Doctors Opposing CircumcisionAugust 22, 2012
AAP Announces Intent to Release its Sixth Major Circumcision Policy
Doctors Opposing Circumcision reaffirms its Genital Integrity Policy
The American Academy of Pediatrics (AAP) revealed that it intends to
publish its sixth major circumcision policy on Monday, August 27, 2012
and in the September 2012 issue of
Pediatrics, its house journal.
This will be its sixth position statement on male circumcision, as it
has previously published position statements in 1971, 1975, 1983, 1989,
and 1999.
The new AAP policy has been five years in the making. The intent to publish a new statement was announced in 2007, however
internal disagreement on its content has prevented publication. The new statement likely will be a compromise between positions.
The AAP, despite its high sounding academic name, actually is a trade
association of pediatric doctors. Its primary duty is to advance the
business and professional interests of its 60,000 members who are called
"fellows". The interests of its child-patients are a distant second to
their primary interest.
There is a severe and intractable conflict of interest between the
financial interests of its fellows and the best interests of the
child-patient. Most of its fellows perform non-therapeutic circumcisions
on children and profit thereby. These members do not want anything to
interfere or disrupt their steady income stream. The AAP will not
publish a statement that would harm that income stream. The AAP ensures
the outcome of its circumcision statements by appointing doctors who are
known to have a pro-circumcision position. The current task force, like
previous task forces on circumcision, is stuffed with pro-circumcision
doctors, including its chairwoman. Obstetricians and family doctors also
profit by doing unnecessary circumcisions. The presence on the task
force of a representative from the American College of Obstetricians and
Gynecologists (ACOG) and the American Academy of Family Doctors (AAFP),
as well as Dr. Stephen Wegner, MD, JD, representing
the AAP Health Care Financing Committee,
highlight the business and financial nature of the forthcoming
circumcision policy statement. We anticipate a very self-serving
statement that protects doctors' income.
Previous AAP circumcision statements have exaggerated the alleged but
unproved prophylactic benefits of non-therapeutic circumcision while
minimizing the risks, complications, drawbacks, permanent irreversible
physical, sexual, and emotional injury of male circumcision. We expect
that this one will use prevention of HIV sexual transmission as a reason
to circumcise boys, even though the African studies that indicate
circumcision prevents HIV infection in adult males have been shown to be
trash and, in any event, not applicable to infants boys in North
America.
In recent years, 46 percent of boys born in the
United States have left the birth facility with intact foreskins. There
is not a shred of evidence that these boys are less healthy than the 54
percent of boys who were circumcised.
Doctors who perform circumcisions have had their income stream
curtailed by the decision of eighteen state Medicaid agencies to
terminate payments for medically unnecessary non-therapeutic
circumcision of children. The AAP is expected to call for restoration of
those taxpayer-funded Government payments to doctors, so as to restore
the income of their fellows.
The AAP, thus far, has consistently refused to recognize that
children are human beings, who have legal rights to bodily integrity and
the security of their person under both American law and international
human rights law, which are trampled by the unnecessary amputation of
the functional body part called the foreskin. The AAP has consistently
misapplied legal rules regarding surrogate consent for therapeutic
operations on children to non-therapeutic circumcision. By so doing, it
has tried to protect the alleged parental right to cut body parts from
boys at will for religious cultural reasons or no reason at all.
As noted above, the AAP is simply a trade association, which advances
the perceived interests of its fellows. Its position statements are not
legal or medical imperatives and do not have the force of law or public
policy. This statement on circumcision is going to be all about money,
not about child health or welfare.
The Royal Dutch Medical Association
has called male circumcision a human rights violation and an unethical
practice. The AAP's forthcoming pro-circumcision policy is not supported
by foreign medical associations.
A court in Cologne, Germany says parents may not grant consent for
unnecessary circumcision. We will see shortly whether the AAP will
reform its abusive practices. We are not hopeful.
Doctors Opposing Circumcision
believes that circumcision of children violates numerous legal rights
of the child and is highly unethical, if not unlawful. We believe that
genital integrity provides the highest level of health and well being
for the child. We do not know what the AAP is going to say in their new
statement, but we are circumcision experts and we are convinced that
non-circumcision is best for children. We reaffirm our
Genital Integrity Policy Statement of 2008, which advocates genital integrity for boys.
We urge parents to ignore this latest statement from the AAP and to continue to protect their sons' whole and complete bodies.
George C. Denniston, MD, MPH
John V. Geisheker, JD, LLM
President Executive Director & General Counsel
Wednesday, August 22, 2012.
