Abstract
The doctrine of informed consent functions reasonably within its area of applicability of competent adults, though even in that setting it suffers from some difficulties both theoretical and practical. When applied by proxy to incompetent persons such as mentally incapacitated adults and newborn babies, the doctrine becomes a legal fiction, i.e., a legal construct created to force-fit a set of facts into an established legal analysis that is not literally applicable. The conceptual, ethical and practical difficulties are maximized with proxy permission to authorize circumcision of neonates. “Proxy consent” for neonatal circumcision is a legal fiction that cloaks a usurpation of agency allowing ostensibly hallowed principles of autonomy and self-determination to be violated with impunity. Such legal fictions conceal our violations from ourselves and others under the pretenses of legal authorization and compliance with ethics and human rights, and—in the circumcision context—the further pretense of medical authorization, masking our failure to properly safeguard human dignity and autonomy.
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Notes
- 1.
Slater v. Baker and Stapleton, 95 Eng. Rep. 860 (1767).
- 2.
See Newmark v. Williams, 588 A.2d 1108, 1115–16 (Del. 1991).
- 3.
See Matter of Storar, 420 N.E.2d 64, 71 (N.Y. 1981).
- 4.
See Talmage v. Smith, 101 Mich. 370, 59 N.W. 656 (1894).
- 5.
Schloendorff v. Society of New York Hospital, 105 N.E. 92, 93 (N.Y. 1914).
- 6.
Salgo v. Leland Stanford Jr. University Board of Trustees, 154 Cal. App. 2d 560, 317 P.2d 170 (1957).
- 7.
Grounded in the ethical principle of respect.
- 8.
Scott v. Bradford, 1979 OK 165; 606 P.2d 554, 559 (1979).
- 9.
Rogers v. Whitaker, 175 C.L.R. 479, 489–491 (Austl. 1992).
- 10.
Wecker v. Amend, 918 P.2d 658, 661 (Ka. Ct. App. 1996).
- 11.
Reibl v. Hughes, 114 D.L.R. 3d 1, 15–17 [1980].
- 12.
Arena v. Gingrich, 733 P.2d 75,76 (1987).
- 13.
Scott v. Bradford, 1979 OK 165; 606 P.2d 554, 559 (1979).
- 14.
See Cruzan v. Director, Mo. Dept. of Health, 497 U.S. 261, 284–286 (1990).
- 15.
Ex Parte Whitbread in the Matter of Hinde, a Lunatic, 35 Eng. Rep. 878, 878 (Ch. 1816).
- 16.
In re Quinlan, 355 A.2d 647, 661-62 (N.J. 1976).
- 17.
Superintendent of Belchertown v. Saikewicz, 370 N.E.2d 417, 421, 431 (Mass. 1977).
- 18.
Prince v. Massachusetts, 321 U.S. 158 (1944).
- 19.
See Strunk v. Strunk, 445 S.W.2d 145, 148–149 (Ky. 1969); Hart v. Brown, 289 A.2d 386, 387-88 (Conn. Super. Ct. 1972).
- 20.
Private communications on July 12, 2011 with Robert S. Van Howe, MD, Marilyn Milos, and Amber Craig.
- 21.
American Academy of Family Physicians 2002.
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Svoboda, J.S. (2013). Tortured Bodies, Tortured Doctrines: Informed Consent as a Legal Fiction Inapplicable to Neonatal Male Circumcision. In: Denniston, G., Hodges, F., Milos, M. (eds) Genital Cutting: Protecting Children from Medical, Cultural, and Religious Infringements. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6407-1_1
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