Circumcision case: What does boy want?

Circumcision case: What does boy want?

By SARAH SKIDMORE

The Associated Press

PORTLAND — The Oregon Supreme Court says the wishes of a 12-year-old boy must be determined in a dispute between his divorced parents over whether he should be circumcised.

The father, who lives in Olympia, converted to Judaism in 2004 and wants the boy to be circumcised as part of the faith, saying the decision is best left to the custodial parent. Lower courts sided with the father.

The mother, who lives in Oregon, appealed to the high court, asking for custody and saying the operation could harm her son physically and psychologically.

The case has drawn attention from Jewish groups concerned that the Oregon court might restrict the practice and from Doctors Opposing Circumcision, backing the mother and saying there is "no more important decision to make for a male child."

More than a million U.S. infants are circumcised each year, but circumcising adults or teens remains relatively rare.

The decision Friday said lower courts failed to determine whether the boy wanted the circumcision, as his father contended, or opposed it, as his mother alleged.

The Supreme Court sent the case back to the trial court to answer that question.

If the trial court finds the child agrees to be circumcised, the Supreme Court said, it should deny the mother's requests. But if the trial court finds the child opposes the circumcision, the court has to determine if it will affect the father's ability to care for the child.

Attorneys for both sides declined to comment. The father, who is a lawyer, is representing himself.

One constitutional-law professor who has been following the case called it "a reasonable ruling."

"I think what may be delicate and tricky is ... how much we can trust what the 12-year-old says, given the circumstances," said Carl Tobias of the University of Richmond. "He likely feels some pressure from [his parents]."

A urologist who met with the boy submitted an affidavit that said the procedure would cause him minor discomfort for about three days but not interfere with his normal activities, the Supreme Court's decision said.

advertising

The custody dispute began when the child was 4, and the circumcision issue began three years ago when he was 9.

The courts have steered clear of religious or medical issues, focusing on the questions of custody and care of the child.

Determining the youth's opinion is important, the Supreme Court said, because forcing him to undergo circumcision against his will at age 12 could affect his relationship with his father and his father's ability to care for him properly.

"We think that no decision should be made without some assessment of [the child's] true state of mind," the decision said.

It said a trial court could order independent physical or mental examinations or set up an independent panel of experts to gather information.

Copyright © 2008 The Seattle Times Company

Need to circumcise newborns debated

By Carrie A. Moore
Deseret Morning News
Published: Saturday, Jan. 26, 2008 12:25 a.m. MST

Rooted in religious tradition among Jews and Muslims for centuries, circumcision is still considered a religious ritual among many adherents, but the United States is the only industrialized nation where circumcision remains more a social norm than a religious one.

Two local philosophers and an anti-circumcision advocate say circumcision of newborn males is an unnecessary surgery that fails to provide any significant physical or emotional health benefits.

But some physicians disagree, writing in peer-reviewed medical journals that the procedure has been proven to help prevent disease.

Panelists at Utah Valley State College addressed the ethics of circumcision during a faculty seminar on Wednesday, contending that the decision to circumcise infants with no ability to understand or consent to the procedure is unethical and possibly profit-driven.

"Circumcision is an example of a social custom whose survival requires suspension of rational thought," said Steve Scott, educational outreach coordinator in Salt Lake City for NOCIRC — the National Organization of Circumcision Information Resource Centers. He said several pervasive myths continue to circulate as a justification for circumcision, including:
• Infants are incapable of feeling pain.

• Uncircumcised males have more difficulty with hygiene.

• If the procedure isn't done at birth, it will have to be performed later.

• Boys will suffer psychological or emotional damage if they're not altered to "look like their father" or don't match their peers.

• The foreskin causes disease.

"These social myths never would have existed if physicians didn't put this into our psyche," Scott said, adding the mandate doctors follow is "to do no harm." Yet those who perform circumcision violate that principle "when operating on a helpless individual and removing specifically designed body parts" without the child's knowledge or consent.

He said that, contrary to popular belief, the foreskin of circumcised babies isn't discarded but is sold to be used in medical research.

Jennifer Howard, an adjunct professor of philosophy and humanities at UVSC, said she and her husband allowed the oldest of their three sons to be circumcised as a baby — despite their concerns — because relatives, friends and health-care personnel told the couple it was necessary for the boy's physical health.

"They said he could get cancer and infection," so the couple consented to what they believed was "a necessary evil." The decision is one she regrets, she said. "I was misinformed. I know now I had no right to make that decision for my son." She said she was "able to protect my next two boys, but it wasn't easy."

She told her doctor explicitly during the next pregnancy that she did not want her son circumcised, and was assured it wasn't required. After he was born, nurses resisted her insistence that a note be placed in his bassinet, instructing doctors not to perform the procedure. When a nurse came to take the baby for the night, Howard asked where she was taking him. "The doctor is here to do circumcisions," was the reply.

"It wasn't even our pediatrician. Another doctor was there to do them all. Circumcision has become so routine that for a parent who questions it, there's distress among the doctors and nurses. ... To request unnecessary surgery on an unconsenting minor should require a raft of legal documents," yet most health-care professionals simply assume that male infants will be circumcised, she said.

The practice "thrives on ignorance and is perpetuated by thoughtless tradition," she said. "It ignores the human rights of the baby. Autonomy over one's own body is a basic human right."

Steve Bulger, associate professor of philosophy and humanities at UVSC, said he believes it will take "50 to 100 years" for Americans to successfully demand legislation that prohibits circumcision of minors, though he has no objection to the practice for consenting adults.

"Parents are obligated to maximize the best interests of their children. To the extent that parents are making decisions that don't do that, then it becomes questionable. I'm willing to listen to the arguments regarding the benefits of circumcision, but at this point in time it doesn't seem to exist," he said, adding "locker room fear" is highly exaggerated as a rationale when a large percentage of males are no longer circumcised.

Utah is one of 12 states where Medicare does not pay for the procedure because it is not recognized as a medical necessity, he said.

No physicians or health-care professionals participated in the panel discussion. But several medical journals have published articles in recent years that contend there are potential health benefits associated with circumcision, when comparing men who have had the procedure with those who haven't.

Dr. Edgar J. Schoen, clinical professor of pediatrics at the University of California in San Francisco, wrote in the December 2007 issue of Canadian Family Physician that "compelling published medical evidence, particularly over the past 20 years, has shown that circumcision offers protection against multiple medical conditions."

He writes that doctors have an important role in providing preventive health care, including childhood immunizations. "Consider newborn circumcision as a vaccine that has a preventive health role against not one but many disorders," he writes.

"In chronological order from infancy through old age, these include severe infant urinary tract infections (UTIs) during the first year of life; local penile infections (balanoposthitis) and mechanical retraction problems (phimosis) in childhood; sexually transmitted diseases, particularly HIV and AIDS, in young adults; and penile and cervical cancer in older adults. Circumcision makes genital hygiene easier throughout life."

Three recent studies in Africa show that circumcision offers a 60 percent to 70 percent protective effect for heterosexual males against contracting HIV, "an effect equivalent to that of many vaccines," he writes. "The results of these studies were so compelling that the trials had to be stopped early, as it was no longer ethical to put men in the uncircumcised control group. The protective effect of circumcision against HIV has been recognized since the 1980s."

According to Schoen, "The preventive effect of circumcision against HIV has now officially been accepted by the World Health Organization, the United Nations, and the National Institutes of Health, and some African countries have begun adult circumcision as a public health measure."

He also contends that circumcision as a protection against other sexually transmitted infections "is well documented," noting that in the past decade, "a large multinational study has shown that uncircumcised men are three times more likely than circumcised men to be carrying the human papillomavirus ... and that antibodies against Chlamydia infection are twice as common in women with uncircumcised male partners."

He writes that "the ideal time for circumcision is when a child is first born. Newborns are extremely resilient and are programmed for stress, having just experienced the trauma of birth ..." and "local anesthesia should always be used." At older ages circumcision is "riskier, more complicated, and about 10 times more expensive."

"It is time for the medical establishment to recognize the compelling evidence favouring newborn circumcision and catch up to the public," Schoen writes, adding that 80 percent of American males are circumcised.

Is Circumcision Another Form of Genital Mutilation

Is Circumcision Another Form of Genital Mutilation?
Tim King Salem-News.com

Legislation could change the future of American males.


(SAN DIEGO, Calif.) - Circumcision is flying to the front of medical and political arguments as Americans face the idea that we as a society may be gravely in error in our choice to allow doctors to complete circumcisions of young boys, particularly those just born which is the common approach in most cases.

Experts on both sides of the argument are esteemed researchers, but a closer look at what circumcision really brings us; campaigns for Viagra and a lack of sexual satisfaction in men, shows that it may be among our worst and most cruel cultural practices.

Talk about a subject that takes people out of their comfort zone. It is hard to learn that your life is not what it was really meant to be, that everything about our sexual lives is impacted by the fact that part of us was cut off and tossed when we were infants, without a voice to complain.

Now the movement is stepping forward with legislation that would curb or end the practice in our hospitals. The MGM Bill to End Male Genital Mutilation in the U.S. could change the way our society treats its young boys.

"The legislation that we are proposing would give boys the same protection from genital cutting that girls have enjoyed since 1997," said Matthew Hess, the group’s president. "Circumcision removes erogenous tissue in both sexes and results in a measurable loss of sexual feeling. It is a traumatic and disfiguring surgery that should not be performed on children unless there is a clear, compelling, and immediate medical need – period."

Hess says genital cutting of girls has been prohibited in the U.S. since 1997 when the Female Genital Mutilation Act took effect, requiring women to be eighteen years old before consenting to any type of genital surgery. The law has been credited with helping to keep forced female circumcision from spreading to the U.S. from Africa and the Middle East, where it is much more common.

Boys were not included in the law, however, and as a result circumcision is still performed on nearly 60% of U.S. newborn males by physicians, religious practitioners, or family members.

A Frankfurt, Germany, regional appeals court pushed circumcision further into the legal gray area recently when it found that the circumcision of an 11-year-old Muslim boy without his approval was an unlawful personal injury. And in November, the Oregon Supreme Court heard a case filed by the mother of a 12-year-old boy trying to protect him from being circumcised by his father for religious reasons. (Oregon Courts Have No Right to Force Circumcision) The court’s decision on the Oregon case is pending.

Anti-circumcision advocates say the latest blow comes from a Johns Hopkins University report that suggests men who are circumcised are at less risk of contracting the AID's virus. People who have studied the subject for years, like Marylin Milos in San Francisco with the National Organization of Circumcision Information Resource Centers, call the information into question and believe it is a death sentence for many.

"People aren't going to stop getting AID's because they're circumcised. This gives false hope and it isn't responsible information for medical professionals to be putting out there."

It does seem like an overly optimistic thought to suggest that a man could have unprotected sex with a person who has AID's without protection and somehow avoid getting sick because his foreskin is removed.

The conservative press group Voices of America published the article about circumcision and AID's yesterday, this is the opening paragraph:

"Epidemiologist Ronald Gray from the Johns Hopkins School of Public Health led the original studies looking at circumcision and HIV risk. In order to convince skeptical men, he says they needed to know if men would be willing to be circumcised and what it would do to sexual performance and satisfaction."

Perhaps the word "convince" says it all. Doctors make money from circumcising young male children.

If you jump past the Biblical origination of the story and flash forward about 1850 years, you learn that Jewish people were actually scorned for their circumcisions in most western societies. But then a belief developed in England that circumcising boys would reduce masturbation. That is all it took, along with the money the practice represents for European and American doctors and hospitals.

Marylin Milos cites other developments over the years including locker room phobia, largely eliminated now as most west coast states are shying away from forcing young students to disrobe in front of one another.

This practice according to Milos, reduces the feeling that men experience during sex. That diminished quality has lifetime implications. She says it is that diminished feeling that leads to men seeking cures for erectile dysfunction.

She says pro-circumcision advocates also released through medical journals decades ago, a connection between uncircumcised men and penile cancer, which was proven to be false information. Instead, she says that in the case of many circumcised men who contract penile cancer, it begins at their circumcision scar.

This is a subject just gaining momentum in this country and it isn't likely to lose steam as parents and others become increasingly aware of a number of problems associated with the practice. The online dictionary Wikipedia clearly defines the practice of circumcision as mutilation.

Wikipedia states, "Mutilation is an act or physical injury that degrades the appearance or function of the (human) body, usually without causing death." Circumcision is listed alongside burning and amputation, as a form of mutilation or maiming.

salem-news.com

here is a link to a story on salem-news.com about the Oregon Supreme Court case of the fight to circumcise a 12 year old boy

http://salem-news.com/articles/december072007/circumcisions_12707.php

read the comments to there are a lot of them the most so far

Making the Cut From Canadian Parents.com

No easy answer in circumcision debate

By Matthew Halliday, Calgary Sun

It used to be a simple choice. If dad was cut, chances are the kid would be too. Today, though, the circumcision issue has become for many a medical and ethical minefield.

“I know people who do and I know people who don’t,” says Linda Lewis, editor of Today’s Parent magazine.

“Certainly we get lots of letters when we publish articles on it. It’s a really hotly contested topic.”

Circumcision in Canada has been on the wane for years, but since no agency tracks circumcisions performed outside hospitals — and most are done in doctor’s offices or private homes — determining the rate of decline is a matter of guesswork.

“It’s not in freefall, that’s clear, but the rate has been declining,” says Dr. Robin Walker, of the Canadian Paediatric Society (CPS).

“It’s safe to say that it’s not as routine as it was.”

According to the CPS, circumcision is still often performed in Western Canada and Ontario. Historically less common in the Maritimes, the procedure is now almost non-existent there.

Parents may decline circumcision for a number of reasons: Concern about possible complications, including bleeding, scarring, infections and excessive skin removal; fear that removal of the foreskin will reduce sexual sensitivity later in life; or simply because they have to pay for it, since it’s no longer covered under any provincial health care plan.

Most doctors agree circumcision lowers the risk of urinary tract infections and penile cancer, but as Walker points out, penile cancer is extraordinarily rare — occurring in around one in 100,000 men. Infections are also rare and easily treated.

Robin Gayley and her husband, Roland, are two Calgary parents who chose not to circumcise their son, Rowan.

“I guess for us it was just that it’s unnecessary,” she says.

Roland is circumcised, but Gayley says that didn’t factor in their decision.

“I don’t think it’s necessary for a child to look like his dad,” she says.

“The kid will understand... I think a major reason people circumcise is just that some moms don’t know how to deal with the foreskin, they don’t know how to clean it and take care of it and how to educate their sons to.”

Besides, she adds, if Rowan decides he does want to be circumcised one day, he can make the decision himself.

“We understand that view,” says Walker. “There are people who say that doing it on a baby, even with parental consent, may not be ethical. I know that physicians’ colleges in B.C. and Saskatchewan have come out somewhat strongly against the practice, partly for that reason.”

Indeed, The College of Physicians and Surgeons of Saskatchewan issued this strongly worded 2002 memo: “Infant male circumcision is often treated as a very minor procedure with virtually no risk of significant complications. That is frankly not true.”

The memo cited a 1993 study in the British Journal of Surgery putting the complication rate between 2% to 10% (most of which are minor), a rate critics say mitigates any benefits.

On the other hand, the CPS’ own current statement is more moderate, stating the benefits and harms are too evenly balanced to recommend routine circumcision, but for the same reason they don’t recommend against it.

“(Parents’) decision may ultimately be based on personal, religious or cultural factors,” it reads.

Dr. Stephen Wainer, a pediatrician at the Peter Lougheed hospital, feels many people are giving the issue more attention than it’s worth.

“In the greater scheme of things, it’s a trivial issue,” says Wainer, who routinely performs circumcisions.
CIRCUMCISION

THE PROS

* Reduces risk of urinary tract infections.
* Reduces risk of contracting STDs (still under debate. A recent study in South Africa found that circumcision may reduce HIV transmission, but the study was not completed.)
* Reduces risk of penile cancer.

THE CONS

* The foreskin is densely packed with nerves and blood vessels and forms a protective covering over the head of the penis. It also provides lubrication. Many advocates claim that removing it therefore reduces sexual sensitivity.
* Circumcision has led to complications from excessive bleeding and infection in the past. But many say that complications resulting from circumcision are far fewer than those averted by it.

VOLUME CIRCUMCISIONS

Beyond the medical debate, circumcision is still a requirement of many religions and cultures.

For instance, the nearly two-year-old son of King Mohammed was circumcised earlier this year in Morocco, prompting thousands of countrymen to also go through the procedure in a massive show of solidarity for the prince.

Some 5,000 boys were circumcised in Casablanca, Morocco’s largest city.