Routine Infant Circumcision: Vital Issues that the Circumcision Proponents may be Overlooking

Abstract

Circumcision is not a mild, neutral medical intervention like a vaccination, but a culturally-loaded amputation of a highly significant and functionally valuable body part that the medical profession should be working to protect against pathological conditions. Instead, a small, vocal, influential group is calling for universal amputation of the foreskin, comparing it to a vaccination. While the average adult is willing to get himself vaccinated against diseases, the vast majority of adult males are not willing to get circumcised. Falling rates of circumcision in the United States may have prompted a surge in circumcision promotion. Demonstrating a circumcision benefit in the United States has been disappointing, so the research moved to Africa, where the latest health crisis, the AIDS epidemic, was at its zenith. Armed with a few studies performed by a handful of investigators, circumcision proponents (CPs) are saturating the medical literature with their opinions and calling on national medical organization to recommend universal infant male circumcision. Policies and recommendations should be evidence-based rather than relying on opinion pieces with selective bibliographies and a narrowly focused perspective (Schoen 2006; Flynn et al. 2007; Dickerman 2007; Morris 2007a; Weiss et al. 2008; Morris et al. 2006; Golden and Wasserheit 2009; Rennie et al. 2007; Gostin and Hankins 2008; Clark et al. 2007; Morris 2007b; Morris 2008; Sawires et al. 2007; Newell and Bärnighausen 2007a; Sullivan et al. 2007; Brusa and Barilan 2008; Katz and Wright 2008; Potts et al. 2006). The purpose of this chapter is to address the issues that the CPs have failed to mention, such as bioethics, human rights, the function of the foreskin, and conflicting information, to present the information their bibliographies selected out, and to itemize the barriers to making a convincing case for universal circumcision.