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Circumcision Exposed
Rethinking a Medical and
Cultural Tradition

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Why Does Infant Circumcision Persist
in North America?

The American medical establishment has consistently failed over the past 100 years
to prove conclusively and unequivocally that infant circumcision carries
any significant advantage over the intact state for the vast majority of males.


There is no absolute medical indication for routine circumcision of newborns.
American Academy of Pediatrics, Report of the Ad Hoc Task Force on Circumcision,
Pediatrics, vol. 56 no. 4, (October 1975): pp. 610-611


Circumcision is a custom in our society.
Herrera, Alfredo J., MD, "Parental Information and Circumcision in Highly Motivated Couples with Higher Education"
Pediatrics, vol. 71 no. 2, (February 1983): pp.233-234.


The cultural, social and historical imperatives surrounding routine neonatal circumcision
seem to be in control for both physicians and parents.

Stein, Martin T. MD, et al., "Routine Neonatal Circumcision: The Gap Between Contemporary Policy and Practice"
Journal of Family Practice vol. 15, no. 1 (1982): pp. 47-53.


We in the United States are culturally acclimated to regard the foreskin
as non-essential and even pathologic. We must not forget that the burden of proof
is on circumcision advocates. Showing disease association is not sufficient.
They must show cause and effect. Furthermore, they must prove (not conjecture)
that the advantages of circumcision outweigh the risks.

Altschul, Martin S., MD, "The Circumcision Controversy"
American Family Physician, vol. 41, no. 3 (March 1990): pp. 817-820.


The American medical establishment has never researched
the long-term physical, sexual, emotional or psychological consequences
to males of infant circumcision, a surgery to which those males did not consent.


The circumcision decision in the United States is emerging as a cultural ritual
rather than the result of medical misunderstanding among parents.
It is more an emotional than a rational decision.

Brown, Mark S. MD, & Cheryl A. Brown, RN, MS, "Circumcision Decision: Prominence of Social Concerns"
Pediatrics vol. 80, no. 2 (August 1987): pp. 215-219.


We conclude there is no medical indication for or against circumcision.
The decision may most reasonably be made on nonmedical factors such as parent preference.

Lawler, Frank H., MD, et al., "Circumcision: A Decision Analysis of Its Medical Value"
Family Medicine vol. 23, no. 8 (1991): pp. 587-593


Circumcision has essentially no effect on either dollar costs or health.
For this reason, personal factors other than health and dollars
could justly be brought into the decision process.
These factors may not be of interest to third-party payers.

Ganiats, Theodore G., MD, et al., "Routine Neonatal Circumcision: A Cost-Utility Analysis"
Medical Decision Making vol. 11, no. 4 (October - December 1991): pp. 282-289.


If health insurance coverage for routine circumcision were to be terminated,
...parents would then be forced to make a conscious decision about circumcision
which takes into account the lack of any medical indication for this procedure.

Lindeke L. et al., "Neonatal Circumcision: A Social and Medical Dilemma"
Maternal-Child Nursing Journal, vol. 15 (1985): pp. 991-992.


Omitting circumcision in the neonatal period should not be considered medical neglect.
The ultimate decision may hinge on nonmedical considerations.

Poland, Ronald L., MD., "The Question of Routine Neonatal Circumcision"
New England Journal of Medicine, vol. 322, no. 18 (May 3, 1990): pp. 1312-1314.


Other factors will affect the parents' decisions,
including esthetics, religion, cultural attitudes, social pressures and tradition.

American Academy of Pediatrics,
"AAP Releases Circumcision Statement" (news release) March 6, 1989.


Clearly, the foreskin is considered dispensable.
It is not surprising that attempts to provide information to parents
have had little impact on the frequency of circumcision,
because the decision is not a rational one.
Its acceptability is rooted in traditional and cultural values.

Circumcision should not be routinely prescribed
on the basis of beliefs disguised as science.

Dozor, Robert, MD, "Routine Neonatal Circumcision:Boundary of Ritual and Science"
American Family Physician, vol. 41, no. 3 (March 1990): pp. 820-822


The authors conclude that many mothers in this population choose circumcision
because of inadequate medical information or strong social motives.

Rand C. et al, "The Effect of Educational Intervention on the Rate of Neonatal Circumcision"
Obstetrics & Gynecology, vol. 62, no. 1 (July 1983): pp.64-67.


Each day in the U.S.,over 3,330 male newborns (60%)
have their foreskin forcibly amputated without anesthesia;
annually over 1.25 million babies, costing over $200 million.


To save a boy later locker room embarrassment seems unrealistic.
He can always be circumcised later. At any rate, it will be his choice
and he will know why he chooses it.

Preston, Noel E., MC, "Whither the Foreskin? A Consideration of Routine Neonatal Circumcision"
Journal of The American Medical Association vol. 213, no. 11 (September 14, 1970): pp. 1853-1858.


The operation frequently features illogical bases for patient selection,
neglect of the requirement to obtain informed consent, disregard for pain,
dubious objectives, and unknown cost-effectiveness.
Until the benefits of the procedure can be proved worth the risk and cost,
medical resources should probably be allocated
to health measures of demonstrated value.
Grimes, David A., MD, "Routine Circumcision of the Newborn Infant: A Reappraisal"
American Journal of Obstetrics and Gynecology, vol. 130, no. 1 (January 15, 1978): pp. 125-129.


Until demonstrated otherwise, prophylactic neonatal circumcision should be regarded
as cosmetic surgery, paid for directly by parents wishing it,
and public health care dollars should be expended
on preventive and therapeutic measures of more certain health or economic benefit.

Cadman, David, MD, et al., "Newborn Circumcision: An Economic Perspective"
Canadian Medical Association Journal vol. 131 (December 1, 1984): pp. 1353-1355.


Attempts to provide information to parents have not had much impact on the frequency
of circumcision. Many third-party payers have begun to refuse payment for the procedure,
and there are indications that this action will diminish the number of circumcisions.

Rockney, Randy, MD, "Newborn Circumcision"
American Family Physician vol. 38, no. 4 (October 1988): pp. 151-155.

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