entirely refuted or at least challenged, the reluctance of the medical community to tell parents the truth about this practice is puzzling. It is entirely obvious that removing a body part will prevent illness from occurring in that area, but that cannot possibly justify routine use of such a procedure. Removing every woman's breasts would effectively thwart breast cancer, but maybe the focus should be on less radical methods of prevention. It is known that the majority of urinary tract infections in intact boys are actually caused by overzealous cleaning and foreskin retractions. Penile cancer is extremely rare, and there are more complications caused by circumcision than cases of penile cancer yearly. Perhaps the most ridiculous argument given in favor of circumcision is to prevent sexually transmitted diseases which could be avoided through abstinence or condom use. At any rate, the reasons that are given by many health-care professionals in favor of circumcision betray their lack of knowledge and an inherent cultural bias towards circumcision.
How can one justify the routine use of this procedure? The most common reason given in favor of circumcision is to not look different from other boys. Is that a satisfactory reason to remove a healthy, fully functioning body part? How ironic that parents set out to have this procedure done for that reason, and in fifteen years, when their son or daughter wants a tattoo or a body piercing, they react with horror at the thought of marring the body just because everybody else is doing it. It is time for people to point out the inconsistencies surrounding circumcision. The AAP's policy statements are very clear about the rights of parents and the ethical responsibilities of physicians. There is obviously no room for routine circumcision in the words of those statements, and yet it continues. It is time to see this for what it is--the routine genital mutilation of newborn male infants. Just because society endorses this practice does not make it right--think about female circumcision and the reaction to that worldwide. Obviously, in those societies, it is acceptable for them. What is the difference? The fact is that we are not looking at ourselves in the same light. Our cultural standards are right and theirs are wrong. This kind of a bias cannot be allowed to continue. Circumcision is a traumatic experience for a brand new baby, and this can have physical and psychological repercussions from infancy and maybe even into adulthood. It is only through education and outreach that the truth about this unnecessary, unethical procedure will ever be known and accepted. We have a responsibility to protect our most vulnerable members from unnecessary harm. Let us not fail to do so.
Peter Brooks, RN Student
St. Louis Community College at Forest Park
Caseyville, Illinois
I am a student nurse doing a rotation in labor and delivery at Barnes-Jewish Hospital in St. Louis. Today I had the privilege of witnessing the miracle of birth and saving a foreskin.
I helped deliver a baby boy whose mother did not speak English. She had been in this country only a few months, and I could tell the whole American hospital experience was very frightening for her. After the baby had been born and we were filling out the paperwork, the doctor routinely asked if they wanted him circumcised. Because no one in the room spoke enough Spanish to ask the mother, someone had to go out in the hall and ask the father. He was Mexican, so I was surprised that he said yes.
Earlier in the labor I had established some rapport with the father and
I felt like I could talk to him, so I quickly left the room and asked him
why he consented to the circumcision. He shrugged and said he thought it
was best, thought it would be cleaner. I asked him if he was circumcised
and if he had had any problems with his foreskin. The answer to both of
these questions was "No." I told him I had done a lot of research on the
subject and in fact was doing a presentation on the subject to my classmates
this afternoon. I explained why the reasons he mentioned were invalid and
I offered him some of my literature to read, hoping to change his mind.
I knew that I would likely get in trouble if anyone knew I gave it to him,
but I felt that I had an ethical obligation to save this new baby from the
pain and unnecessary mutilation he was about to undergo, and that outweighed
the risk of overstepping my boundaries as a student with a patient.
The father sat quietly and thoughtfully read a copy of my presentation while
we tended to the needs of the new mom and baby. As we were taking them up
to the nursery 30 minutes later, the father told the nurse in charge that
he had changed his mind and did not want his son circumcised! I was so proud,
I could have cried!
When I had a minute alone with him again, I congratulated him and thanked
him for his decision. He, in turn, thanked me for the education. He said
he would let his son decide later what to do with his body. I was so happy!
I had earlier observed him on the phone speaking Spanish and he said he
was speaking with his brother who is a doctor in Mexico. He affirmed everything
my report had said. The father had initially agreed to the mutilation because
that is "the American way," and being new to this country, he wants to do
all he can to assimilate his family into the culture. How sad that this
is what our American culture does to people.
Why does this country continue this barbaric, torturous practice? Those
in the medical field are aware that there is no benefit from it. We've all
heard the statistics and can agree that saving one old man from penile cancer
is not worth mutilating 99,999 innocent boys' penises, causing them lifelong
emotional, sexual, and neurological damage. I believe that the main reason
it continues is greed. It is a multi-million dollar money-maker for US hospitals
and doctors. If insurance companies and Medicaid would stop paying for the
surgery, I'm sure the incidence of circumcision would decrease dramatically.
So perhaps the question should be "Is greed ethical?" The answer, of course,
is a resounding "NO."
What right do parents or doctors have to decide to remove a natural functioning
part of the human body? I feel this is akin to removing the little finger
of newborns. It serves no purpose. It is my opinion that there is no ethical,
medical, or logical reason for circumcision.
Later in the day, I did my presentation on the subject to my clinical group.
My purpose was to educate my fellow nurses on this unnecessary and unethical
practice, and to empower them to follow the example of the nurses in Santa
Fe, New Mexico, who refused to participate in the barbaric act. It was very
well-received and I know that I really opened some eyes, including those
of my instructor. The presentation was supposed to be twenty minutes, but
because of the questions and discussion it generated, it went for thirty-five
minutes. I educated a lot of people today.
My ethical obligation as a nurse is to educate all expecting and brand new
parents of the functions of the natural foreskin and the pain and risks
involved in circumcision. My obligation as an activist is to encourage other
nurses to do the same. I was able to fulfill both of these obligations today,
and that feels great.
"There is no absolute medical indication for routine circumcision of newborns."
American Academy of Pediatrics.
Read more at http://www.cirp.org/news/Mothering1997/
Brian Earp, Freshman
Yale University
New Haven, Connecticut
How fortunate that I escaped the hospital with my penis intact. Certainly I had nothing to do with it. I had no control over the destiny of my own body. But against odds and despite medical routine, humanity prevailed. My mother and father, my only advocates, wouldn't condone an act that was to them "barbaric"--the cutting up of a newborn baby's genitals, their sons.
I took my first breath fully seven weeks before I should have, the epitome of helpless, fragile. I weighed little more than four pounds; you could pick me up and hold me with one hand. Life-assist tubes running up my nose and electrode patches glued all over my tiny frame, I spent the first weeks of my life in an incubator, unable to speak or defend myself, completely at the mercy of a vast and unforgiving world.
My parents spoke where I had no voice, defended my body where I had no defense. They made an honorable decision. They fought against medical routine, against statistical normalcy and social expectation, and stood up for a fundamental human right: the right of their son to grow up unabridged, whole. They gave him the right to educate himself, to develop his own sense of corporal integrity. To decide about his own body. My body.
Certainly I've suffered for my parents' choice. My whole life, I've been "different." Not merely a statistical aberration, but different as a human being, with human struggles: embarrassment, the need to maintain self-esteem, to be accepted, appreciated. The majority of my classmates, from kindergarten through the end of high school, were circumcised. That's what a normal boy was: circumcised. The social consequences of my being different in such a private, personal sort of way followed me around for much of my life, in different forms. In elementary school, I was faced with ridicule at the swimming-pool change room, filling me with embarrassment and insecurity. In high school, I got the sense that an uncircumcised boy was some sort of sexual absurdity, undesirable. I heard girls talking about "an extra flap of skin" that somehow dangled off the side of an uncircumcised penis, a vestigial superfluity, shrouded in myth.
But this mythology is not unique to high school teens. Our society at large seems to misunderstand the foreskin. Just recently, I came across an article that called the prepuce "vestigial, like the appendix."² Opinions like this reflect a culture-wide ignorance of the ramifications of this neonatal genital "surgery."
Vestigial? No. The foreskin serves more than one important function. First, it protects the soft, moist, and sensitive glans penis. The "head" of a circumcised penis, in contrast, becomes leathery and tough (as well as desensitized) as it rubs against clothing: there is no foreskin, no protective sheath to shield this sensitive organ from its environment. Second, it serves sexual functions as well: the nerve endings on its inner surface become exposed when the penis is engorged, while the foreskin glides over the glans during intercourse, increasing pleasure for both partners and making vaginal dryness less likely a problem.
In fact, circumcision first became a standard medical practice (and subsequently a cultural habit) in the United States as a means of combating masturbation (which was wrongly thought to be the cause of sundry ills), in other words, to reduce the sexual function of the foreskin:
"In cases of masturbation we must, I believe, break the habit by inducing such a condition of the parts as will cause too much local suffering to allow of the practice being continued. For this purpose, if the prepuce is long, we may circumcise the male patient with present and probably with future advantage; the operation, too, should not be performed under chloroform, so that the pain experienced may be associated with the habit we wish to eradicate."1
Some advocates of routine circumcision point to health benefits, with evidence and arguments that are either trivial or outright spurious. In fact, routine infant circumcision is not practiced in most medically advanced countries: over 80% of the worldıs living men are intact.2 However, as there is a substantial literature on both sides of the health issue, it seems appropriate, here, to return to the essential point.
It is beyond the scope of this essay to elucidate the many arguments against circumcision in terms of its embarrassing cultural history, its medical uselessness, its physical cruelty, or its often-traumatic psychological consequences. The documentation and support for these criticisms are virtually endless, as anyone with a minimum of interest and effort will soon find out. The crux of the issue lies, glaring, in the question of ethics.
Neonatal circumcision is inhumane. It is the genital mutilation of a human being who has no power to speak for himself, who cannot and does not consent to the cutting away of his own foreskin. No human being (man or woman) should be subject to such invasive cruelty for the sake of bad medicine turned cultural hobby.
Over the years I've learned to love my body as God or Nature made it, and my embarrassment has evolved into something like a sense of pride. Now I am an adult, educated, aware. And I'd like to keep my body just the way it is. Thank God that decision is up to me.
_____________
1. Johnson, Athol AW. "On An Injurious Habit Occasionally Met with in Infancy and Early Childhood." The Lancet, Vol. 1 (7 April 1860):344-345. (Accessed at Restore Maine Online. 18 October 2004. <http://www.restoremaine. freeservers.com/mgm_history.htm
<http://www.restoremaine.%20freeservers.com/mgm_history.htm>)
2. Ray, Mary G. "The Circumcision Decision: An Overview." 1998. Mothers Against Circumcision Online. 18 October 2004. http://www.mothersagainstcirc.org/.
Barbara J. Fabyan, Freshman
Oakland Community College
Highland Lakes Campus
Highland, Michigan
When my son Michael was born nine years ago, I was a young mother of a two-year-old daughter. I was thrilled at the prospect of raising a boy, for I have five brothers whom I adore and had always wanted a boy of my own.
As I recall, the morning after I gave birth to Michael, his pediatrician stopped by my hospital room to congratulate me on the birth of a healthy baby and to ask if I planned to have him circumcised. Without any deliberation, I told the doctor "Yes," and simply asked when the procedure would be done and if my baby "would be alright." It was as quick and simple as that, I am ashamed to say.
In a pharmacology class I recently took at college to prepare for the nursing program, the instructor discussed circumcision and encouraged us to learn more online at www.NOCIRC.org. I did so and was appalled at what I learned.
I have always prided myself on being a logical, practical-minded person. I reasoned at the time of Michael's birth that most boys are circumcised, my brothers are, and so is my husband. Why would I not have my son circumcised? Also, the pediatrician did not discourage the procedure or mention its potential risks (nor did I ask about them). The doctor seemed to assume that I would agree to have my boy circumcised, and I suppose that I assumed it was a safe and desirable procedure. Besides, what good mother would subject her son to future ridicule in the locker room where her son's peers would discover his "abnormality?" Of course, now I know that it is circumcision that's abnormal.
Knowing the truth now about circumcision has left me angry at myself, at Michael's doctor, and at society in general for allowing and encouraging this unethical, barbaric procedure to be performed on vulnerable, defenseless babies. I am most angry at myself for not questioning circumcision's appropriateness, its safety, its painfulness. How could I not at least have asked whether my baby would be given an anesthetic and pain medication? I have considered looking into my son's records to find out whether he did, but am afraid to learn that the answer is probably no.
Instead, I am left to imagine what very likely did happen: my son was placed naked and cold on a board, his arms and legs strapped to it, the operating room's harsh lights above him. I imagine the doctor pulling back Michael's foreskin, slitting it like a hunk of meat, and cutting the foreskin off. All the while, I imagine my baby boy screaming and writhing in pain, with a cry so frantic that his voice trembles and his face turns purple-red. Despite his distress, I imagine that Michael is quickly whisked off the table, bandaged, diapered, and wrapped in a blanket to be returned to the maternity ward. Was he given a comforting hug, a few soft words, or a kiss on his cheek to console him?
I cry as I write this because, had I known then what I do now--that I would jump in front of an oncoming train to save his life, that my son's pain is my torture--I would never have consented to his circumcision. How could I have allowed it without asking even a few basic questions? Why did my son's doctor not see that I was ill-informed and ill-prepared to make such a decision?
Had my husband and I properly considered the question of circumcision beforehand, we would have learned that circumcision presents some potentially serious risks such as excessive bleeding, infection, surgical mishap, resulting in damage to or loss of the glans or penis, anesthetic complications, and even death. We would also have learned that circumcision results in a definite loss of nerve tissue that provides heightened sexual pleasure and that the foreskin protects the glans and keeps it moist. And most importantly, we would have learned that this procedure is based on outmoded ideas and is entirely unnecessary and unethical. Logic should have led me to conclude that every body part serves a purpose and the foreskin is no exception. There are no "useless" body parts!
The ultimate question really is: Why are the majority of baby boys in the United States circumcised at all? I had always heard that circumcision allowed for greater genital cleanliness, but we now know that the penis can be kept adequately clean with the foreskin intact. Myth and tradition are what drive us to have our newborn boys undergo this barbaric amputation of a perfectly useful body part. So ingrained is this tradition that even my nephew, who was born with several severe congenital heart defects that precluded his circumcision at birth, elected to undergo the procedure at age nine so that he would "look more like dad and other guys."
I now wholeheartedly believe that circumcision is unethical and that we must stop subjecting our baby boys to the procedure unless it is medically warranted. Such a change would be most effective if implemented nationwide. I suppose this would require the enactment of a law prohibiting circumcision of babies. It is time we see this procedure for what it truly is: the genital mutilation of a non-consenting, defenseless child. Could there be anything more unethical than that?
Pauline Kohl, Sophomore
Montclair State University
Bedminster, New Jersey
Circumcision: a word that has become procedure in bringing a baby boy into the world in the United States. However, what you almost never hear is that circumcision has the potential to cause such extreme amounts of pain that it can shock and even kill a baby. You don't hear that children are denied the right of choice to decide what will be done to their bodies. Historically, circumcision was earlier thought to be a cure for masturbation because it limits the amount of pleasure a male feels during sexual stimulation and activity. It was also believed to be a means of prevention for some diseases because it removes a portion of skin that has the possible potential of sheltering an area between the foreskin and penis in which bacteria could easily grow and spread because of its inaccessibility during cleaning. Long ago, some medical professionals even went so far as to encourage doctors not to use anesthetics so that the pain caused would condition the child to abhor and even fear masturbation.
Supporters of circumcision today are inclined to defend their positions by claiming that circumcision can protect children from STDs, urinary tract infections, and other unhygienic health problems. Though in some cases it has been shown that men who are intact have faced some of these problems, there is no concrete proof that this is because they weren't circumcised, nor does it mean that all circumcised men are free from such complications and diseases. In fact, studies published by the British Medical Journal, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and other medical groups and professionals have agreed that there is no implication that the circumcision of a newborn is medically justified. Any medical benefits are considered merely potential and uncertain.
The basic principles of ethics are based on beneficence, non-maleficence, autonomy, and justice. Circumcision, though a very popular procedure in the United States, is almost non-existent in the rest of the world. Though it did have times of popularity, obviously most countries have found that the benefits of circumcision are not great enough to outweigh the risks and pain that it causes. In the United States, parents think that they're doing the right thing by circumcising their sons because they're told, not that they are doing what's healthy and beneficial, but that they should have it done because it is an accepted procedure. The surgery is immoral and does not do the child any good because its possible benefits are not medically proven or documented and its possible negative effects are much more likely and verifiable.
A doctor is supposed to practice non-maleficence, and this procedure undeniably causes a great deal of pain for the child, especially when anesthetics aren't used which is usually the case. To watch and/or listen to the procedure being done is almost like feeling tortured, and it's not even happening to you. It is also undeniable that the child's autonomy is being violated because he can't voice his opinion on the subject, unless it's with his screams during the process. This is not like the discussion on abortion in which a pro-choice supporter could suggest that the mother has the right to decide for the child because they can be considered one entity. In this case, the child is a separate entity, unconnected to the parents, other than in their responsibility for his welfare. Therefore, the child has the right to wait until he is older to decide whether he would prefer to undergo circumcision, or remain intact.
Finally, one must consider the principle of justice or fairness in considering circumcision. This discussion of circumcision is similar to the one surrounding the surgery of transsexual babies. These children are forced to undergo a form of cosmetic surgery simply because it's become socially accepted. Many parents accept circumcision because, like a transgender surgery, it is a procedure that is accepted. Parents are deathly afraid of allowing their children to be odd or different in any way that could possibly bring about criticism. In actuality, many boys and even adult men nowadays are questioning why they were circumcised while others were left alone and given the choice. A lot of people also believe the old idea that circumcision can reduce the possibilities of certain diseases. However, as has been previously stated, the benefits aren't certain, and usually basic cleaning and hygienic practices can be just as effective without the risks or pain involved in circumcision.
Many guardians and parents feel that circumcision is best done while the child is a baby because or six have been observed to show increased aggressiveness and withdrawal, and a reduction in their abilities to adapt in comparison to intact boys. The problem is that in a nation like the U.S., in which circumcision is so common, its effects can be interpreted as normal. Furthermore, many adult men claim apathy concerning their circumcision as children based on the idea that they won't remember it, but recently it has been suggested that the trauma is remembered subconsciously and affects the child throughout his lifetime. The American Academy of Pediatrics Task Force on Circumcision, for example, reported that after circumcision most children portrayed a greater degree of irritability, varying sleep patterns, and distortions in the relationship and interaction between the infant and the mother. Many boys around the age of five or six have been observed to show increased aggressiveness and withdrawal, and a reduction in their abilities to adapt in comparison to intact boys. The problem is that, in a nation like the U.S., in which circumcision is so common, its effects can be interpreted as normal. Furthermore, many adult men claim apathy concerning their circumcision as children based on the idea that circumcision is undeniably justified because of their concept of the procedure as customary practice. However, some have been bold enough to express anger, distrust, feelings of victimization, and their jealousy of intact men.
In conclusion, doctors and parents should be just, beneficent, non-maleficent, and respect autonomy and realize that simply because something is a popularly held belief, it is not necessarily ethical. This is especially true in the case of circumcision, in which the risks of the procedure so heavily prevail over any possible benefits. Society should be empowered and informed enough to not only question circumcision, but to keep it from being performed on so many infants. Circumcision should be reserved for the practice of religious beliefs in the spirit of the freedoms of our country. Otherwise, it should no longer be an established common procedure in the United States that is promoted as the practice of medical prevention for horrific diseases.
[Note: When a child is circumcised in the USA because his parents are practicing their "freedom of religion," the child is marked by his parents' religion and his freedom of religion is violated. This brings into question the constitutional right of the infant, even if the validity of the question is not yet acknowledged.]
Bridget Laudien, Sophomore
Montclair State University
Matawan, New Jersey
Any person of a sound mind would never agree to let a newborn baby make a decision for himself. Similarly, most adults value their medical autonomy. Though, more often than not, adults do not even have this choice because it has already been chosen for them. Because of the fact that most circumcisions are done at birth, when I refer to this act, I am assuming that it is being done at birth and therefore am consciously disregarding circumcisions performed on a consenting adult. In this spirit, I don't ever see how circumcision could be ethical, especially at birth. When a newborn baby, girl or boy, is circumcised, there is a direct violation of her or his body that is not only painful but irreversible.
Whether or not there are medical, social, or religious "benefits" to circumcision, that is not satisfactory enough to answer the question of whether or not circumcision is ethical. For 'feeding' into those questions is an act done by the parents and/or legal guardians of the newborn baby--not by the baby. 'Shouldn't parents make the decisions their children are incapable or making themselves?' In some cases, yes--of course. However, I think it is universally agreed upon, especially here in America, that the decisions parents are expected to make for their children are supposed to avoid causing that child harm. Granting that there are varying versions of injury in every culture, there are certain inalienable rights having to do with harm. One of these is intelligence, or the possibly of intelligence. A newborn baby has virtually no idea of what to do with itself--or even how to survive but does that mean we can take advantage of that? We would not tell a baby to find his or her own food, or to change his or her diaper. No--we take the liberty of knowing what is best for them and go with that. In this, we so often take those rights to a further step and begin to push our beliefs onto our children. Though these beliefs may not be bad, they take away the opportunity for the baby to learn for him or herself.
In America, it is without a doubt more socially accepted for males to be circumcised. In other countries, it is more accepted to be uncircumcised. In addition, while to be a circumcised female in this country is heinous, it is absolutely necessary in some cultures. Keeping this in mind, one must admit that the social burdens of rejection will be somewhat lifted. Because people are skeptical of what they are not used to, it will be somewhat easier for the circumcised individual to fit in his or her specific culture. However, people raise their kids to be certain religions that are not socially accepted and never think twice about telling their children to be confident about it. Regardless of how you are raised, whoever you are born to be--you will face rejection and you will face the confrontation of difference between cultures. This is practically unavoidable. In that same spirit, parents ordinarily encourage their young children to do what the parents feel is right. Whether they believe that to be conforming to society or staying true to yourself--up until a certain age you are what your parents have grown you to be. This development, while deeply rooted, is not irreversible. On the other hand, had your parents made you get plastic surgery to be what they thought was better--that would be permanent. Circumcision is no different.
To cut the extra skin off of a baby boy's penis or to cut off the clitoris of a baby girl's vagina is to take a being that is seemingly and usually intact and tell them that they are not allowed to be what they are born as. It is imposing a social construct on something that is not even aware it is alive yet. With the growing numbers of suicide, eating disorders, and crime rates among youth-- it is surprising that someone has not pointed out that we have begun telling children from day one (mainly males) that they are not okay in their natural form. Moreover, in the societies where girls are circumcised, it is usually accompanied with the beliefs that she should not have the same sexual rights as men should have. This goes beyond just a social construct and deliberately makes women unequal to men just by the default that they were born. Forget just making them feel uncomfortable with being natural--they are told to hate their sexuality, to back down, and to be okay with the fact that they have a piece of their body missing for no reason. Some cultures even go so far as to couple up the act of circumcision with sewing up the vaginal opening to the point of making sex a ridiculously painful act.
More specifically than just my own feelings on social abstracts, circumcision is an unnecessary waste. For example, in America, while some men would like to have their bodies intact, $250 million dollars are being spent to perform circumcisions on more than 1.25 million babies, annually. Moreover, globally, no less than 20% of male children will be subject to some kind of genital mutilation that is not medically warranted. As far as female circumcision goes, the reasons are almost always either religious or political (and usually occur in countries where government and religious beliefs are hand in hand). But, in America, where church and state are more or less separated by law (and where child abuse is illegal), the question we must ask is why we would ever take a naturally healthy baby and without knowing what they are going to want later on in life, cut off a natural piece of their body. There are a number of points we must consider when assessing this question.
Firstly, circumcision, to infants, causes a traumatic interruption of the natural separation between the foreskin and the glans. Secondly, not only does circumcision interfere with penile development because the surgeon must tear skin from sensitive glans to permit removal, but poor surgical result is not recognized until years later. Next, circumcision includes a subtraction of one-third or more of erogenous penile skin. Additionally, when tissue is taken away that has to do with sexual functioning, that functioning is affected. Lastly, it simply hurts. As a social addition to the pure facts, studies aimed towards circumcised males have shown that the majority of the respondents have felt a strong sense of parental violation, a feeling of having been mutilated, and report degrees of sexual harm, including progressive loss of glans sensitivity, excess stimulation needed to reach orgasm, and/or painful coitus and impotence.
So, not only with the knowledge that we are consciously hurting a non-consenting minor (none the less a newborn baby), there is an overwhelming amount of evidence to contradict the popular belief that circumcision is okay, or moreover, desired. Whether male, female, Christian, Jewish--we are all born human and our bodies, as well as each of their parts, have a function as well. Circumcision not only has little or no medical benefit, but it is just one of the many abundant (and rapidly growing) examples of how our societies can program into the heads of even little children what exactly they should be. To assess whether or not circumcision is ethical, one must really contemplate how much the cutting off of a body part can symbolize what may be along the lines of suppression. Skin may be tangible but suffering is not; and this procedure can be proven effective in a medical sense no more than it can in the cultural context as the social construct that it has become.
Jennifer Leeper, Freshman
Johnson County Community College
Kansas City, Missouri
Americans are often told to protect the children of this country, to prevent minors from being harmed, but each day there are little boys who are essentially mutilated because of cultural tradition. The practice of circumcision may be considered a cultural tradition in this country, but is it an ethical practice?
In other countries, where women are forced to undergo genital mutilation, America protests, but who protests here in this country when non-consenting male babies are forced to experience a similar procedure?
Is it less an invasion of someone's basic human rights when they are not in a position to defend these rights? In fact, it is more of an invasion because there is a legal and ethical expectation in this country that these fundamental rights, specifically associated with a minor, will be protected from corrupting forces. Corruption can occur mentally, physically, and emotionally. With circumcision of male infants, there is a definite physical corruption, if not emotional and mental.
It has been proven by medical experts that circumcised infants do experience pain, high blood pressure, heart rate, and behavior changes. If someone intentionally caused another adult this kind of pain, it would be considered unethical and even illegal in some instances but, when it involves an infant, then it is rationalized using the argument that it's a cultural tradition that has occurred for thousands of years. There are many horrible "cultural practices" that went on for years (i.e., slavery, racism), but simply because a practice is deemed 'normal' or 'right' by one culture does not mean that it is objectively ethical.
When the practice of circumcision originated, humans were living in much simpler, more primitive times, when human sacrifice was still an acceptable ritual. Human sacrifice is no longer a predominant issue in modern civilized society and neither are many of the other cruel and unusual cultural traditions of more primitive eras. So, why does this country hold onto a relic of those eras? Why does circumcision prevail when it is an obvious form of human mutilation and perhaps even degradation? Perhaps it is because those who must undergo it do not have the voice yet to say otherwise.
In American court cases where a defendant does not have the normal mental capabilities of an average adult there is special consideration when considering a punishment. They are protected from punishment that would be punitive considering the circumstances. They are held less accountable than an adult with a normal mental capacity. Why then, if criminals are treated with such care, are innocent male babies not treated with even more care when considering the pain of a practice like circumcision? These babies are not on trial for anything, but they are inflicted with unnecessary pain anyway.
In addition to the legal system working against them, male infants who are circumcision candidates do not always fair well when it comes to the application of the principle of tolerance by this country. This country was founded on a primary desire for a tolerant society, but does not always use discretion when doling it out. For example, if this country's legal system were to prosecute Jewish men and women for circumcising their baby boys, there would be a huge intervention by the ACLU and other civil rights organizations on behalf of these Jewish men and women. Has the ACLU ever defended a male baby in a case where the infant declares he has been mutilated by his parents or some other adult through the procedure of circumcision? No, there has never been such a case because an infant cannot articulately or authoritatively command a defense on their behalf.
What if someone, for religious or cultural purposes, in modern times decided to mutilate some other area of an infant's genitalia? Would that be tolerated? It's very doubtful that it would be. But, this is a contradiction of what was just stated in the last paragraph. Just as the ACLU would defend a practice of mutilation that has been around for centuries, they would just as quickly contradict the premise of that particular defense if someone was found to have committed some new and different form of infant genital mutilation, or even a variation on circumcision. If it is unethical and wrong to perform genital mutilation in one instance, then why is it not in another scenario?
What about the benefits associated with performing a circumcision? Some studies show that it may aid in the prevention of cervical cancer or sexually transmitted diseases, but so do other lifestyle variables that do not inolve painful procedures on infants. Is it still ethical to cause someone pain because in the end it may prevent them from contracting a disease which can most likely be treated anyway? Even if circumcision did prevent a person from developing cancer or some other disease, is that really the best or only way to protect someone? Isn't America a leader in innovation and wouldn't it be counterproductive to this innovative spirit to rely on circumcision as a primary way to prevent disease?
We are all born with basic human rights in this country. To say that we are born with them is to imply a need for their protection from the beginning and if a person, whether an infant or adult, but especially an infant or child, cannot provide for their own defense, then society is liable for doing so. Circumcision, regardless of religious, cultural, or practical justifications favoring the procedure, will never be ethical because it will always cause pain and indignity to those whose rights are the most vulnerable.
Sara Lucarelli, Sophomore
Pasadena City College
Pasadena, California
Circumcision is an age old practice, beginning in roots of religious beliefs and fostered through medical research. However, despite the growing normality and acceptance of the practice, there are concerns and problems that should be brought to light. In our modern day society, wrought with legal, medical, and ethical advances, complications, and double standards, circumcision, upon scrutiny, can be considered an outdated procedure. Although the practice is known worldwide, it is in America, especially, that uncircumcised men are the minority. This is not the manifestation of theological or medical concerns as much as it is the accepted, standard practice and what constitutes a "normal" penis to many Americans. This is a barrier that blinds our society to the problems and complications stemming from circumcision, while simultaneously serving as an ethical and society-based conundrum in itself.
Although it is rare that anyone recalls being born, it isn't difficult to imagine the shock and confusion a few moments old baby sustains after being pushed out of its safe, warm world that was all he knew; thrust into a cold, daunting, new place of existence. Within 24 hours of this revelation, the majority of American male babies are rushed to a papoose board and strapped by hands and feet with Velcro. His penis is cleaned, a local anesthetic is applied, a clamp is chosen, and his foreskin (prepuce) removed.
The procedure itself, aside from all other medical, religious, and social implications, can be regarded as barbaric. Adult men who go through the procedure get the option of general anesthetics, so do not have to be conscious during the surgery. However, a newborn only receives a local anesthetic that numbs the area where the surgery will take place, yet leaves the scared baby wide awake. Furthermore, the anesthetics themselves can be harmful. For example, a popular local anesthetic chosen for the procedure is penile nerve block, which is injected at the angles of 10 and 2 o'clock at the base of the penis. Putting a needle in the new baby's soft and delicate flesh often causes bleeding, bruising, or even scarring. Also popular is EMLA cream--it is applied to the penis, which is then wrapped in a dressing. The child must wait 90 minutes until the cream works--unless he urinates or the dressing leaks, in which case the cream must be reapplied.
After the anesthetic is applied, a clamp must be chosen. Often, the parent and the doctor choose the tool together. The three different clamps are the Gomco clamp, the Mogen clamp, and the Plastibell clamp. The Gomco clamp stretches the baby's foreskin over a metal bell while the clamp is tightened; although this produces good cosmetic results, its is likely to cause excessive bleeding as well as remove too much skin from the shaft of the penis. The Mogen clamp pulls the foreskin through a hinge, where it crushes the foreskin for a full 90 minutes, and has a high risk of accidentally removing the tip of the penis. Lastly, the Plastibell clamp requires a surgical cut in the foreskin beforehand, after which a surgical string is tied around the device and over the foreskin while the tissue is trimmed off. The ring is left tied in place until the tissue underneath dies and sloughs off and the ring naturally falls off in 10 to 12 days.
Although circumcision may be a necessary medical procedure for adult men as a way of treatment for such conditions as balanitis (inflammation of penis tip) and phimosis (a condition that makes it difficult to pull foreskin back from the head of penis), the advantages for doing the procedure to a new born are relatively low. Interestingly, there are no medical forums that endorse or discourage the practice. Circumcision at birth does prevent the chance of urinary tract infection, especially during the baby's first year of life, and it is also known that a circumcised penis may have a slightly less chance of contracting an STD once becoming sexually active. On the other hand, however, circumcision often causes the baby pain, excessive bleeding, infection of circumcised site, and opening of urethra, irritation of exposed tip, and scarring due to surgical error or as a result of infection. Later in life, the circumcised male often experiences less sexual stimulation as well.
Despite these possible complications from circumcision, it is a very common, almost standard procedure after a child is born. What is most disturbing, aside from the procedure's intricacies and resulting problems, is that parents have the right to make such a decision for the child at all, as if that child's birthrights were stripped bare. A person is not considered a legal adult until they are 18 years of age; it is at this age that the law considers the individual to be old enough to take responsibility for their actions, and know how to judge the ramifications of their choices. The law requires that one waits until he is 18 before legally purchasing tobacco products, yet simultaneously allows a child less than a day old to have the decision made that he shall lose a piece of his body that he was naturally born with. This not only is insulting to the man who, later in adult life may wish he had his foreskin intact for his own personal reasons, but also insulting to our country that we place so much power in the hands of a parent to go beyond the necessity-driven decision-making for their child's well-being, into the realm of decisions based on superstition and vanity. The latter embodies stark American realism--in efforts to be open minded, we often land in a partisan, superficial pitfall of what is accepted, what is considered to be right, what is beautiful, and so on. The small piece of skin that covers a male penis does not escape this entanglement of society's ideals. It is more common for the penis to be circumcised so therefore it is more normal and therefore "weird" if the opposite. In a domino-effect fashion, the decision for parents to have their child circumcised is made easier, and the numbers of circumcised men increase.
However, all change must begin somewhere. Like trends that flow throughout the turn of the times, once more and more people begin to wear a certain type of clothing or dance a certain way or like a certain style of car, it isn't long before what was uncommon is common and what was unaccepted is accepted. Uncircumcised men would go through a similar social feat.
Naturally, if an adult man decided for medical, cosmetic, sexual, or another reason that he wished to be circumcised, that would be a decision made of his own free will, with an adult, rational mind, weighing the consequences, pros and cons, and with justified reasoning. However, to mutilate a newborn's body when he cannot even understand the logic to why he would or would not want his foreskin intact, seems to be fostered in an outdated mind set. Furthermore, the fact the procedure, if done for religious reasons, results in a controversial state, widens the gap of what is considered ethical and what is not to the boundaries of what is legal and what is not. Religious-based circumcisions are divergent then if the motives are medical or vanity-based, for one of our most cherished rights in this country is freedom of religion. If, once grown, the man does not embrace his parent's religion, he is not able to reverse their actions manifested of that religion if he would so choose--and that would be an indirect attack on that man's rights. Amplified by the horrific medical procedure itself, which would be traumatic to any newborn child, circumcision can be considered highly unethical and should be taken more gravely, regardless what the motives for the circumcision happen to be. If steps are taken for circumcision's abolishment or regulation, we would therefore be taking positive steps to ensuring newborn children's rights while protecting the children from undue pain and health risks. Despite the barrier of the growing unpopularity of uncircumcised men as the standard, once the procedure and its delicate social and legal ramifications are looked at under a microscope, America could be on its way to taking those steps and to, ultimately, give children the right and respect they deserve.
