October , 2012
Intact America Calls on American Academy of Pediatrics to Rescind Pro-Circumcision Report that Violates Ethics, Human Rights of Baby Boys
By Georgeanne Chapin
Click to enlarge
in New Orleans papers
during the AAP Convention
Intact America, the nation’s leading intactivist organization critical of neonatal male circumcision, today called on the American Academy of Pediatrics (AAP) to reject a one-sided Task Force report that presses insurance companies and state Medicaid plans to pay for an unnecessary, and unethical surgery that even the task force cannot see its way clear to recommend.
“The AAP stacked its circumcision Task Force with pro-circumcision doctors and activists, and apparently is afraid to let its members learn the truth about the unnecessary, unethical, and risky surgery that U.S. doctors perform more than a million times a year on baby boys who cannot consent,” said Georganne Chapin, Executive Director of Intact America. The AAP had originally accepted Intact America’s application and payment for a booth at its exhibition hall but then cancelled it without warning after Intact America and others openly criticized the report of its Circumcision Task Force.
Intactivists, as critics of neonatal male circumcision are called, will be coming from around the United States and Canada to protest outside the Ernest N. Morial Convention Center in New Orleans, where the AAP is holding its annual convention starting on October 20th. They include a number of men expected to express outrage that they were forced to undergo the surgery without their consent.
“They can kick us out of their hall, but they can’t escape the growing realization that they have trapped themselves in an ethical quagmire by seeking reimbursement for surgery the American Medical Association properly calls ‘non-therapeutic,’” Chapin said. “They know that growing numbers of American parents are saying no to the removal of healthy functioning tissue from the genitals of their baby boys in a surgery that is a gross violation of medical ethics and the baby’s basic human rights.”
The AAP action came shortly after Chapin authored an essay appearing in Huffington Post, arguing that the AAP was acting more like a trade association than a doctors’ organization that claims to be “dedicated to the health of all children.” In its report issued this summer, the AAP Task Force acknowledged that there were not enough benefits to justify recommending circumcision, but sought to win approval for reimbursement by insurance companies and the 18 states’ Medicaid programs – including Louisiana’s – where the surgery is currently not covered.
“Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns,” the report reads.
The AAP relied heavily on studies of sexually-active adult African men and the role circumcision might play in retarding female-to-male – but not male-to-female – transmission of the HIV virus linked to AIDS. The AAP and Centers for Disease Control correctly report there is no evidence circumcision plays any role in retarding male-to-male HIV transmission, which along with sharing intravenous needles is the predominant mode of HIV transmission in the United States.
“Ethical and scientific problems with the African research aside, trying to extrapolate from studies of sexually active adult African men to infant boys in America is bad science, bad medicine and bad health policy,” Chapin said. “Medical ethics requires necessity and informed consent for something as invasive as surgery. The foreskin is normal tissue, an integral part of the male anatomy; it protects the rest of the penis and plays an important role in sexual pleasure. Babies should be left alone. When they become men, they can make their own informed decision about whether they want to remove a part of their own penises.”
“Not only does the Task Force report blatantly ignore the ethical obligation of physicians to respect their patients' autonomy and do no harm, it repeatedly calls for doctors to be paid [by the taxpayer] for removing healthy, functioning tissue from somebody who cannot consent.” Chapin wrote.
While the male circumcision rate in the United States was around 80 percent 30 years ago, it has steadily dropped to around 50 percent today. In Europe, circumcision rates in most countries are well under 10 percent, and European physician groups and even courts are now calling for doctors to stop performing all child circumcisions that are not medically indicated.
The Royal Dutch Medical Association has recommended against routine male circumcision, the organization calling it a medically-unnecessary form of surgery.
"The patient has to give consent, but children can't give consent and we feel that is wrong and a violation of the child's right,” said Gert Van Dijk, an ethicist at The Royal Dutch Medical Association. "In our code of medical ethics, it states that you must not do harm to the patient, but with this procedure this is exactly what you're doing."
In Denmark, Prime Minister Helle Thorning-Schmidt has commissioned an investigation into whether non-medical circumcision procedures violate its health code. In Germany, a court ruled in June that non-therapeutic male circumcision amounted to bodily injury and violated human rights provisions of the country's laws. The judge explicitly ruled that the parents' religious freedom cannot override the child's right to physical integrity and self-determination. "The body of the child is irreparably and permanently changed by a circumcision," the judge wrote. "This change contravenes the interests of the child to decide later on his religious beliefs."
Following the German court's decision, hospitals in Austria and Switzerland suspended all medically-unnecessary infant circumcisions. Political discussion continues in Germany over whether religious circumcisions might be allowed, but no European physician organization is contending that there is any medical justification for routinely circumcising babies or children.
The AAP letter kicking Intact America out of the convention hall in New Orleans, sent from its Illinois headquarters and dated October 10th, cited content on the Intact America website and Intact America’s Facebook page for its actions. Intact America and other critics of circumcision have rented exhibition space for years without incident at AAP conventions.
“Pediatricians must be reminded that their patients are the babies,” Chapin said. “If we can’t remind them in the hall, we will remind them in the streets of New Orleans.”
Meanwhile, the AAP has printed a second letter from Profressor Brian Morris in support of its policy, while withholding moderate, referenced letters in opposition. Professor Morris' letter cites three papers, all co-authored by himself.
Professor Morris's website still carries material headed with the Gilgal Society logo, and a verse written by the head of the Gilgal Society, Vernon Quaintance, convicted of possessing child pornography, though Professor Morris purged his material of most of the references soon after the conviction. The Gilgal Society continues to advertise Professor Morris's leaflets, though "a major computer failure" prevents them from being available from the site.