QUEENSLAND LAW REFORM COMMISSION
RESEARCH PAPER
1. INTRODUCTION............................................... 1 (a) Terms of Reference..................................... 1 (b) Consultation........................................... 2 (c) The Need for Reform and The Commission Approach........ 2 2. THE HISTORY OF MALE CIRCUMCISION........................... 3 (a) Origins................................................ 3 (b) Western Cultures....................................... 7 (c) Aboriginal and Island Culture.......................... 8 (d) Current Practice.......................................10 3. THE PROCEDURE..............................................11 (a) Jewish Ritual Circumcision.............................11 (b) Non-Ritual Circumcision................................12 4. THE LEGALITY OF CIRCUMCISION...............................13 5. THE PREPUCE................................................17 (a) Function of Prepuce....................................17 (b) Removal of Prepuce.....................................17 6. HEALTH REASONS FOR REMOVAL OF PREPUCE......................18 (a) Neonatal Circumcision..................................18 (b) Non-neonatal Circumcision..............................19 (i) Phimosis.........................................20 (ii) Paraphimosis.....................................20 (iii) Non-retractable prepuce..........................21 (iv) Recurrent balanitis..............................22 (v) Complications of previous, inadequate neonatal circumcision............................22 7. PROPHYLACTIC REASONS FOR REMOVAL OF PREPUCE................22 (a) Hygiene................................................22 (b) Risk of Cancer.........................................23 (c) Urinary Tract Infections...............................27 (d) Sexually Transmitted Diseases..........................27 (e) Psychological and Sociological.........................30 8. ARGUMENTS AGAINST ROUTINE REMOVAL OF PREPUCE...............30 (a) The prepuce has a function.............................31 (b) Pain...................................................32 (c) Complications..........................................32 * Death................................................32 * Damage to shaft......................................33 * Damage to urethra....................................34 * Amputation...........................................35 * Unsightly appearance.................................35 * Urethral fistulas....................................35 * Haemorrhage..........................................35 * Incision line........................................35 * Phimosis.............................................35 * Infections of meatus.................................36 (d) The Cost...............................................37 9. CONCLUSION.................................................38 10. POSSIBLE REFORMS..........................................40
APPENDIX 1: HEALTH INSURANCE COMMISSION STATISTICS: CIRCUMCISIONS - AUSTRALIA 1988 - 1993 APPENDIX 2: NUMBER OF CIRCUMCISIONS PERFORMED - QUEENSLAND PUBLIC HOSPITALS ON PUBLIC PATIENTS 1988-1991 APPENDIX 3: CIRCUMCISION AND HIV INFECTION
COMMISSIONERS
Chairman: The Hon Mr Justice G N Williams Deputy Chair Her Honor Judge H O'Sullivan Members Ms R G Atkinson Mr W G Briscoe Mr W A Lee Ms L Willmott
SECRETARIAT
Secretary: Ms S P Fleming Principal Legal Officer: Ms P Cooper Project and Research Ms J Daley Consultants: Ms M Westbrook Administrative Officers: Ms P McCarthy Ms J Smith
Previous Queensland Law Reform Commission publications on this Reference: Consent by Young People to Medical Treatment, Information Paper, May 1993.
The Commission's premises are located on the 13th floor, 179 North Quay, Brisbane. The postal address is P. O. Box 312, Roma Street, Q 4003. Telephone (07) 227 4544. Facsimile (07) 227 9045.
Queensland Law Reform Commission
December 1993.
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