ILLINOIS: New AAP male circumcision policy expected next month

August 13, 2012	.

The Intactivism Pages
August 13, 2012

AAP male circumcision policy due in September

By Hugh Young

The American Academy of Pediatrics plans to issue a new policy on male circumcision at the end of the month. The policy is forshadowed in the Contents of the September issue of Pediatrics.

The new policy has been delayed several times since it was announced that a task force had been convened to examine the issue. The previous AAP male circumcision policy was issued in 1999.[This site rebuts it here.]

The AAP has never recommended male circumcision, but since the 1970s it has issued policies that leave the decision up to parents. The policies have always closely reflected US - but not world - cultural biases toward circumcision, omitting the structure and functions of the foreskin, passing over the lack of ethics in practising unnecessary reductive surgery on healthy newborns, and emphasising minor benefits while minimizing its risks and inevitable harms.

The AAP's treatment of the issue is in sharp contrast to that of other countries, such as the Royal Dutch Medical Association (KNMG), which roundly condems the practice. In May, a court in Cologne, Germany, ruled that circumcision of a healthy boy was bodily harm under the Basic Law.

One member of the task force on male circumcision, Dr Douglas Diekema, has hinted that the policy would lean further towards recommending genital cutting of healthy babies in the USA, in the light of studies of male volunteers for the adult operation in high-HIV-prevalance areas of Africa that seemed to show a reduction in their - but not women's - acquistion of HIV by heterosexual intercourse. (To the contrary, one study suggested male circumcision might increasethe risk to women. USAID surveys of HIV rates show higher rates among circumcised than non-circumcised men, in a majority of the countries for which it has figures.)

Dr Diekema was the chair of the AAP's Bioethics Committee in 2010 when it issued a policy that would allow a token, ritual nick to girls' genitals "much less extensive than neonatal male genital cutting". An outcry by anti-FGC organisations, led by Intact America, caused the policy to be "retired" within a month.

Speaking in more general terms, Dr Diekema has said under oath "I fully agree with the Bioethics Committee of the American Academy of Pediatrics when they state:

"...[P]roviders have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. ... The pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent."

- but he has never applied this to male infant circumcision.