Drs. John Russell and Ivan Connell of Hillsborough Medical Centre, Auckland, New Zealand have been placed on the “Known Genital Mutilators” directory at neonatalcutting.org.
The Hillsborough Medical Centre website claims that the doctors provide “high quality, comprehensive healthcare,” but all they appear to do is mutilate infant boys’ genitals, which is not necessary, comprehensive or caring. And far from “healthcare,” circumcision is risky, unethical, and sometimes deadly.
From “About Circumcision:”
“Circumcision of infant boys has been practised for centuries for religious and cultural reasons. It involves the removal of the prepuce of the foreskin, which is the skin that covers the tip of the penis.
Some believe there are benefits such as cleanliness and reduced cancer risk. It also avoids the occasional need for it to be done when the child is older involving a general anaesthetic and significant postoperative discomfort.
Deciding whether to have your newborn son circumcised can be difficult. You will have to consider both the benefits and risks of circumcision. Other factors such as your culture, religion and personal preference will also affect your decision.
As parents you have the right to decide what is in the best interests of your child. The information contained in this pamphlet may help you make your decision. If you have any concerns or questions, talk to one of our doctors before making an appointment for this procedure.”
Wrong, wrong, wrong. Circumcision in modern times was meant to diminish sexual pleasure in boys and therefore stop masturbation, totally devoid of ethics or any medical reasoning.
The “decision” really isn’t difficult – you allow the boy to decide when he grows up; it’s not the parent’s body, so it’s not the parent’s decision. And mutilation for religious reasons is just as wrong for boys as for girls.
Are there any benefits from circumcision?
Studies have provided conflicting results. Most authorities say that the benefits of circumcision are not significant enough to recommend it as a routine procedure. Urine infection and some sexually transmitted infections are thought to be less common in circumcised boys. Cancer of the penis although rare is also less common in men circumcised as infants.
Correction: all medical authorities do not recommend it as a routine procedure, and the American Academy of Pediatrics warns that surgery of this type on infants is harmful to the immature nervous system of a baby.
We read further:
How is circumcision done?
There are many different methods used, but our research shows that the Plastibell device is one of the safest to use in infants under local anaesthetic. The Plastibell is a plastic ring that is fitted over the head of the penis under the foreskin. It is then firmly secured by a special tie so that no stitches or dressings are required. The remaining foreskin is then removed leaving a consistent length of foreskin. The Plastibell is designed so that the baby can urinate normally.
How barbaric, an invention made of plastic to maim, mutilate and disfigure healthy baby boys genitals. Hopefully the doctor picks the right size “Plastibell” or your child may suffer a lifetime of misery or even death.
Then we read:
Are there any complications?
Both Dr Connell and Dr Russell are highly experienced having done over 5000
operations. This method has a very low rate of complications. Parents should notify
the doctor beforehand of any family history of bleeding problems or if your baby has
not had the Vitamin K injection at delivery. Occasionally there can be minor
infection or bleeding. The amount of foreskin removed can vary. Longer term there
occasionally can be narrowing of the urinary outlet or anaesthetic complications.”
There’s one problem right there – many circumcision deaths have been caused by surgery on babies with bleeding disorders that were unknown till the baby bled to death.
Further on, they do offer links to The Royal Australasian College of Physicians website and their position on circumcision, which agrees with every other medical organization that they do not recommend routine circumcision of newborns.
Here’s an excerpt from that paper that touches on issues of ethics and autonomy and hints that circumcision may be illegal:
LEGAL STATUS OF INFANT CIRCUMCISION
Circumcision of males is legal in Australia, New Zealand, the UK, USA and Canada.
However, routine neonatal circumcision has been declared unlawful in South Africa,
Sweden (except on religious grounds) and Finland.
New Zealand health practitioners who perform the procedure are covered by a number of
laws and regulations. Circumcision is defined as a restricted activity under the Health
Practitioners Competency Assurance Act (2003). This means that the procedure is
only to be performed by a medical practitioner. The legal acceptance in Australia & New
Zealand is based on clearly established rights of parents to make decisions about medical
treatment for their children. Society may however decide to place limitations on the scope
of such parental choices if significant harm results from such choices.
The British Medical Association’s statement on the Law and Ethics of Male Circumcision
states that “if it was shown that circumcision where there is no clinical need is prejudicial to
a child’s health and well being it is likely that a legal challenge on human rights ground
would be successful. Indeed if damage to health was proven there may be obligations on
the State to proscribe it”.
ETHICAL CONSIDERATIONS OF NEONATAL CIRCUMCISION
Circumcision of infant males is a medical procedure. The ethics of this medical procedure
fall within the ethical framework which applies to all medical procedures performed on
children. This framework has 3 main principles: (1) Focus on the child, and their needs and
interests; (2) minimisation of harm to the child (including prevention of
avoidable/unnecessary harm); (3) recognition of the child’s parents as the decisionmakers
for the child (on the basis that this best promotes the child’s interests and wellbeing).
The standard ethical position is that parents have the right and obligation to make
medical decisions for their child – a right which can only be taken away from parents if
their decision is significantly detrimental to the child. The standard ethical obligations of
doctors are to act in the child’s best interests, not cause excessive or avoidable suffering
to a child, and provide the child’s parents with information so that they are able to make a
fully informed decision about their child’s health care. A basic ethical requirement for
performing a medical procedure on a child is that it can reasonably be expected to
produce more benefits than burdens (in the long term) for the child.
Parental reasons for wanting infant male circumcision fall broadly into three categories: (1)
health, (2) hygiene and appearance, and (3) religio-cultural reasons. Depending on their
reasons, parents are aiming to secure different types of benefits for their child: physical
health (medical) benefits, and/or psychosocial benefits of various kinds. The physical
health benefits for a male of being circumcised (e.g. reduced risk of HIV infection) could
largely be obtained by deferring circumcision to a much later age. The psychosocial
benefits that parents seek, including full inclusion and participation in a religious or cultural
community, or fitting in with family and social group norms, often cannot be obtained
unless circumcision is done in the newborn period, as required by the religious or cultural
Since circumcision involves physical risks which are undertaken for the sake of
psychosocial benefits or debatable medical benefit to the child, the ethical question is
whether it is ethically justifiable to allow parents to make this decision for their child – or is
it a parental decision which ought to be overridden because it is detrimental to the
interests of the child?
There are analogous situations where parents decide on medical procedures for a child
that involve physical risk to the child, and where the intended benefits are primarily
psychosocial. Cosmetic procedures are an obvious example – e.g. removal of skin lesions,
pinning of ears, re-shaping of the skull. The psychosocial benefits (fitting in, not being
subject to ridicule or exclusion) are often regarded as clearly worth the physical risks of the
procedure. Obtaining bone marrow from one child for transplant to a sibling is another
clear example of seeking psychosocial benefits (i.e. survival of a sibling) at the risk of
physical distress and harm. Thus infant male circumcision is not ethically unique. Physical
risk to children is sometimes tolerated for the sake of psychosocial benefit to them. For
infant male circumcision, the issue is whether the risk/benefit ratio is within reasonable
bounds, and hence able to be left to the discretion of parents.
Some of the risks of circumcision are low in frequency but high in impact (death, loss of
penis); others are higher in frequency but much lower in impact (infection, which can be
treated quickly and effectively, with no lasting ill-effects). Low impact risks, when they are
readily correctable, do not carry great ethical significance. Evaluation of the significance of
high-impact low-frequency risks is ethically contentious and variable between individuals.
Some are more risk averse than others. However, a statistical risk of death is not generally
regarded as an absolute barrier. Most patients and most people in general accept the very
low probability of death as a risk they are willing to take in pursuit of medical benefits,
lifestyle, recreation, employment, and so on. The benefits of circumcision (or
disadvantages of non-circumcision) are not readily assessable by doctors (unless they
happen to belong to the same religious or social community as the parents), as they
depend upon the role of circumcision within that community.
This suggests that parents are in principle better placed than doctors to weigh up the risks
and benefits of circumcision for male infants. It is ethically appropriate for the decision
about infant male circumcision to be left in parents’ hands, with the proviso that the
decision may be overridden in individual cases where circumcision poses greater than
average physical risks to the child (for example, because of concurrent morbidities). To
deny parents the option to choose circumcision for their male infant would be to judge that
it is clearly detrimental to a child’s overall well being and interests in all circumstances.
Parents will need comprehensive, accurate information about the procedure (including
options for how, when and by whom it might be performed), the risks, and how these could
be minimised or managed if they occur. The information to be provided legitimately
includes the opinion or recommendation of the doctor. Doctors who have a conscientious
objection to performing infant male circumcision should make this known and refer parents
to another doctor.
The option of leaving circumcision until later, when the boy is old enough to make a
decision for himself does need to be raised with parents and considered. This option has
recently been recommended by the Royal Dutch Medical Association. The ethical
merit of this option is that it seeks to respect the child’s physical integrity, and capacity for
autonomy by leaving the options open for him to make his own autonomous choice in the
future. However, deferring the decision may not always be the best option. As noted
earlier, the psychosocial benefits of circumcision (e.g. full inclusion in a religious
community) may only be obtained if circumcision is done in infancy. Waiting until the boy is
twelve years old or more (i.e. old enough to make his own decision) may mean losing
benefits that circumcision was intended to produce.
Children may grow up to disagree with decisions that parents have made for them when
they were young. This cannot always be prevented or avoided. Some decisions have to be
made at the time. The later disagreement of the child does not show that the parents’
decision at the time was unethical or wrong. Parents and doctors have to decide the basis
of their own evaluations of benefits and burdens, being aware that they are making
predictions and that nothing is guaranteed. A boy circumcised as an infant may deeply
resent this when he grows older; he may want what he cannot have – not to have been
circumcised. But it is also possible that a boy not circumcised as an infant (so that he can
make his own decision later), may also deeply resent this. He may also want what he
cannot now have – to have been circumcised as a baby.
SUMMARY OF LEGAL & ETHICAL ISSUES
In New Zealand and Australia at the present time, newborn and infant male circumcision is
legal and generally considered an ethical procedure, if performed with informed parental
consent and by a competent practitioner with provision of adequate analgesia. In the
absence of evidence of risk of substantial harm, informed parental choice should be
respected. Informed parental consent should include the possibility that the ethical
principle of autonomy may be better fulfilled by deferring the circumcision to adolescence
with the young man consenting on his own behalf.
Bonus Intactivist Video: “Unrepresented Voices in Circumcision.” From the description: “The bioethics discourse around neonatal circumcision rarely includes the perspectives of the infant, parents with regret, adults who dissent, or conscientious objectors. Yet, these marginalized narratives are among the most telling and important to consider.”
The doctors’ practice information follows:
Dr Russell 027 481 5744
Dr Connell 021 313 030
Office phone 09 625 7010
165 Hillsborough Road, Hillsborough, Auckland,
— gary costanza (@jerrytheother) February 4, 2017