GEORGE HILL
1323 NORTH RIVER ROAD
PORT ALLEN, LA 70767-3303
E-mail DYKS96A@prodigy.com
Tel: 504-383-8067
Fax: 504-381-8200
26 August 1996
Maurice E. Keenan, MD
President of the Executive Committee
The American Academy of Pediatrics
16 Bristol Road
West Newton, MA 02165
Joe M. Sanders, Jr.
Executive Director
American Academy of Pediatrics
141 Northwest Point Boulevard
P. O. Box 927
Elk Grove Village, IL 60009-0927
Re: Composition, mission, and name of task force on circumcision.
Gentlemen:
I understand the Executive Committee is to appoint a task force on circumcision. I would like to share with you my thoughts about the mission and composition of the task force.
The damage circumcision causes to health1, sexuality2, and emotional development3 is now well documented. It is no longer a matter for debate. Furthermore, the alleged health benefits have been disproved. The anatomy, histology, and functions of the foreskin are known in greater detail than ever before.4 The prestigious Fetus and Newborn Committee of the Canadian Paediatric Society has re-examined the recent medical literature. It could find no convincing reason to circumcise but did find many convincing reasons not to circumcise.5
Since the formation of the United Nations at the end of World War II, there have been many advances in our understanding of human rights and medical ethics. It is now clear that circumcision of non-consenting children violates human rights and medical ethics. The traditional American practice of unnecessary circumcision of non-consenting children that was introduced in the late 19th century stands in direct violation of the UN International Covenant on the Rights of the Child (1989) and the American Medical Association's Principles of Medical Ethics (1992).6
Documentation of the damage circumcision causes is now available to the public on the Internet World Wide Web.
Today, many thousands of men circumcised as babies have become aware of the sexual damage done to them. They have restored their foreskins and experienced a rebirth of sexual sensation that circumcision denied them. These men bear witness to the harmful effects of circumcision on human sexual response.7 They are angered by the injury done to them.
Foreskin restoration is a growing movement. The Joy of Uncircumcising! by Jim Bigelow, Ph. D.,8 is now in its second edition. The popular press is now featuring articles on foreskin restoration.9
In this climate, the unnecessary circumcision of non-consenting minors is unacceptable.
Another pros and cons statement on circumcision will not be enough. The mission of the task force on circumcision must be redefined. It must be given the mission of calling a halt to the non-therapeutic non-consensual circumcision of minors. This would bring American practice into compliance with international law and medical practice.
This will require a strong, unambiguous statement from the AAP. A program of physician and hospital re-education must be developed and instituted. This program must encompass the entire medical community, including hospitals, obstetricians, family practitioners, and general practitioners. Medical schools must incorporate new information into their curricula. Doctors-in-training must no longer be required to perform circumcisions.
There are no valid medical issues concerning circumcision. However, there are valid issues in the realm of medical ethics, human rights, and non-proxy patient informed consent law. There must therefore be strong representation from the Committee on Bioethics.
The task force would benefit by the inclusion of doctors whose foreskins are intact. Only an intact male can fully understand and appreciate the functions of the foreskin.
The name of the task force is important because it denotes its mission and purpose. Task Force on Circumcision is inappropriate. I suggest Task Force on Foreskin Function, Protection, and Care.
The educational program must retrain doctors to use conservative non-invasive therapies for minor foreskin problems that preserve foreskin tissue. There are many reports of American pediatricians who are unaware of the normal care of healthy intact boys. They frequently give contraindicated advice to parents. This needs to be rectified. Failure to keep abreast of advances and to put modern effective conservative treatments into practice is malpractice and shows lack of ethics.
The American Academy of Pediatrics has historically championed the needs and rights of the child.10,11,12 Let us see the AAP return to its proper role as a leader in advancing and protecting the real interests of children.
cc: Child Rights Organizations
Human Rights Organizations
Medical Ethics Organizations
Medical Journals
Medical Ethics Journals
AMA
ACOG
AAFP
AHA
ACP
CPA
WWW
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Neonatal Circumcision Revisited. Can Med Assoc J 1996; 154:769-780.