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Circumcision Wars

03/26/18 9:13 AM

While the issue has been fluid, as of the date this post was penned, the Icelandic parliament was considering a bill to outlaw male circumcision for nonmedical reasons. 

The bill, introduced […] by four political parties, uses the same wording as a 2005 Icelandic law banning female genital mutilation, changing the word “girls” to “children,” Silja Dogg Gunnarsdottir of the centrist Progressive Party, said in an email. Those who violate the ban could be imprisoned for up to six years. 

While many children do not have complications from circumcision, she said, “one is too many if the procedure is unnecessary.”…. 

At least 400 doctors — about a quarter of the practicing doctors in Iceland — have signed a petition in support of the bill and, according to news reports, more than 1,000 nurses and midwives have also endorsed it. 

“Every medical intervention must be weighed against its complications,” said Dr. Eyjolfur Thorkelsson, who wrote the petition. “In our opinion it’s a fundamental question about what the doctor-patient relationship really means. As a doctor you must treat everybody equally, regardless of class, religion, gender, gender preference or ethnic descent.” 

Part of that, he added, is the first rule of medicine: Do no harm. 

Putting aside any issues vis a vis freedom of religion, the US medical community follows a different path.  

A study published in 2014 in JAMA Pediatrics, an American Medical Association journal, approximated that there were still 1.4 million circumcisions a year in medical settings. 

The American Academy of Pediatrics said in a 2012 statement that the health benefits of circumcision outweighed the risks, but stopped short of recommending that the procedure be performed routinely. It was promptly criticized by a group of European doctors, who said the organization’s recommendation was influenced by cultural bias. 

Dr. Douglas Diekema, a pediatrician who helped draft the American academy’s policy, said the data was clear. “You don’t know that the individual child getting the circumcision will be the one that benefits, but some of those kids will,” he said. 

Clinical trials conducted in Africa have demonstrated that adult circumcision can play a role in preventing H.I.V., genital herpes and certain strains of human papilloma virus, or H.P.V., the C.D.C. reported

Circumcision can also help prevent urinary tract infections in infants, Dr. Diekema said, avoiding hospitalizations and the use of intravenous antibiotics. 

“It’s a big deal in a newborn,” he added. 

The most common problems arising from circumcision are bleeding and infection, he said, but serious complications are “exceedingly rare.” 

The JAMA Pediatrics study found few adverse events if the procedure was performed during the first year of life — that number increased tenfold to twentyfold when circumcision was performed after infancy. 

Which brings me to a now resolved custody battle between two warring parents fighting over, you guessed it, should junior be circumcised. This case was memorialized in Hironimus v. Nebus.  

Hironimus became the subject of national attention after Florida’s 4th District Court of Appeal upheld a ruling forcing Hironimus to go through with a 2012 agreement she had signed allowing the boy’s father, Dennis Nebus of Boca Raton, to have their son circumcised. When she later changed her mind about the agreement, Palm Beach County Circuit Judge Jeffrey Gillen ruled to enforce the agreement anyway. 

The signed co-parenting agreement from 2012 stated the child would be circumcised for hygienic reasons. The mother argued that the son should not have to experience an unnecessary anesthesia or anxiety. She absconded with her son to an undisclosed domestic abuse center. 

On May 14, 2015, Hironimus was arrested. 

On May 22, 2015, signed a circumcision consent form in a Palm Beach County courtroom.  

On June 11, 2015 the child was taken to Joe DiMaggio Children’s Hospital for the procedure.  

On June 12th, 2015 it was reported: 

Joe DiMaggio Children’s Hospital on Friday said the surgery wasn’t done against his mother’s wishes on Thursday as scheduled. 

“Joe DiMaggio Children’s Hospital has gone on record to state the child is not a patient of the hospital, any Memorial facility or the doctor. We stand by that statement, and therefore the procedure in question did not happen,” it said. 

Like much of the information about the circumcision battle between the child’s parents, Heather Hironimus and Dennis Nebus, the Hollywood hospital issued the statement on its Facebook page. 

Anti-circumcision activists throughout the world, who have supported Hironimus’ efforts to stop Nebus from having the boy circumcised, had varying reactions to the hospital’s announcement. Some declared victory. Some questioned whether the hospital was lying. Others parsed the hospital’s words carefully, questioning whether the surgery was done at another location. 

What happened since? The timeline is unclear. But two things are certain. The child was circumcised. And the child received a diagnosis of leukemia.  

In 2017, criminal charges for abducting her son in violation of court order were dropped after Hironimus underwent a mental health examination, a four hour parenting course, and other provisions.  

The topic of circumcision often stirs up spirited debate. More than other “body modification” procedures such as, say, cosmetic rhinoplasty in minors or piercing ears. Regardless, it might be hard to steady one’s hands to do a proper cutting if there were protestors outside the door.  

What do you think? Use the comments box below to weigh in.


Posted by Medical Justice | in Legal | 5 Comments »

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Gregory Laurence MDDrumminDocCarla SchlisselEasyEJoe Horton Recent comment authors
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Joe Horton
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Joe Horton

Silja Dogg Gunnarsdottir…said, “one [complication] is too many if the procedure is unnecessary….”

And if one more than normal gets a complication from ~not~ having it, is that one too many as well?

Same argument can be raised about vaccinations. I wonder how Ms. Gunnarsdottir feels about that issue. I can guess, but it would be enlightening to know.

EasyE
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EasyE

Leave the work to a Mohel if you want your son to have a nice penis.Quick, painless, and several thousand years of research. No brainer.

Carla Schlissel
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Carla Schlissel

Easy E – Agreed. Although not quite painless. My father held my son at the time and said he felt “a shock” go through my son. However, at 8 days there a few, if any, complications and the baby has no recollection what-so-ever. As far as one complication being one too many – I assume, therefore, there are no cosmetic surgery procedures being performed in Iceland for any non-medical reasons. After all, there are far more complications from cosmetic surgeries than from circumcision. Oh. And circumcision has nothing to do with leukemia.

DrumminDoc
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DrumminDoc

While Pakistan and Haiti have the highest penile carcinoma rates in the world (no circumcisions), Israel has the lowest rate of cervical cancer.
To lower HIV transmission rates (esp in Africa) circumcision is encouraged.
Unless there is a compelling reason to circumcise, in the West it’s probably reasonable to wait to allow the individual decide for himself.
There is no medical indication for “circumcizing” any human female.

Gregory Laurence MD
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Great Blog Dr S!
WWJD?
hahaha! (Easter Joke)