SEATTLE: AAP ethicist misrepresents role of circumcision in death

September , 2012

AAP ethicist misrepresents circumcision's role in death

By Hugh Young
The ethicist for the American Academy of Pediatrics has mis-stated the role of circumcision in a baby's death.

On radio KQED, he said the family of a very sick baby had wanted him circumcised before he died.
Yet the baby's mother had blogged, while he was still struggling for life against a circumcision-caused haemorrage, "I almost killed my baby".

The baby was born in Indiana in August 2010 with a major heart defect, virtually half his heart missing. He underwent heart surgery three days later. In October, the hospital told his mother he was well enough to be circumcised, but they nicked an artery and he died the next day.

The doctor came in this morning and asked if we wanted to get it done today. I said yes.... I should have known better. I should have said no. I had hoped that he would do well and that it wouldn't be such a big deal. But instead, I almost killed my child by consenting. ... Why did I have to say yes?

Clearly, she was desperately hoping and praying her son would live (of course).

On Radio KQED on August 29 2012, the ethicist for the American Academy of Pediatrics, Dr Douglas Diekema, grossly misstated the case, portraying the mother as abandoning hope (starting at 12:40):

"There's at least, y'know, one of these cases that gets trotted out, involved a very sick baby that was likely to die anyway, and his parents wanted him circumcised before, ah, his death, and to attribute that to a circumcision is silly, um, that kind of a death."

His mother's blogs give the lie to that interpretation. [She has since removed all reference to circumcision from her blog.]

Intactivists were accused at the time of exploiting the baby's death, after several had urged her not to circumcise, and berated her afterwards. Dr Diekema seems to be exploiting it in a much more cynical way, attributing to the mother a callous disregard for the baby's life.

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.