Male and female circumcision in Canada (letter)

Can Med Assoc J, Volume 149, Issue 1: Page 16, 1993.

I applaud CMAJ and Dr. Eike-Henner Kluge for the publication of Kluge's article Female circumcision: When medical ethics confronts culturalvalues (Can Med Assoc J 1993; 148: 288-289).

It is high time that the medical profession took a more definitive stand on the issue of circumcision. I agree with Kluge's reasoning and conclusions that the circumcision of girls and boys is unethical and is nonconsensual mutilation of a minor for nonmedical reasons.

I am pleased to read that the College of Physicians and Surgeons of Ontario has banned the practice of female circumcision and hope thatother provinces will follow suit.

Male circumcision is still widely practised. Frequently the decision to circumcise is not grounded in religious or cultural identity. In my discussions with parents who have opted for circumcision of their infants, their reasons stem from complete ignorance (doesn't it prevent bladder infections and problems with small foreskins?) or ambivalence or bewilderment (neither parent is really quite sure why it was done, since there was minimal discussion beforehand, or the father had been circumcised and the couple thought it was justdone).

In Canada we now have a medical-legal responsibility for full disclosure before consent is given for any medical treatment. Circumcision as practised at present often does not involve full disclosure. Many parents remain unaware of how it is actually done; they do not realize that the procedure is excruciatingly painful and is often performed without any anesthetic or analgesia. This is inexcusable in light of the very simple and safe regional block of the dorsal nerve of the penis, which, done properly, can provide complete anesthesia for the procedure.¹

Circumcision without analgesia is not only unethical, it is barbaric. It is our fault as physicians that this is allowed to continue.

As long as circumcision is practised, physicians must ensure that parents are fully informed about it. we should emphasize that it is painful and insist that proper analgesia be administered.

Mary E. Lynch, MD, FRCPC
Victoria General Hospital, Halifax, NS

References

Cousins MJ, Bridenbaugh PD (eds): Neural Blockade in Clinical Anesthesia and Management of Pain. 2nd ed. Lippincott, Philadelphia, 1988: 657, 685.

The Circumcision Information and Resource Pages are a not-for-profit educational resource and library. IntactiWiki hosts this website but is not responsible for the content of this site. CIRP makes documents available without charge, for informational purposes only. The contents of this site are not intended to replace the professional medical or legal advice of a licensed practitioner.