Abstract
Recently the ethics of infant male circumcision has generated a considerable debate in bioethics journals. In previous publications we have sought to argue that, by contrast, healthcare lawyers have unjustifi ably neglected the topic, accepting a dominant characterization of male circumcision as a standard and benign medical practice, which parents can choose for their children free of legal scrutiny. In this paper, we seek to problematize both the way in which male circumcision is debated in the ethics literature and how it is constructed as a non issue for healthcare lawyers. We are concerned here particularly with the cost/benefi t analysis that has underpinned professional guidance and court decisions on the legitimacy of male circumcision. We argue that how these costs and benefi ts have played out in the ethico-legal debates and assessments as to what is in the best interests of the child are highly problematic.
The debate on male circumcision, in contrast to that on female circumcision is marked by an absence of statute law. There are also few reported cases. In the absence of clear legal authority, ‘soft’ law sources, particularly guidance issued by professional medical bodies, assumes enhanced signifi cance. In the United Kingdom, the British Medical Association issued revised guidance as recently as 2003, but it is currently being re-considered. The current General Medical Council Guidance dates from 1997, while in 2001 a Joint Statement on male circumcision was issued by the British Association of Paediatric Surgeons, The Royal College of Nursing, The Royal College of Paediatrics and Child Health, The Royal College of Surgeons of England, and the Royal College of Anaesthetists. A common theme of this guidance is the way in which it constructs the issue of male circumcision as a legitimate parental choice—a position which we argue is in need of review.
In this paper we adopt a comparative approach in order to examine guidance on male circumcision issued by professional medical associations in countries which share a similar tradition of circumcision to the United Kingdom. Thus, we examine guidance issued in the United States, Canada, Australia, and New Zealand. Our focus is on professional guidance, that adopts a more progressive and less tolerant approach to the issue of elective neonatal circumcision. Thus, we seek to explore what the medical profession in the United Kingdom and the United States could learn from guidance issued by the Fetus and Newborn Committee of the Canadian Paediatric Society in 1996 and in a Policy Statement on Circumcision issued by the Paediatric and Child Health Division of the Royal Australian College of Physicians in 2002.
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References
Earlier versions of this paper have been presented at the 9th International Symposium on Genital Integrity and Human Rights 24–26 August 2006, University of Washington, Seattle; at the British Academy and Feminism and Legal Theory Workshop ‘Exploring Key Concepts in Feminist Legal Theory: The Family,’ Emory University, Atlanta, September 7–8, 2007, and at the AHRC Centre LGS Workshop on Body Modification, University of Keele, 24 October 2007. We would like to thank the participants at these events for their feedback which has helped shape this paper.
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Certainly in comparison to the guidance issued by the American Academy of Paediatrics, “Task Force on Circumcision, Circumcision Policy Statement” (1999) 103 Paediatrics 686– 693 — see R. Darby and J. S. Svoboda, “A Rose by Any Other Name? Rethinking the Similarities and Differences between Male and Female Genital Cutting” (2007) 21 Medical Anthropology Quarterly 301–323 at pp 313–315.
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Fox, M., Thomson, M. (2009). Reconsidering ‘Best Interests’. In: Denniston, G.C., Hodges, F.M., Milos, M.F. (eds) Circumcision and Human Rights. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9167-4_2
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