Cultural Bias in AAP's 2012 Technical Report and Policy Statement on Male Circumcision
Abstract
The American Academy of Pediatrics (AAP) recently released its new
technical report and policy statement on male circumcision, concluding
that current evidence indicates that the health benefits of newborn male
circumcision outweigh the risks. The technical report is based on the
scrutiny of a large number of complex scientific articles. Therefore,
while striving for objectivity, the conclusions drawn by the eight task
force members reflect what these individual doctors perceived as
trustworthy evidence. Seen from the outside, cultural bias reflecting
the normality of non-therapeutic male circumcision in the US seems
obvious, and the report’s conclusions are different from those reached by doctors in other parts of the Western world,
including Europe, Canada, and Australia. In this commentary, a quite
different view is presented by non-US-based doctors and representatives
of general medical associations and societies for pediatrics, pediatric
surgery and pediatric urology in Northern Europe. To these authors,
there is but one of the arguments put forward by the AAP that has some
theoretical relevance in relation to infant male circumcision, namely
the possible protection against urinary tract infections in infant boys,
which can be easily treated with antibiotics without tissue loss. The
other claimed health benefits, including protection against HIV/AIDS,
genital herpes, genital warts and penile cancer, are questionable, weak and likely to have little public health relevance in a Western context, and do not represent compelling reasons for surgery before boys are old enough to decide for themselves.
Authors and Affiliations (38 people)
Morten Frisch, MD, PhD: Consultant, Statens Serum Institut,
Copenhagen, and Adjunct Professor of Sexual Health Epidemiology, Faculty
of Medicine, Aalborg University, Aalborg, Denmark
Yves Aigrain, MD, PhD: Professor of Pediatric Surgery,
Hôpital Necker Enfants Malades, Université Paris Descartes, Paris,
France
Vidmantas Barauskas, MD, PhD: Professor and President of the Lithuanian Society of Paediatric Surgeons, Lithuania
Ragnar Bjarnason, MD, PhD: Professor of Pediatrics, Landspitali University Hospital, Reykjavik, Iceland
Su-Anna Boddy, MD: Consultant in Pediatric Surgery and
Chairman of the Children’s Surgical Forum of the Royal College of
Surgeons of England, UK
Piotr Czauderna, MD, PhD: Professor of Pediatric Surgery, Medical University of Gdansk, Gdansk, Poland
Robert P. E. de Gier, MD: Consultant in Pediatric Urology
and Chairman of Working Group for Pediatric Urology, Dutch Urological
Association, The Netherlands
Tom P. V. M. de Jong, MD, PhD: Professor of Pediatric
Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam,
The Netherlands
Günter Fasching, MD: Professor and President of the Austrian Society of Pediatric and Adolescent Surgery, Austria
Willem Fetter, MD, PhD: Professor and President of the Paediatric Association of the Netherlands, The Netherlands
Manfred Gahr, MD: Professor and General Secretary of the German Academy of Paediatrics and Adolescent Medicine, Germany
Christian Graugaard, MD, PhD: Professor of Sexology, Aalborg University, Faculty of Medicine, Denmark
Gorm Greisen, MD, PhD: Professor of Pediatrics, Rigshospitalet, Copenhagen, Denmark
Anna Gunnarsdottir, MD, PhD: Consultant in Pediatric
Surgery, Landspitali University Hospital, Reykjavik, Iceland, and
Karolinska University Hospital, Stockholm, Sweden
Wolfram Hartmann, MD: President of the German Association of Pediatricians, Germany
Petr Havranek, MD, PhD: Professor of Pediatric Surgery, Thomayer Hospital, Charles University, Prague, Czech Republic
Rowena Hitchcock, MD: Professor and President of the British Association of Paediatric Urologists, UK
Simon Huddart, MD: Professor and Honorary Secretary of the British Association of Paediatric Surgeons, UK
Staffan Janson, MD, PhD: Professor and Chairman of
Committee on Ethics and Children’s Rights, Swedish Paediatric Society,
Sweden
Poul Jaszczak, MD, PhD: Vice President and Chairman of the Ethics Committee of the Danish Medical Association, Denmark
Christoph Kupferschmid, MD: Practicing Pediatrician and
Member of Ethics Committee of the German Academy of Pediatrics, Germany
Tuija Lahdes-Vasama MD: Consultant in Pediatric Surgery and
President of The Finnish Association of Pediatric Surgeons, Finland
Harry Lindahl, MD, PhD: Associate Professor of Pediatric Surgery, Helsinki University Children's Hospital, Helsinki, Finland
Noni MacDonald, MD: Professor of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Canada
Trond Markestad, MD: Professor of Pediatrics, Chairman of
the Ethics Committee of the Norwegian Medical Association, Oslo, Norway
Matis Märtson, MD, PhD: Consultant in Pediatric Surgery and
President of the Estonian Society of Paediatric Surgeons, Tallinn,
Estonia
Solveig Marianne Nordhov, MD, PhD: Consultant in Pediatrics and President of The Norwegian Paediatric Association, Norway
Heikki Pälve, MD, PhD: Chief Executive Officer of the Finnish Medical Association, Finland
Aigars Petersons, MD, PhD: Professor and President of the Latvian Association of Pediatric Surgeons, Latvia
Feargal Quinn, MD: Consultant in Pediatric Surgery, Our Lady's Children's Hospital, Dublin, Ireland
Niels Qvist, MD, PhD: Professor of Pediatric Surgery, Odense University Hospital, Odense, Denmark
Thrainn Rosmundsson, MD: Chief of Pediatric Surgery, Landspitali University Hospital, Reykjavik, Iceland
Harri Saxen, MD, PhD: Associate Professor of Pediatrics, Helsinki University Children’s Hospital, Helsinki, Finland
Olle Söder, MD, PhD: Professor and President of the Swedish Pediatric Society, Stockholm, Sweden
Maximilian Stehr, MD, PhD: Professor of Pediatric Surgery,
Dr. v. Haunersches Kinderspital, Ludwig-Maximilians Universität, Munich,
Germany
Volker C.H. von Loewenich, MD: Professor and Chairman of
the Commission for Ethical Questions, German Academy of Pediatrics,
Frankfurt, Germany
Johan Wallander, MD, PhD: Professor and Chairman of the Swedish Society of Pediatric Surgery, Sweden
Rene Wijnen, MD, PhD: Professor and Chairman of the Dutch Society of Pediatric Surgery, The Netherlands
|
No comments:
Post a Comment