Friday, August 24, 2012

What the new AAP policy on circumcision does not address

* Adults who are unhappy that they were circumcised. I think this is a vital element. If the pediatrics are there for the well-being of the child, what happens when a recommended procedure has long lasting effects over the body and/or psyche of the adult-who-was-a-child? Has the AAP or any research group bother to approach or study those men who feel severely damaged by their infant circumcision? Dismissing them as an anomaly doesn't cut it. And they are relatively easy to find now: and

* What are the benefits of not being circumcised?

* The policy barely mentions some Korean men finding less pleasure in masturbation. What about the studies on dullness syndrome, loss of sensation on the glans? You acknowledge keratination of the glans, but your studies on sensitivity don't go beyond 12 weeks after adult circumcision which you acknowledge is not enough to assess long term.

* What about the studies of the nerve endings of the foreskin? Is the anatomy of the foreskin relevant at all? What about studies that show how the sexual function is altered when the penis is altered? You must have heard about it.

* Data on the most severe risks is ignored because it's only reported as case reports. But understanding the most severe risks is important when assessing the decision, isn't it? i.e., what's the worse that can happen and what are the chances? I would ask that.

* Justifies removing healthy tissue from one person's body based on the parents' religion, culture or preferences. As long as it's just the foreskin - any other tissue would be protected, including the clitoral hood of the girls in spite of being anatomically the same tissue.

* The study of complications leaves a lot to be desired. "Financial costs of care, emotional tolls, or the need for future corrective surgery (with the attendant anesthetic risks, family stress, and expense) are unknown.". How can you advise a parent without that kind of information.

Some notes: "parents are granted
wide latitude in terms of the
decisions they make on behalf of their
children, and the law has respected
those decisions except where they are
clearly contrary to the best interests
of the child or place the child’s health,
well-being, or life at significant risk of
serious harm"  <-- What if circumcision does place the child's health, well-being and life at significant risk of serious harm? How do you define significant risk?

Is circumcision a human right issue? Can irrevocably removal of healthy tissue from a non-consenting individual regardless of any purported benefit be considered morally and ethically correct or a violation of human rights?

If the US is a "pluralistic society
of the United States, where parents
are afforded wide authority for determining
what constitutes appropriate
child-rearing and child welfare", why is it that the only healthy tissue that can be legally removed by a doctor or religious practicioner is the foreskin? Why is the foreskin not granted the same protection as, say, the tip of the nose, the lips, the skin of the fingers, the clitoral hood? Is it really just a matter of having a health benefit to justify it when the individual does not have the ability to consent?

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