4 10 240 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>Circumcision violates child’s right to an open future</h3> A paper in the Journal of Medical Ethics (on-line first, January 2013) argues that non-therapeutic circumcision (is ethically objectionable and legally borderline because it violates a child’s right to an open future. This principle is widely accepted in ethical and legal circles and has often been applied to limit the power of parents to indoctrinate children into particular political beliefs or cultural identities. It has less often been applied to bodies rather than minds, and never previously to permanent bodily alterations such as circumcision. In this paper, the author (Dr Robert Darby) elucidates the open future principle and consider whether it is applicable to non-therapeutic circumcision of boys, whether performed for cultural/religious or for prophylactic/health reasons. He argues that the principle is highly applicable to non-therapeutic circumcision (NTC), and concludes that NTC would be a violation of the child’s right to an open future, and thus objectionable from both an ethical and a human rights perspective. Dr Darby suggests that NTC is similar to designer deafness (i.e. causing a child to suffer hearing loss) because it also results is sensory deprivation, and also that circumcision is comparable to smoking, in that it is really a bad habit that causes long term harm to the body. Preventing a child from smoking and protecting his foreskin have the same rationale: to preserve the body for future use and ensure that the future adult is able to make autonomous decisions about such intimate personal matters. ABSTRACT The principle of the child’s right to an open future was first proposed by the legal philosopher Joel Feinberg and developed further by bioethicist Dena Davis. The principle holds that children possess a unique class of rights called rights in trust – rights that they cannot yet exercise, but which they will be able to exercise when they reach maturity. Parents should not, therefore, take actions that permanently foreclose on or pre-empt the future options of their children, but leave them the greatest possible scope for exercising personal life choices in adulthood. Davis particularly applies the principle to genetic counselling, arguing that parents should not take deliberate steps to create physically abnormal children, and to religion, arguing that while parents are entitled to bring their children up in accordance with their own values, they are not entitled to inflict physical or mental harm, neither by omission nor commission. In this paper I aim to elucidate the open future principle and consider whether it is applicable to non-therapeutic circumcision of boys, whether performed for cultural/religious or for prophylactic/health reasons. I argue that the principle is highly applicable to non-therapeutic circumcision, and conclude that NTC would be a violation of the child’s right to an open future, and thus objectionable from both an ethical and a human rights perspective. The paper concludes: The child’s right to an open future complements the four principles of bioethics developed by <a href="https://en.wikipedia.org/wiki/Medical_ethics">Beauchamp and Childress</a> by meeting the objection that children cannot possess rights because they lack moral autonomy and the capacity to make rational choices. Children may lack such autonomy now, but as adults-to-be they will develop such autonomy in the normal course of their growth. It also supports and extends the <a href="http://www.cirp.org/library/ethics/hodges3/">argument of Hodges et al</a> that additional scrutiny is demanded when we make decisions about non-essential surgery on children, especially when it entails removal of functional body parts. One of the compelling features of the principle is its alignment with John Locke’s proposition that parental authority derives from their duty of care towards their children and is limited by the interests of the latter. Circumcision is analogous to smoking, eating junk food and not cleaning one’s teeth because it causes long term harm to the body and reduces its future functionality. Forcing children to brush their teeth or endure painful vaccinations, preventing them from smoking and protecting their foreskin all have the same rationale: to preserve the body for future use and ensure that the future adult is able to make autonomous decisions about such matters. The open future principle both constrains parents and gives them authority – constrains them from cutting off their children’s future options, but gives them the authority to prevent their children from recklessly doing the same. Source: Robert Darby. <a href="http://jme.bmj.com/content/early/2013/01/29/medethics-2012-101182.short?g=w_jme_ahead_tab">The child’s right to an open future: Is the principle applicable to non-therapeutic circumcision?</a> Journal of Medical Ethics, on-line first, 30 January 2013 <a href="https://www.circinfo.org/Journal_of_medical_ethics_July13.html">Journal of Medical Ethics, July 2013: Special issue on the ethics of male circumcision</a> <a href="https://www.circinfo.org/Circumcision_and_human_rights.html">Circumcision: A medical or a human rights question?</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Circumcision violates the child's right to an open future darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> The rights and wrongs of circumcision come under scrutiny in the July issue of the <a href="http://jme.bmj.com/">Journal of Medical Ethics</a>. With a series of specially written essays by experts from around the world, this special issue of the journal represents the most detailed and comprehensive analysis of the ethical aspects of male circumcision that has yet appeared in print. The range and quality of the contributions show that the debate about routine circumcision has entered a new and more intense phase, confirming the <a href="http://www.openforum.com.au/content/should-circumcision-be-illegal">prediction of several commentators</a> that the argument is no longer over whether circumcision has “medical benefits”, but whether it is ethically permissible to perform the operation on non-consenting children. The answer given in the world’s leading bioethics journal would appear to be a resounding negative. <h3>Argument is now over conflicting rights, not "health benefits"</h3> The most striking feature of the contributions is that only one contributor sought to defend non-therapeutic circumcision of boys on medical or health grounds, and even then only half-heatedly. Even those who argued that parents should be allowed to have their boys circumcised if the operation was required by or customary in their religion or cultural traditions agreed that there was no valid medical or health argument for the practice. In fact, the near-unanimous sentiment was that the debate about the permissibility of circumcision was relevant only to parents from cultures and religions that traditionally circumcise boys; while they might be entitled to have their boys circumcised, the question did not even arise for parents from non-circumcising cultures. Nobody attempted to argue that all parents were entitled to have their boys circumcised simply by virtue of their parental authority, and one paper (by Robert Van Howe) subjected the very notion of “parental rights” to a searching and sceptical critique. This near-consensus represents a forceful rejection of the position of the American Academy of Pediatrics, in its 2012 circumcision policy statement, that because the “benefits” of circumcision outweighed the “risks of complications”, parental choice on the question was appropriate. On the contrary, while parental preference might be justifiable in relation to circumcision for religious or cultural reasons, it could not possibly play a part in any decision based on medical arguments: parents lack the expertise to make an informed judgement on controversial medical questions, and it is not, in any case, their body that is being subjected to the surgery. In the absence of any consensus on the benefits of circumcision and wide agreement that they are either trivial or non-existent in childhood, the logical and ethically preferable position is to leave the decision up to the owner of the penis. The sole contributor who did consider health benefits to be relevant, David Benatar, claimed that “new” evidence about the possible effect of circumcision in reducing the risk of infection with heterosexually transmitted HIV was a factor that parents ought to add to the “circumcision decision”. The principal objection to this suggestion is its lack of logic, for it is only sexually active heterosexual adults who engage in high-risk sex practices who are at risk of contracting HIV. Since children are not sexually active, the decision can be safely left – and is more appropriately left – until the boy is old enough to make the decision for himself. Such a manifestation of respect for the bodies and rights of others would satisfy the principle of the child’s right to an open future, as argued in this issue by Robert Darby, as well as recognising their human rights, as insisted upon by Steven Svoboda. In other words, this special issue of the Journal of Medical Ethics amounts to a comprehensive rejection of the “American” point of view on circumcision, and an endorsement of the European-British position – that non-therapeutic circumcision of male minors is harmful to the child and is thus ethically impermissible and legally problematic. A summary of each of the articles appears below. <h3>1. Editorial: Bennett Foddy, Medical, religious and social reasons for and against an ancient rite</h3> This month’s issue of the Journal of Medical Ethics is a special issue devoted entirely to the ethics of infant male circumcision—an elective surgical practice that is currently performed on around a third of the world’s male population. The last time the Journal ran a symposium on this issue was in 2004, and there has been relatively scant discussion of the practice in the ethical literature since then. Three events that took place in the past year have brought the ethics of infant male circumcision back into the global spotlight. First, in April of 2012, controversy erupted after it was reported that a baby had died in New York City after contracting Herpes Simplex virus during the Orthodox Jewish variant of circumcision known as metzitzah b’peh, which involves the oral suction of blood from the infant’s penis following the circumcision procedure. Later that year, the American Academy of Pediatrics (AAP) released a policy statement which suggested that the health benefits of ordinary forms of male circumcision outweigh the risks and costs of the practice. A number of articles have since been published in support and in criticism of the AAP’s report, and the debate continues in these pages, as Steven Svoboda and Robert Van Howe write a critique of the evidentiary basis of the AAP’s report, and the AAP Task Force responds. Finally, the issue was also in the news in Europe, after a controversial German court decision ruled that the circumcision of male infants amounts to grievous bodily harm, and that the practice violates a child’s right to bodily integrity and to self-determination. As legal scholars Merkel and Putzke discuss in this issue, the ruling was later accompanied by a new law enshrining the right to perform circumcisions for religious reasons. Much of the debate so far has focused on the medical benefits and risks of circumcision. Yet at least outside of the USA, the great majority of circumcisions are performed as religious rites in Muslim or Jewish families. For this reason, and in light of the German legal decisions, our call for papers asked authors to also consider the non-medical goods and harms associated with the practice, and its religious and cultural justifications. Joseph Mazor’s feature article takes up that challenge in these pages. While he argues that the risks and benefits of male circumcision are finely balanced in non-religious families, he argues that the practice is justified in religious families by its role in integrating the infant into the religious community. His arguments are challenged not chiefly on principled grounds but primarily on empirical grounds in two commissioned commentaries. David Benatar, one author of perhaps the best-known moral defence of circumcision argues that Mazor overstates the medical downsides of circumcision, while David Lang argues that Mazor understates these risks. Mazor, in his response, concludes that parental choices should prevail as long as reasonable disagreements persist over the balance of scientific evidence on benefits and risks. Matthew Johnson also argues in favour of the idea that religious justifications of circumcision should be given some weight. However, he cautions that the use of such justifications can make religious bodies responsible for any ill-consequences that may result from the operation, and he argues that men who believe that they have been harmed by their circumcision should be able to seek damages against their religious community. On the other side of the aisle, several authors in this month’s issue argue more directly for the impermissibility of male infant circumcision. Medical historian Robert Darby argues that circumcision violates a child’s ‘right to an open future’, while paediatrician Robert Van Howe argues that we ought to abandon the idea that parents have a right to make decisions regarding their children’s welfare in cases where these decisions conflict with the rights and/or best interests of the child. Hanoch Ben-Yami takes a different approach to the evidence and to religious justifications in his brief article. Although he concludes that circumcision is on balance a ‘primitive’ and harmful practice, he argues in favour of a policy of harm minimisation rather than an outright ban. In Ben-Yami’s view, outlawing circumcision might engender racial and religious disharmony, and might also make the practice less safe, resulting in an overall greater level of harm to children and to society at large. Bioethicist Dena Davis also argues that harm reduction measures should be employed. But she points out, controversially, that similar measures might also make certain forms of female genital cutting ethically acceptable and justifiable on religious grounds, and she proposes that we re-open the discussion on female genital cutting. It is our hope that by publishing a diverse range of views on controversial subjects such as these, the ethical debate can be driven forward — not only on the medical justifications of circumcision, but on the cultural, political and religious justifications of one of the most common, yet most contentious medical procedures. <h3>2. Editorial: Julian Savulescu, Male circumcision and the enhancement debate: Harm reduction, not prohibition [Extract]</h3> Around a third of men worldwide are circumcised. It is probably the most commonly performed surgical procedure. Circumcision is also one of the oldest forms of attempted human enhancement. It is and has been done for religious, social, aesthetic and health reasons. Circumcision has a variety of benefits and risks, many of which are discussed in this issue. There is some dispute about the magnitude and likelihood of these benefits and risks. Some argue that the risks outweigh the benefits and circumcision should not be performed on children who are not competent to make their own decisions. If the risks of circumcision clearly outweighed the benefits, great harm has been done and is being done globally through this procedure. Around a third of all men would have been harmed. This is an extraordinary public health injury. Presumably, many would be entitled to compensation. The fact that relatively few people think that the situation is as bad as this indicates that most people implicitly believe that circumcision is not generally a significant harm, if a harm at all. (This is an example of the kind of argument called modus tollens. If p, then q. Not-q, therefore not-p.) One might thus conclude either that: (1) It is not clear from existing evidence whether the risks of properly performed circumcision outweigh the benefits, or vice versa. Or (2) If circumcision is against the interests of an infant or young child, it is only mildly so. In general, people should make their own decisions about body modification and human enhancement when this is possible. Such an approach speaks in favour of waiting until a child becomes an adult to make his or her own decision about circumcision. And procedures which are not clearly in a child’s interests should not be performed on that child. <h3>3. Editorial: Brian Earp, The ethics of infant male circumcision [Extract]</h3> With perspectives in this issue ranging from Joseph Mazor’s articulate defence of infant male circumcision as both morally and legally permissible to J Steven Svoboda’s contention that circumcision is an unambiguous affront to human rights, it is clear that the debate on this issue is far from over. Nevertheless, the overall balance of opinion may be shifting toward one of general scepticism concerning circumcision — even within religious communities. Increasingly, individual Muslim and Jewish thinkers are managing to persuade their fellow faith practitioners that the involuntary ablation of children’s foreskins is unnecessary for contemporary religious observance. This type of intra-religious influence can be traced at least to the famous 19th century debates within the German Jewish community concerning whether or not circumcision was to be performed in the modern era. It continues today with the founding of such groups as Jews Against Circumcision as well as with the establishment of symbolic alternatives to preputial amputation. One such alternative is the non-violent, non-sexist welcoming ceremony known as brit shalom officiated by a growing number of Jewish rabbis. As Dena Davis puts it in the title to her essay, we are dealing with a fundamental incompatibility between what she calls ‘ancient rites’ and ‘new laws.’ How this incompatibility will be addressed, and whether it can be dealt with in a way that ensures not only the coherence and proper functioning of religious communities, but also the well-being and basic rights of the children being raised within their care — only time will tell. <h3>4. Joseph Mazor, The child’s interests and the case for the permissibility of male infant circumcision</h3> ABSTRACT Circumcision of a male child was recently ruled illegal by a court in Germany on the grounds that it violates the child’s rights to bodily integrity and self-determination. This paper begins by challenging the applicability of these rights to the circumcision debate. It argues that, rather than a sweeping appeal to rights, a moral analysis of the practice of circumcision will require a careful examination of the interests of the child. I consider three of these interests in some detail. The first is the interest in avoiding a moderate decrease in expected future sexual pleasure. I argue that even if such a decrease were to occur, it is not wholly unreasonable to think that this might actually be a good thing for the child. Second, I consider the interest in self-determination. I argue that this interest is not as strong as it might appear because the adult’s circumcision decision is subject to a variety of biases and a significant lack of information. Finally, I consider the child’s interest in avoiding the future costs of adult circumcision. I argue that this interest becomes much stronger in the religious case because the child is quite likely to choose to become circumcised as an adult. The likelihood of the child choosing circumcision in the religious case also reduces the extent to which infant circumcision violates his interest in self-determination. I conclude that male infant circumcision falls within the prerogative of parental decision-making in the secular case and even more clearly so in the religious case. Finally, I distinguish male circumcision from female genital cutting in several important respects and argue that we can coherently hold that male circumcision is permissible without also endorsing all forms of female genital cutting. <h3>5. Commentary on Mazor (1): David Lang, Circumcision, sexual dysfunction and the child’s best interests: Why the anatomical details matter</h3> The author raises six objections to Mazor’s argument, the most important of which is that he glosses over the anatomy and physiology of the foreskin and thus ignores the damaging effect of circumcision of sexual function and erotic sensation. Two extracts follow: The author insufficiently explores the profound implications of a serious equivocation in the term ‘circumcision’ that is common throughout the literature. He does superficially reference the article on ‘Circumcision’ in The Jewish Encyclopedia, which describes in detail the actual steps involved in brit milah versus brit periah. Despite this general allusion, though, he hardly discusses the matter further, as though the distinction were practically irrelevant. It does have fundamental import, however. Milah is merely a token clip of the very tip (the overhang flap or akroposthion) of the prepuce, which leaves most of the organ system (including all its essential functions) intact. This was evidently the version practiced in biblical times under the old Abrahamic–Mosaic covenant, before the Talmudic guardians of Judaic ethnic and religious identity proposed (around 150 AD) a means to prevent Hellinising Jewish men from attempting foreskin restoration by stretching their remaining preputial tissue forward. The rabbis mandated the replacement of milah with the more drastic procedure of periah, a radical surgery that cuts and tears from the penis its entire covering, leaving the glans irreversibly denuded. Unlike traditional milah, the innovation of periah necessarily has significant adverse consequences. … Despite the distinctions throughout his paper between ‘rights’ and mere ‘interests’ that can be trumped by parental authority, Mazor cannot circumvent the hard reality of the integral role of the prepuce in normal sexual functioning. Speculative gestures at hazily-considered ‘levels’ of ‘expected pleasure’ (averaged across whole populations of men) fall flat in the face of what is actually known about the foreskin, including its protective, erogenous and functional-mechanical properties. Any parental decision to remove this structure in its healthy state risks numerous adverse consequences for the child—if not by organic harm as an infant, then as a man suffering from iatrogenic sexual dysfunction. <h3>6. Commentary on Mazor (2): David Benatar, Evaluations of circumcision should be circumscribed by the evidence</h3> Benatar objects to Mazor’s analysis and conclusions on the grounds that he exaggerates the harm of circumcision with respect to sexuality and sexual functioning, and underestimates the potential benefits, particularly the evidence from Africa that it may reduce the risk of contracting HIV during unprotected intercourse with an infected female partner. He concludes: “The new evidence does not warrant a stronger conclusion—that parents ought to circumcise their sons or that routine neonatal circumcision should be recommended—but it certainly provides parents with further evidence for counting protection against HIV as a benefit of circumcision. Dr Mazor is correct that we need to attend to such benefits and not dismiss them by appealing to the rights of a child. If circumcision is a net benefit to a child, parents do not violate his rights to bodily integrity or self-determination by circumcising him. Careful attention to (the evidence for) the costs and benefits of circumcision to the child himself is thus essential.” <h3>7. J. Steven Svoboda and Robert Van Howe, Out of step: Fatal flaws in the latest AAP policy report on neonatal circumcision</h3> ABSTRACT The American Academy of Pediatrics recently released a policy statement and technical report on circumcision, in both of which the organisation suggests that the health benefits conferred by the surgical removal of the foreskin in infancy definitively outweigh the risks and complications associated with the procedure. While these new documents do not positively recommend neonatal circumcision, they do paradoxically conclude that its purported benefits ‘justify access to this procedure for families who choose it,’ claiming that whenever and for whatever reason it is performed, it should be covered by government health insurance. The policy statement and technical report suffer from several troubling deficiencies, ultimately undermining their credibility. These deficiencies include the exclusion of important topics and discussions, an incomplete and apparently partisan excursion through the medical literature, improper analysis of the available information, poorly documented and often inaccurate presentation of relevant findings, and conclusions that are not supported by the evidence given. <h3>8. Douglas Diekema, The AAP Task Force on Neonatal Circumcision: a call for respectful dialogue [Reply to Svoboda and Van Howe]</h3> The AAP Task Force was invited to reply to this critique, but ignored the substantive criticisms raised here (as well in the <a href="http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896">letter from European, British and Canadian paediatricians</a>), and confined itself to complaints about being misunderstood and demands for greater respect. To be fair, it must be said that the AAP’s 2010 policy statement does not recommend circumcision, and might well have been announced with the headline: “Circumcision not recommended: AAP policy statement”. A short extract from the full reply follows. The American Academy of Pediatrics (AAP) Task Force on Circumcision published its policy statement and technical report on newborn circumcision in September 2012. Since that time, some individuals and groups have voiced objections to the work of the Task Force, while others have conveyed their support. The AAP task force is pleased that the policy statement and technical reports on circumcision have stimulated debate on this topic and welcomes respectful discussion and dialogue about the scientific and ethical issues that surround neonatal circumcision. We believe this is a complex issue that does not lend itself to simplistic solutions. The Task Force encourages those of all viewpoints to contribute to a vibrant, thoughtful and respectful evidence-based dialogue. We appreciate that the free exchange of competing ideas is a necessary component of scientific discovery. We also recognise that all clinical decisions carry ethical dimensions and that a respectful and thoughtful dialogue about these issues is important. However, the Task Force also feels strongly that this debate and the academic literature are demeaned when those with an ideological agenda disseminate inaccurate information, misapply scientific principles, make accusations that are unsupported, communicate in a vitriolic tone, and attempt to discredit and mischaracterise alternative views and those who hold them. <h3>9. Reinhard Merkel and Holm Putzke, After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault?</h3> ABSTRACT Non-therapeutic circumcision violates boys’ right to bodily integrity as well as to self-determination. There is neither any verifiable medical advantage connected with the intervention nor is it painless nor without significant risks. Possible negative consequences for the psychosexual development of circumcised boys (due to substantial loss of highly erogenous tissue) have not yet been sufficiently explored, but appear to ensue in a significant number of cases. According to standard legal criteria, these considerations would normally entail that the operation be deemed an ‘impermissible risk’ — neither justifiable on grounds of parental rights nor of religious liberty: as with any other freedom right, these end where another person’s body begins. Nevertheless, after a resounding decision by a Cologne district court that non-therapeutic circumcision constitutes bodily assault, the German legislature responded by enacting a new statute expressly designed to permit male circumcision even outside of medical settings. We first criticise the normative foundations upon which such a legal concession seems to rest, and then analyse two major flaws in the new German law which we consider emblematic of the difficulty that any legal attempt to protect medically irrelevant genital cutting is bound to face. <h3>10. Matthew Johnson, Religious circumcision, invasive rites, neutrality and equality: Bearing the burdens and consequences of belief</h3> ABSTRACT The decision of the German regional court in Cologne on 26 June 2012 to prohibit the circumcision of minors is important insofar as it recognises the qualitative similarities between the practice and other prohibited invasive rites, such as female genital cutting. However, recognition of similarity poses serious questions with regard to liberal public policy, specifically with regard to the exceptionalist treatment demanded by certain circumcising groups. In this paper, I seek to advance egalitarian means of dealing with invasive rites which take seriously cultural diversity, minimise harm and place responsibility for the burdens and consequences of beliefs upon those who promote practices. <h3>11. Dena Davis, Ancient rites and new laws: how should we regulate religious circumcision of minors?</h3> ABSTRACT The ancient practice of metzitzah b’peh, direct oral suction, is still practiced by ultra-Orthodox Jews as part of the religious rite of male newborn circumcision. Between 2000 and 2011, 11 children have died in New York and New Jersey, following infection by herpes simplex virus, presumably from infected practitioners. The City responded by requiring signed parental consent before oral suction, with parents being warned of the dangers of the practice. This essay argues that informed consent is not an appropriate response to this problem. An outright ban would a better response to a practice that is dangerous to children, but might prove unconstitutional under New York State law. <h3>12. Hanoch Ben Yami, Circumcision: What should be done?</h3> ABSTRACT I explain why I think that considerations regarding the opposing rights involved in the practice of circumcision—rights of the individual to bodily integrity and rights of the community to practice its religion—would not help us decide on the desirable policy towards this controversial practice. I then suggest a few measures that are not in conflict with either religious or community rights but that can both reduce the harm that circumcision as currently practiced involves and bring about a change in attitude towards the practice, thus further reducing its frequency. These measures are the compulsory administration of anaesthetics; the banning of the metzitzah b’peh; and having an upper age limit of a few months on non-therapeutic circumcision of minors. I conclude with general considerations on why the steps taken towards the reform of circumcision should be moderate. <h3>13. Robert Darby, The child’s right to an open future: Is the principle applicable to non-therapeutic circumcision?</h3> ABSTRACT The principle of the child’s right to an open future was first proposed by the legal philosopher Joel Feinberg and developed further by bioethicist Dena Davis. The principle holds that children possess a unique class of rights called rights in trust—rights that they cannot yet exercise, but which they will be able to exercise when they reach maturity. Parents should not, therefore, take actions that permanently foreclose on or pre-empt the future options of their children, but leave them the greatest possible scope for exercising personal life choices in adulthood. Davis particularly applies the principle to genetic counselling, arguing that parents should not take deliberate steps to create physically abnormal children, and to religion, arguing that while parents are entitled to bring their children up in accordance with their own values, they are not entitled to inflict physical or mental harm, neither by omission nor commission. In this paper, I aim to elucidate the open future principle, and consider whether it is applicable to non-therapeutic circumcision of boys, whether performed for cultural/religious or for prophylactic/health reasons. I argue that the principle is highly applicable to non-therapeutic circumcision, and conclude that non-therapeutic circumcision would be a violation of the child’s right to an open future, and thus objectionable from both an ethical and a human rights perspective. <h3>14. J. Steven Svoboda, Circumcision of male infants as a human rights violation</h3> ABSTRACT Every infant has a right to bodily integrity. Removing healthy tissue from an infant is only permissible if there is an immediate medical indication. In the case of infant male circumcision there is no evidence of an immediate need to perform the procedure. As a German court recently held, any benefit to circumcision can be obtained by delaying the procedure until the male is old enough to give his own fully informed consent. With the option of delaying circumcision providing all of the purported benefits, circumcising an infant is an unnecessary violation of his bodily integrity as well as an ethically invalid form of medical violence. Parental proxy ‘consent’ for newborn circumcision is invalid. Male circumcision also violates four core human rights documents—the Universal Declaration of Human Rights, the Convention on the Rights of the Child, the International Covenant on Civil and Political Rights, and the Convention Against Torture. Social norm theory predicts that once the circumcision rate falls below a critical value, the social norms that currently distort our perception of the practice will dissolve and rates will quickly fall. <h3>15. Robert S. Van Howe, Infant circumcision: The last stand for the dead dogma of parental (sovereignal) rights</h3> ABSTRACT John Stuart Mill used the term ‘dead dogma’ to describe a belief that has gone unquestioned for so long and to such a degree that people have little idea why they accept it or why they continue to believe it. When wives and children were considered chattel, it made sense for the head of a household to have a ‘sovereignal right’ to do as he wished with his property. Now that women and children are considered to have the full complement of human rights and slavery has been abolished, it is no longer acceptable for someone to have a ‘right’ to completely control the life of another human being. Revealingly, parental rights tend to be invoked only when parents want to do something that is arguably not in their child’s best interest. Infant male circumcision is a case in point. Instead of parental rights, I claim that parents have an obligation to protect their children’s rights as well as to preserve the future options of those children so far as possible. In this essay, it is argued that the notion that parents have a right to make decisions concerning their children’s bodies and minds—irrespective of the child’s best interests—is a dead dogma. The ramifications of this argument for the circumcision debate are then spelled out and discussed. Source: <a href="http://jme.bmj.com/">Journal of Medical Ethics, Vol 39 (7), July 2013</a> Abstracts available for free; full articles may be purchased or accessed through a subscribing library See also: <a href="https://www.circinfo.org/Circumcision_and_human_rights.html">Circumcision: A medical or a human rights question?</a> <h2>Is circumcision of male infants ethnically permissible? Further response to Mazor</h2> Following the special issue of the Journal of Medical Ethics special issue on circumcision, the Jewish film maker Eliyahu Ungar-Sargon has published a detailed, courteous but hard-hitting critique of the arguments advanced by Joseph Mazor. His conclusion is as follows: “While Dr Mazor’s argument at first glance appears to be somewhat compelling, upon closer examination it really falls apart. As I’ve sought to demonstrate above, he doesn’t actually prove that bodily integrity and self-determination are mere interests in the case of infant circumcision. Moreover, there are serious problems with the manner in which he weighs the various conflicting interests to arrive at his conclusions. Parenting is an ethical minefield and I’m willing to concede that under certain circumstances the child’s rights to bodily integrity and self-determination can be overridden. But nothing in Mazor’s argument convinces me that being born male is a sufficiently compelling circumstance to justify infant circumcision." ABSTRACT This is a response to Dr Joseph Mazor’s paper “The child’s interests and the case for the permissibility of male infant circumcision.” I argue that Dr Mazor fails to prove that bodily integrity and self-determination are mere interests as opposed to genuine rights in the case of infant male circumcision. Moreover, I cast doubt on the interest calculus that Dr Mazor employs to arrive at his conclusions about circumcision. Source: Eliyahu Ungar-Sargon. <a href="https://dx.doi.org/10.1136/medethics-2013-101598">On the impermissibility of infant male circumcision: A response to Mazor</a>. Journal of Medical Ethics, on-line first, 6 September 2013 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Circumcision under the spotlight in medical ethics journal darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>American Academy of Pediatrics experts fail to defend circumcision</h3> The Twentieth Pitts Lectureship in Medical Ethics at the Medical University of South Carolina in Charleston, South Carolina, held on 18-19 October 2013, was the scene of an epoch-making confrontation between advocates of genital integrity and supporters of routine infant circumcision. On the pro-circumcision side were Drs Michael Brady and Douglas Diekema, members of the American Academy of Pediatrics (AAP) <a href="https://www.circinfo.org/United_States_circumcision_policy.html">Task Force on Circumcision</a>. Arguing for genital integrity were J. Steven Svoboda from <a href="http://www.arclaw.org/">Attorneys for the Rights of the Child</a>, supported by ARC Legal Advisor Peter Adler, community activist Aubrey Taylor, and her husband, Angel Alonso Terron. In the following personal report, Steven Svoboda takes up the story. Brady was my opponent in the debate about whether circumcision is legal and ethical. Diekema, despite initial claims of objectivity, joined with Brady as a proponent of circumcision. Brady gave a presentation on Friday, October 18, 2013 that closely tracked his PowerPoint. My response followed. Our PowerPoint was by that point persuasive enough that, as they each personally told me later, two of the five physician presenters who are not AAP Task Force members were completely convinced by our arguments and went from being pretty strongly pro-circumcision prior to the event to coming to oppose the procedure based on our arguments. (This also is a good testament to the open-mindedness and objectivity of these doctors.) Following my presentation was a scheduled 45-minute debate between Dr. Brady and me. We each got our blows in, but it quickly became clear that Brady was unaware of recent political developments and pertinent medical studies. On Saturday, we were each allowed five minutes to summarize our views. After I spoke for the full five minutes, Dr. Brady was unable to effectively rebut any of my points, speaking for just over a minute in an effective concession of defeat. Brady referred to me in his short talk as “Dr, er excuse me, Mr Svoboda.” On Friday, Dr. Brady had audibly complained about how the organizers had allowed “non-physician presenters” to speak, of which I was the only one. On Saturday, October 19, after each presenter spoke, an open discussion ensued amongst all eight panelists for about 2.5 hours, the last half of which was focused on male circumcision. Peter, Aubrey, and Angel each made very powerful and effective points that helped move the discussion further in our direction. Aubrey and Angel also videotaped, as I had arranged with the conference organizers, all conference proceedings on Friday, and were supposed to record Saturday as well but some presenters asked that no recording be done on Saturday and this was agreed to without informing me of the change. Peter, Aubrey, Angel and I were able to drive home over quite a few key points, such as uncertainty about the effectiveness of circumcision in reducing the risk of heterosexually acquired HIV. Even the AAP is calling for further studies regarding the connection (if any) between male circumcision and HIV, and eminent scholar Michel Garenne says you need a condom even if you are circumcised. In that case, what’s the point of circumcision. Aubrey offered a great analysis of how Dr. Brady was treating a healthy body part as if it were a tumor, thus pathologizing normal, functional tissue. Dr. Brady said in his PowerPoint: If the benefits can’t be clearly shown to outweigh problems, then circumcision should not be done. I argued, does not the fact that 38 eminent physicians (37 of whom are in Europe) say in the AAP’s own journal that we should not do it in itself cast sufficient doubt that the practice should be stopped? As I asked near the end of the event, “If circumcision is so great why doesn’t the AAP recommend it? I would think the AAP would be taking out ads in the New York Times to say that everybody should get circumcised. Why the weird balancing act in which the AAP says that circumcision is not recommended but that Medicaid should cover it?” Angel asked if people present could explain the functions of the foreskin and no one answered it, including Brady and Diekema. Brady said, “I don't think anybody knows the functions of the foreskin,” then reiterated, in nearly identical words, “Nobody knows the functions of the foreskin.” I noted that there was not a word about the functions of the foreskin in the 2012 AAP report, and asked, shouldn’t we know something about the functions of the healthy body part that is being removed? One amusing aspect: Diekema criticized me on Friday for allegedly being unfair in emphasizing a sentence where the AAP admits that circumcision complication rates are unknown. So the next day, in my five minutes, I read three sentences from that same passage in full, quoting directly from the AAP report, and pointing out several other interesting points contained therein. Here's what I read: “The true incidence of complications after newborn circumcision is unknown, in part due to differing definitions of ‘complication’ and differing standards for determining the timing of when a complication has occurred (ie, early or late). Adding to the confusion is the commingling of ‘early’ complications, such as bleeding or infection, with ‘late’ complications such as adhesions and meatal stenosis. Also, complication rates after an in-hospital procedure with trained personnel may be far different from those of the developing world and/or by untrained ritual providers.” I then pointed out all the doubt and uncertainty contained therein: Confusion, complication rates differing, differing definitions, differing standards, unknown incidence. After all this, Diekema alleged in his five minutes that I was still quoting selectively. The audience saw through all of this eventually. An African woman was smiling at Aubrey toward the end and the whole row of audience members were clearly on her side. Angel and Aubrey and Peter each was awesome. Aubrey had this brilliant time in the sun where she was allowed to speak for over five minutes and through the whole issue into a new light in a brilliant way by developing the detailed analysis I mentioned of the pathologization of healthy tissue. Angel talked about his own experience being an intact man and no one could argue with that. The circumcision advocates tried to blame female genital cutting on patriarchy and argued that if male circumcision was bad, men who have all the power under patriarchy, would have stopped it long ago. In reply to this, Angel talked about male denial and about Sparta, an extremely patriarchal society where men faced extreme oppression, proving that society-wide male oppression can and does exist, even under patriarchy. [In patriarchal societies, it is the young men and boys who are oppressed by the old men, and who must typically endure painful initiation rituals in order to be able to graduate to adult status and enjoy adult privileges, such as access to women. It is not adult men who are subjected to circumcision in patriarchal societies, but infants or boys.] I was able to cite those “well-known anti-circumcision groups” the United Nations, the Council of Europe, and the other European organizations that I didn’t fit into my PowerPoint on Friday. The circumcision advocates could not say much about that, except to offer the response that I was just citing individuals, not all of Europe. Diekema accused me of oversimplifying, and I responded that no, these issues are incredibly complex and I wasn’t oversimplifying anything. Rather, I used the word “Europe” to describe the location of several countries that have recently found non-therapeutic circumcision of children to be illegal. Then Diekema said that those are only physicians’ groups, and hence not all physicians, and that I was oversimplifying again. This weak argument essentially refuted itself. After we effectively prevailed in Saturday’s panel, Brady responded by claiming that he had inside information that both “Australia” (presumably the Royal Australasian College of Physicians) and Canada are about to issue position statements echoing that of the AAP. No evidence was presented, however, and one may be forgiven for suspecting that perhaps no such evidence exists. Overall, this debate was personally perhaps the single most gratifying experience I have had in my nearly two decades as a promoter of genital integrity. Papers arising from the conference will be published in a special issue of the Journal of Law, Ethics and Medicine next year. </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Charleston bioethics debate highlights harm of circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h2>German court rules non-therapeutic circumcision of boys unlawful</h2> Hot on the heels of a resolution of the Finnish Greens that non-therapeutic circumcision of children should be prohibited, a district court in Cologne, Germany, has ruled that non-therapeutic circumcision of children, even when performed for religious reasons at the request of a boy’s parents, is unlawful, and that those responsible are guilty of inflicting bodily harm. The case arose from a 4-year old boy circumcised by an Islamic doctor who later suffered severe bleeding requiring emergency medical care. The case has far-reaching implications for the future of medically unnecessary circumcision of minors and the human rights of children. The following article is translated from the German newspaper, Financial Times. German court: Religiously motivated circumcision is unlawful A judgment of the District Court of Cologne [refers to] a widespread medical intervention carried out for religious reasons. According to this judgement, (non-therapeutic) circumcision of boys will in future be regarded as personal injury. Those who circumcise boys for religious reasons make themselves liable to prosecution for assault causing bodily injury. This is the decision of the Cologne regional court, in a landmark ruling that has come to the attention of the Financial Times Germany. In its judgment, the Court made it clear that neither the rights of the parents nor the freedom of religion guaranteed in the basic law can justify this intervention. Thus, for the first time a German court places circumcision as a religious custom under the threat of penalty. Each year, several thousand boys in their first years of life are circumcised in Germany at the request of the parents. In the United States, even the majority of all boys are circumcised largely independently of religion directly after birth. Massive resistance to this practice has now developed. Worldwide around a quarter of all men are circumcised. For decades doctors in Germany operated in a legal grey area when they circumcised boys for purely religious reasons, without medical necessity. Up till now, however, they could rely on the claim that they did not know that religiously-motivated circumcision was unlawful. Even if a court accepted that there had been personal injury, the doctor would be acquitted because of legal technicalities. The Cologne decision has now eliminated this possibility. Holm Putzke from the University of Passau said “The decision is extremely important especially for doctors because they have legal certainty now for the first time.” The legal expert has called for an explicit prohibition of non-therapeutic circumcision for years. “In the past courts – like politicians – have been afraid to act out of fear of being accused of anti-semitism and hostility to religion”, said Putzke. “This decision could influence not only future case law, but lead to a change of consciousness and greater respect for the fundamental rights of children.” Muslim and Jewish organizations have so far rejected suggestions that circumcision of children is unlawful. They regard a ban as “serious interference with the right to the free exercise of religion”. They did not respond immediately to requests for comment on the Cologne court’s decision, but wanted time to consider the judgment. The judgment is likely to provoke discussions. For years struggle politicians and welfare associations have struggled to improve the integration of the Muslim population. In 2006 Wolfgang Schäuble, as Minister for the Interior, convened an Islamic Conference on his own initiative. The former German President Christian Wulff said: “Islam belongs to Germany.” His successor Joachim Gauck also commented: “Muslims who live here are part of Germany." Some Muslims are now likely to regard the Cologne decision as a step backwards. Experts assume that more cases like this will come before the courts. Eventually the question could be settled by specific regulations governing religiously motivated circumcision issued by the Federal Constitutional Court. In the Cologne case, a Muslim physician circumcised a four-year old boy at the request of the parents. Two days later he suffered severe haemorrhage, and the mother brought the boy in for emergency medical care. The public prosecutor’s office was informed of this and pressed charges against the circumciser. After the medical legal tribunal ruled the procedure to be legal the prosecutor lodged an appeal. As a result of this, the Court assessed the circumcision as “serious and irreversible impairment of physical integrity”. Source: Matthias Ruch, <a href="http://www.ftd.de/politik/deutschland/%3Akoerperverletzung-gericht-stellt-religioese-beschneidung-unter-strafe/70054618.html">Court: religious circumcision is punishable</a>, Financial Times (Germany), 25 June 2012 <h3>Circumcision of boys “an assault”: Melbourne Age</h3> The following report of the decision was published in the Melbourne Age. A GERMAN court has ruled that circumcising young boys represents grievous bodily harm, a decision that could have significant repercussions for religious groups. The president of the Central Council of Jews in Germany condemned the decision by the regional court in Cologne as '”an unprecedented and dramatic intrusion on the self-determination of religious communities” and called on the German parliament to pass legislation protecting circumcision as a religious practice. The case centred on a four-year-old boy whose Muslim parents had him circumcised by a doctor, which led to medical complications. Advertisement: Story continues below. The doctor was charged with grievous bodily harm but acquitted by a lower court, which judged he had acted within the law as the parents had given their consent. On appeal, the regional court also acquitted the doctor, but for different reasons. It upheld the original charge of grievous bodily harm, but ruled that the doctor was innocent as there was too much confusion on the legal situation. Although Muslims and Jews circumcise infant boys as a religious practice and many other people do so for health reasons, the court found that the child's “fundamental right to bodily integrity” was more important than the parents’ rights. “The body of the child is irreparably and permanently changed by a circumcision,” it said. ''This change contravenes the interests of the child to decide later on his religious beliefs.” According to the court, the religious freedom “would not be unduly impaired”, because the child could later decide whether to have the circumcision. Germany has no law against male circumcision, as there is against female genital cutting. Experts said the decision would not be enforceable in other jurisdictions. But the legal uncertainty and threat of prosecution could lead doctors to decline to perform the procedure. Holm Putzke, a criminal law expert at the University of Passau, said the ruling was not binding for other courts, but could send a welcome signal. “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate,” he told the German news agency DPA. Source: <a href="http://www.theage.com.au/world/circumcision-on-boys-assault-court-rules-20120627-212rw.html">Circumcision on boys assault, court rules</a>, The Age (Melbourne) 28 June 2012 <h3>Court ruling on circumcision is final: German legal expert</h3> The following analysis of the Cologne court ruling by the German legal expert <a href="http://www.holmputzke.de/">Dr Holm Putzke</a>, professor of law at <a href="http://www.jura.uni-passau.de/">University of Passau</a>, was published as an interview in German Turkish News, 26 June 2012. An edited English translation follows Opinion: Doctors should refuse to perform religious circumcision The District Court of Cologne has recently ruled that the circumcision of boys, even for religious reasons, shall henceforth be considered a crime. ... Criminal law professor Dr. Holm Putzke of the University of Passau evaluates the judgment in an interview for the German Turkish News. For him, the ruling is an appeal to parents to deliberate whether such interventions are really necessary. German Turkish News: How do you interpret the ruling of the Cologne Court? Is this a landmark decision? Holm Putzke: Although the Cologne District Court generally follows prevailing opinion in the legal and medical literature, this ruling does represent an important turning point. For the first time, a court has declared – no ifs and/or buts about it – that medically unnecessary circumcision on non-consenting boys is illegal, and in fact is punishable by law. Prior to this decision, the legal situation was unclear for lack of a clear judicial decision. ... German Turkish News: Could you say it's a specific feature of Western democratic societies that the legal right to physical integrity is trumps the right to religious freedom? Holm Putzke: There’s no blanket answer to that. Protecting religious freedom is important and necessary, just as it’s essential to protect the physical safety of persons, especially children. It would be a queer understanding of religious freedom if religions were simply allowed to physically injure people in the name of their faith and thereby circumvent the prevailing statutory laws of German society. ... German Turkish News: What does this ruling now mean for doctors? Should doctors basically refuse to perform circumcisions for religious reasons? Holm Putzke: Two Munich doctors, Maximilian Stehr and HansGeorg Dietz, collaborated with me on an article in 2008 that was published in the German Medical Journal regarding the criminalization of religious circumcisions on boys. Since then, more and more doctors have refused to participate in medically unnecessary circumcisions of non-consenting boys. This is primarily because the surgery carries risks, and confers absolutely no health benefits in childhood. After the Cologne ruling, doctors can now be threatened with criminal prosecution, and without going into too much detail, the inherent illegality – of the act of circumcising boys who don’t need it – will likely impact doctors’ liability insurance. If doctors are presented with a request to perform a religiously-motivated circumcision, they would do well to advise the parents of the legal situation in this country, as well as the risks of surgery itself, and refuse to perform the surgery. At the same time, doctors should clearly point out that circumcision should be postponed until the individual in question can decide about the procedure himself. German Turkish News: What message does this ruling send to the religious communities? Holm Putzke: The message is: Think about, really reflect, whether it is really necessary to put a small, often utterly frightened boy through surgery that has no medical necessity and that carries risks, or whether you can hold off on this or opt for some other ritual that symbolically fulfils the religious intent. ... German Turkish News: Do you expect there to be an appeal? Holm Putzke: This was already an appellate decision. Since the state bar apparently has decided not to consider any further appeals, the judgment is final. There is no way to challenge this ruling. This message is especially true for individuals or organizations that might viscerally attack this decision just to declare their outrage and disgust. German Turkish News: Do you expect more lawsuits because of similar incidents? Holm Putzke: I won't hazard an answer. Conceivably a storm of indignation from religious groups might initially discourage other prosecutors from bringing such cases. But in the long run the solid arguments will prevail. And those arguments pretty clearly now say that children should not have their genitals forcibly violated. Rather, they can make a decision at an appropriate age about whether they want it or not. Prof. Dr. Holm Putzke, LL.M. teaches Criminal Law at the University of Passau. Since the 2008 publication of his essay "The Criminal Relevance of Circumcision of Boys," he has made many other contributions to the subject and has participated in the public debate on the criminalization of circumcision of minors that is not medically indicated. Source: <a href="http://www.deutsch-tuerkische-nachrichten.de/2012/06/455709/nach-urteil-%E2%80%9Eaerzte-sollten-religioese-beschneidung-ablehnen%E2%80%9C/">DeutschTurkischeNachrichten, 26 June 2012</a> <h3>Implications of German circumcision decision for Britain (and Australia?)</h3> Dr John Warren’s letter to The Times Doctors throughout Europe, where there is no tradition of infant male circumcision in medical practice, have been faced in recent years by an increasing demand for this service, due to the immigration of families from other parts of the world where male circumcision has been a cultural norm. There is confusion over how to respond to this demand, both among the medical and also the legal professions. The ruling in Germany, reported in The Times on 28 June, illustrates this problem. In this case a state court ruled that circumcision on non-medical grounds of a child amounted to grievous bodily harm. In The Netherlands, the Royal Dutch Medical Association has issued a report stating that non-therapeutic circumcision of underage boys amounts to a violation of a child’s physical integrity, and so contravenes Article 8 of the European Convention of Human Rights and Article 11 of the Dutch constitution. In Norway, the Centre Party has proposed an outright ban on non-therapeutic male circumcision of under-age boys, provoking a heated debate. Here in the UK , there has so far been little debate, despite the fact that large numbers of boys are being circumcised for non-therapeutic reasons, some within the NHS, some in private clinics, and some by non-medically qualified operators. It is impossible to determine accurately how many. However, the medical literature shows a complication rate of anywhere between 2 and 20%. These do not include late problems discovered by adult men who were circumcised as infants, and our records at NORM-UK include many examples of both physical and psychological problems that appear to result from this operation. Earlier this month (June) the Westminster coroner gave a verdict of accidental death in the case of a one month old baby boy who died of haemorrhage from his wound two days after circumcision. The General Medical Council does not have a position on the issue of non-therapeutic male circumcision of children. It states: We do not have general authority to determine public policy on issues that arise within medical practice – these are matters for society as a whole to determine, through the parliamentary process. There are four principles of medical ethics: autonomy, beneficence, non-maleficence and justice. Clearly a child’s autonomy is breached by a non-therapeutic procedure permanently altering his anatomy. Regarding beneficence, no medical organisation in the world recommends routine infant circumcision for health reasons. Non-maleficence refers to not doing harm; the possibility of complications mentioned above shows that there is considerable potential for harm from this procedure. Justice asks the question ‘is it fair?’ Would you do the same to a girl? Would you do the same to an adult male without his consent, that is tie him down and forcibly remove his foreskin, possibly without anaesthesia? In my view the UK needs a debate involving doctors, lawyers, ethicists, politicians, representatives of religions and the wider public on the subject of non-therapeutic circumcision of underage boys. And the General Medical Council should consider coming off the fence and consider carefully whether its lack of position on this topic is consistent with its role: to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. Dr John Warren Chairman NORM-UK This letter was sent to The Times (London), but not published. <h3>Professor Holm Putzke’s interview with Bavarian Radio</h3> “Protection from violence is more important than religious rites” Because of an article four years ago, he finds himself now seriously threatened: Professor Holm Putzke of the University of Passau speaks out against the circumcision of boys. The recent judgment of the District Court in Cologne rests on his findings. “It’s really a question of postponing a religious act,” he explains in an interview with Bavarian Radio. BR.de: How do you view the judgment of the District Court in Cologne? Holm Putzke: The judgment of the District Court in Cologne is correct. The court came to its conclusion, after an intensive analysis of the jurisprudential debate, that religious freedom ends where physical safety of children is irreparably impacted, in this case due to unnecessary and risky surgical procedures. It should be self-evident that we simply don't allow this in a society that emphasizes the protection of children from forceful or violent acts. The verdict The District Court in Cologne determined that the circumcision of a minor boy for religious reasons in June 2012 was an injury. The judges argued that religious circumcision is a permanent and irreversible intrusion on the child. Jewish and Muslim groups criticized the decision as impermissible encroachment on the freedom of religion. BR.de: What significance does it have? Holm Putzke: It’s a brave decision, because the wave of indignation was predictable and the climate of discussion almost always suffers when it comes to any criticism of religion. Despite the this ruling being non-binding on other courts or prosecutors, the ruling could send a signal and - more importantly - finally lead to a long-overdue public discussion. BR.de: Isn’t this a very western, and therefore one-sided, view of things? Holm Putzke: It's not actually a one-sided view of things, because the court doesn’t simply make an assertion. Rather, it reaches a judgment after a careful weighing of the constitutionally protected rights to self-determination and bodily integrity against the parents’ right to free exercise of religion. You also can't really say this is a “typically western” view, since in other parts of the world enlightened people are thinking the same way. BR.de: What does the ruling now mean for doctors? Should they decline to do circumcisions for religious reasons? Holm Putzke: The risk of doctors being held criminally liable in case of complications, or losing their insurance coverage, is now elevated. However, as a doctor I wouldn't simply decline to do these circumcisions because they’re religiously-motivated, but rather because performing medically unnecessary surgery on children who can not defend themselves is ethically incompatible with the medical profession. BR.de: What message do the court judgment and your legal commentaries send to the religious communities? Holm Putzke: The point of my early 2008 article, dealing with legal culpability in the religious circumcision of boys, was not to criminalize doctors and parents, or really even religious groups. Rather, I was hoping that a broad public debate might get underway about how much religiously motivated violence against children is tolerable. Neither the judgment nor the overall viewpoint it favors prevents anyone from exercising their religion. It’s not about discrimination against religious groups or the total prevention of religious practice; it's really just about postponing a religious act. BR.de: Is this whole thing a typical German debate? How do you think this topic will be handled in Europe and globally? Holm Putzke: In other countries, especially in the United States, there has been a strong movement for decades that criticizes medically unnecessary circumcision on non-consenting children as unethical. Even Israel has seen intense debate over whether religious circumcision of children is ethically justifiable. I have received numerous letters from Israel, where parents have told me that despite their ongoing religious affiliation to Judaism they've abstained from infant circumcision, and prefer to wait until their child is able to make his own independent decision about it. So it seems that if it’s supposed to always be the case, as the Central Council of Jews here in Germany claims, that infant religious circumcision remains essential and indisputable in Judaism... then they're really only telling half the story. BR.de: There’s a good chance you’re going to be reviled and threatened over this ruling. How do you plan to handle it? [Threats to Professor Putzke have included drowning and forcible circumcision.] Holm Putzke: It would be naive to think that my critiques, and the skeptical views of what is by now the majority in the medical and law professions, will only be discussed in a rational, calm and composed manner. Any criticism of religion has always triggered emotional reactions. Insults and threats don’t bother me really, if for no other reason than some people are simply hiding behind them when they can't express their displeasure any differently. Good arguments, however, are much more likely to impress me. Source: <a href="http://www.br.de/themen/aktuell/inhalt/interview-beschneidung-putzke100.html">Bayrische Rundfunk, 29 June 2012</a> <h3>Information on Professor Putzke</h3> <a href="http://www.holmputzke.de/" rel="noopener" target="_blank">Homepage</a> Publications Zirkumzision bei nicht einwilligungsfähigen Jungen: strafrechtliche Konsequenzen auch bei religiöser Begründung; in: Deutsches Ärzteblatt 2008, A 1778–1780 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) <a href="http://www.aerzteblatt.de/archiv/61273">Full text here (in German)</a> Strafbarkeit der Zirkumzision von Jungen. Medizinrechtliche Aspekte eines umstrittenen ärztlichen Eingriffs (Liability to penalty for circumcision in boys. Medico-legal aspects of a controversial medical intervention); in: Monatsschrift Kinderheilkunde 8/2008, S. 783–788 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) <a href="http://www.holmputzke.de/images/stories/pdf2008_mschr_kinderheilkunde_zirkumzision.pdf">Full text (PDF) here (in German)</a> ABSTRACT in ENGLISH Often (pediatric) surgeons or (pediatric) urologists have to face the request for circumcision of a minor male by persons having the care and custody in absence of a medical indication. This review points out the imperative of refraining from such a procedure to avoid being a possible addressee of a claim according to civil law or even being accused in a lawsuit later. The attending physician who performs the circumcision without medical indication on a minor male, incurs a penalty according to § 223 para. 1 German Criminal Code, even though the person having the custody of the child signed the informed consent to that procedure. Lacking the cognizance of disposition about the legally protected interest of the child (physical inviolability), the consent is namely not effective. In this article not only the german current legal status is demonstrated, but arguments for the legitimacy of a male circumcision (treatment of phimosis, prevention of different diseases, religious aspects) are discussed. <h3>“Physical integrity is of the highest value”:</h3> <h2> <a id="maxim" name="maxim"></a>Circumcision requires consent of the individual</h2> The following interview with Munich paediatric surgeon Maximilian Stehr appeared in Deutsche Welle, 17 July 2012 Children have to be old enough to give their consent to a religious circumcision, says leading pediatrician Maximilian Stehr. But the law does not need to be changed. Maximilian Stehr is a pediatric surgeon at the University Hospital in Munich and chair of the working group on pediatric urology at the Germany Association for Pediatric Surgery. DW: What has been the effect as far as pediatricians are concerned of the ruling by the court in Cologne regarding the religious circumcision of boys who are not yet able to give informed consent? Maximilian Stehr: To start with, one should note that this ruling has not changed the law, it has merely interpreted existing law and applied it. There has of course been an effect on colleagues working in the field of pediatric surgery and urology in that the ruling has led to a public discussion, and, should similar charges be brought against a doctor in future, it will not be possible to argue [as in this case] that the doctor could not be expected to know that his actions were illegal. I know of many doctors who are currently not carrying out any circumcisions of boys who are not able to give informed consent. What is your advice to doctors who ask whether they should carry out this operation? I've always given the same advice, even before this ruling. I've always held the view that this medical intervention cannot be regarded as conforming to current law or current medical ethics. And so I continue to advise doctors not to carry out this operation; instead, if religiously-motivated circumcision is to be carried out, it should only be carried out at an age when the child or the young person is able to permit it himself or at least consent to it. Would you see the issue of the inability of the child to give its consent as a bigger issue than that of the child's physical integrity? I don't think you can separate the two. Physical integrity is certainly the highest value. That goes without question. There are certainly medical conditions and situations in which people want to decide for themselves that they would like to change something about their body. That is standard procedure in cosmetic surgery - it's the same in pediatric surgery, for example, when we correct protruding ears. For that, the child has to be able to judge for itself the seriousness of the operation, as well as its risks and side-effects, and that is only possible when the child is 14 or 16 years old. How far is this an issue of medical ethics? Medical ethics is very closely related to the Hippocratic Oath. All our actions as doctors must work towards healing and towards the benefit of the patient to the best of our knowledge and conscience. A further principle is never to cause any harm. Both these principles are imperiled when one carries out the circumcision of a boy who is unable to give consent. That means it's an unnecessary operation? It is an unnecessary operation. All the benefits which are said to come from circumcision, some of which are certainly valid - for example, concerning sexual infections or penile cancer or the development of tumors - are all reasons which argue for circumcision as a possible preventative measure - but not at this age. The German government wants to find a speedy solution to the problem, and it has hinted that it plans to introduce a law which will continue to permit religious circumcision. Would you consider that any solution must include restrictions as to age? I don't see any reason to pass a new law - one just has to apply existing law and existing medical ethics. There's no need for anything else. Then you come to the situation we have at the moment, that, if one wants to carry out such an operation which has no medical justification, it requires the consent of the patient. I would find extremely dangerous if there were to be a special law to permit such an operation to be carried out on, for example, Jewish children. That would go entirely against the principle of equal treatment. One could then certainly argue that this in itself would be discrimination. Currently, though, it's the case that the parents can decide, since they have legal custody. The legal custody of the parents only allows decisions which are clearly for the benefit of the child. That's why I consider this medical intervention to be illegal. It can only be dealt with if the religious communities can agree that the operation can be delayed until the child is old enough to decide for itself or to give its consent. There has to be a compromise, but I don't see any compromise possible which involves special laws for specific religious communities or other groups. That would go against the principle of equal treatment and would backfire in the end. Source: <a href="http://www.dw.de/dw/article/0,,16101556,00.html">Wait until later, say paediatricians</a>, by Dagmar Breitenbach and Joanna Impey, Deutsche Welle, 17 July 2012 <h3>Further discussion of Cologne court circumcision judgement</h3> Brian Earp, <a href="http://blog.practicalethics.ox.ac.uk/2012/06/religion-is-no-excuse-for-mutilating-your-babys-penis/">Religion is no excuse for mutilating your baby’s penis</a>, Practical Ethics Blog, 28 June 2012 Andrew Sullivan, <a href="http://andrewsullivan.thedailybeast.com/2012/06/germany-bans-circumcision.html">Cologne decision a victory for religious freedom</a>, Daily Beast, 27 June 2012 Kerre Woodham, <a href="http://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=10816649">Spare the children</a>, New Zealand Herald, 1 July 2012 <a href="http://intactnews.org/" rel="noopener" target="_blank">Humanistic Judaism increasingly critical of child circumcision</a>, IntactNews, 30 June 2012 Jewish Journalist Larry Derfner, <a href="http://972mag.com/stand-up-for-your-son-say-no-to-ritual-circumcision/49669">Stand up for your son: Say ‘no’ to ritual circumcision</a>, 972Mag, 29 June 2012 Robert Darby, <a href="http://www.onlineopinion.com.au/view.asp?article=13841">Non-therapeutic circumcision of minors: A legal and ethical minefield</a>, On-Line Opinion, 9 July 2012 <a href="http://www.openforum.com.au/content/should-circumcision-be-illegal" rel="noopener" target="_blank">Open slather, illegal or regulated: The new debate on male circumcision</a>, Open Forum, 16 July 2012 Dr Maximilian Stehr, <a href="http://www.spiegel.de/international/germany/commentary-circumcision-without-medical-justification-is-wrong-a-846395.html">Circumcision without medical necessity is wrong</a>, Spiegel International, 26 July 2012 <a href="http://www.circumstitions.com/news/news47.html#germany-illegal25" rel="noopener" target="_blank">Turkish-German politician supports circumcision restriction</a> (“Boys should decide at age 14”), TagesZeitung magazine, Berlin, 26 July 2012 Kenneth Houston, <a href="http://www.irishtimes.com/newspaper/opinion/2012/0731/1224321157056.html">Male genital mutilation a gross breach of baby's bodily integrit</a>y, Irish Times, 31 July 2012. <a href="http://ethxblog.blogspot.co.nz/2012/07/against-male-cicumcision-for-religious.html" rel="noopener" target="_blank">Against male circumcision on religious or cultural grounds</a>, Udo Schuklenk's Ethx Blog, 31 July 2012 Anthony Levin, <a href="http://www.thepunch.com.au/articles/we-must-bring-religion-in-on-the-push-to-ban-circumcision/?from=scroller&pos=3&referrer=article&link=text">We must bring religion in on the push to ban circumcision</a>, The Punch, 8 August 2012 <a href="http://pro-kinderrechte.de/faq-english/" rel="noopener" target="_blank">Pro-Kinderrechte - In favour of the rights of children</a> (in German; FAQ in English) Toby Lichtig, <a href="http://newhumanist.org.uk/2856/circumcision-time-to-cut-it-out">Circumcision: Time to cut it out?</a> New Humanist, Sept/Oct 2012 Brian D. Earp and Robert Darby, <a href="http://theconversation.edu.au/tradition-vs-individual-rights-the-current-debate-on-circumcision-10199">Tradition vs individual rights: The current debate on circumcision</a>, The Conversation, 2 November 2012 The Cologne decision has generated immense debate, especially in Europe, and new developments and commentary appear too fast to record. To keep up to date, check out the news pages of <a href="http://www.circumstitions.com/">Circumstitions.com</a> and <a href="http://circumstitionsnews.blogspot.co.nz/">Circumcision News Blogspot</a> <h2>German circumcision law shows political opportunism, not ethical principle</h2> In the wake of the Cologne court’s decision that non-therapeutic circumcision of minors constituted bodily harm and a violation of the child’s physical integrity and religious freedom and was thus unlawful, the German parliament passed a law clarifying the legality of circumcision. In an article published in the international journal Bioethics, Diana Aurenque and Urban Wiesing argue that the law was a response to political lobbying and ignored accepted principles of human rights and bioethics. Assessing the balance of benefits and harms from circumcision, the authors conclude that circumcision provides no benefits to the child as a child, but only risks and harms. ABSTRACT: The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the ‘child as a child’ and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany’s unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues – as in the case of religious circumcision. Diana Aurenque and Urban Wiesing, German law on circumcision and its debate: How an ethical And legal issue turned political. <a href="http://onlinelibrary.wiley.com/doi/10.1111/bioe.12077/abstract">Bioethics, early view, 23 December 2013</a>. See also the <a href="https://www.circinfo.org/Journal_of_medical_ethics_July13.html">article by Reinhard Merkel and Holm Putzke</a> in the July 2013 edition of the Journal of Medical Ethics. <h2>Finland: Parents’ power vs rights of the child</h2> Meanwhile in Finland there is a growing gulf between legal regulators, who want to tolerate minority cultural practices, and doctors and bioethical experts who consider circumcision of boys to be genital mutilation, no different in ethical and moral terms from female genital mutilation. Recently the Finland Greens passed a resolution that all non-therapeutic circumcision of minors should be stopped. The following commentary is from a Helsinki newspaper. The issue of circumcisions performed on boys for religious and cultural reasons has reached a stage in Finland in which it is difficult to find a solution that is acceptable to all. The Green League voted in favour of a resolution at its party congress a week ago that such procedures should be phased out in Finland either through advice or, if necessary, through legislation. Finns Party MP Vesa-Matti Sarakkala submitted a legislative initiative in Parliament calling for an outright ban on circumcisions. Earlier in the spring the issue was also taken up by Minister of Justice Anna-Maja Henriksson (Swed. People’s Party). In her view, the procedures should be permitted, but legislation, or at least guidelines from the ministerial level are needed on who may perform the circumcisions and under what circumstances. There are problems involved in both permitting and prohibiting the operations, but there are also problems involved in the Finnish status quo, which has no specific legislation to back it up. It is estimated that hundreds of non-medical circumcisions are performed on boys each year, but the circumstances under which they might be permitted, and when they would be classified as criminal assault are unclear. A basic guideline has been the decision handed down by the Supreme Court in 2008, in which the religiously motivated circumcision performed on a Muslim boy was not considered a crime, as it was performed in a medically sound manner. The decision has been interpreted in such a way that non-medical circumcisions have been seen as permissible as long as they are performed by a doctor. However, last year Helsinki District Court took a tougher line. The court ruled, among other things, that the person undergoing the procedure should understand what is happening. This means that circumcision of small children would not be allowed. The court based its decision on the <a href="http://conventions.coe.int/Treaty/en/Treaties/html/164.htm">Convention on Human Rights and Biomedicine</a> of the Council of Europe, which was adopted by Finland only after the Supreme Court’s decision. The case is still in the Court of Appeals, and it is too early to say if the Supreme Court will rule on it someday. As long as no legislation is passed, or case law established, cases will end up in court. The situation causes uncertainty among parents who do not know if they could face charges. If the surgeries are banned, there is a danger that they will be performed abroad, or that quacks might be enlisted for the purpose, and that if complications occur, the parents might be afraid to take their children in for treatment. In addition, both the Jewish and Muslim communities oppose any ban. However, if the procedures are permitted, Finland will be giving its approval to medically unnecessary surgery that interferes with the integrity of the body. The Finnish Medical Association takes the stand that child circumcisions are in conflict with medical ethics. The Ministry of Social Affairs and Health favours a compromise. It does not take a stand in either direction on the issue of legislation, but it is preparing a set of guidelines for health care professionals. Ministry official Marie Kolimaa is not disclosing the content or schedule of the guidelines. “There are many things that remain open”, she says. This is certainly easy to believe. A number of thorny questions need to be considered: <ul> <li>Should public health care be used for the performance of a religious ritual?</li> <li>What if all doctors refuse on ethical grounds?</li> <li>If the procedures are consigned to the private sector, is it still possible to get a public subsidy?</li> </ul> There is also the question of basic principles, which the Greens also referred to. Should Finland seek to act in such a way that non-medical circumcisions of boys would become less common, or be eliminated completely? If so, what would be the means to that end? Source: Irina Vähäsarja, <a href="http://www.hs.fi/english/article/NEWS+ANALYSIS+Finland+lacks+policy+on+religiously-mandated+male+circumcision/1329104229469">Finland lacks policy on religiously-mandated male circumcision</a>, Helsingin Sanomat International edition, 28 May 2012 <h2>Comment by CIA: Circumcision the only issue that unites Jews and Muslims</h2> Defence of their right to commit an act of violence against their children seems to be the only issue that distracts Jewish and Muslim adults from their need to commit violence against each other. Yet there is a major difference between Jewish and Muslim circumcision practices: for a devout Jewish parent who follows all the rules laid down in the Torah, there is a passage in Genesis that appears to require them to circumcise their male children on the eighth day (and also their servants and employees, though this is not insisted upon these days). Circumcision is (or should be) performed by a Mohel as a religious ceremony, analogous to baptism, with a service, liturgy, ritual and celebration following a set pattern. There are no such requirements in the Muslim scriptures: the Koran makes no mention of circumcision, and the only words from the prophet Mohammed recorded on the subject state that is desirable or meritorious for both men and women as a sign of piety and commitment to the faith. Unlike in Judaism, there is no liturgy or religious ceremony associated with the operation, which (these days) is normally carried out by a doctor in a sterile clinical setting, and no ritual elements at all. In other words, there is no obligation placed on parents to circumcise their children; circumcision is merely an act of faith that a devout Muslim might be expected to elect for himself. It follows that there is no valid reason why children of Muslim parents should not be protected from circumcision until they are old enough to decide the matter for themselves. Those who talk about the right to religious freedom forget that the treaties and declarations that guarantee such freedom extend it to everybody, irrespective of age: children have their own entitlement to religious freedom. As to the question of assault, there can be little doubt that forcible circumcision of an adult would be a criminal assault occasioning actual bodily harm; if that is the case, at what age does the same action become a legal and acceptable practice? Would it be legal to forcibly circumcise a 15-year old boy? What about a 10-year old? A 5-year old? From a logical point of view, if to circumcise an adult without his informed consent is a criminal assault, it must be equally wrong to perform the same action on a minor. To argue otherwise would be to imply that while it is wrong to commit sexual assault or rape on an adult, it would be perfectly OK to rape a child. Society has decided the contrary: that assaults on defenceless children are far more wicked than the same assaults on adults. Why should cutting of a boy’s genitals be regarded any differently? The words of Holm Putzke, a criminal law expert at the University of Passau, get to the heart of the matter: “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate.” <a href="https://www.circinfo.org/ethics.html" rel="noopener" target="_blank">Further information on the ethics page</a> <h2> <a id="bma" name="bma"></a>Doctors urge British Medical Association to stop non-therapeutic circumcision of boys</h2> The British Medical Association will be urged to debate the banning of Unnecessary Male Circumcision at its annual meeting next week after a baby bled to death in Queens Park, London. The tragic case of 28 day old Angelo Ofori-Mintah is the latest in string of deaths and injuries that have prompted some doctors to call for laws that protect girls from unnecessary genital cutting to be extended to protect boys. The <a href="http://www.circumstitions.com/news/news46.html#london-death">news of Angelo’s death</a> came in the same week that The British Association for Community Child Health reported in it’s quarterly newsletter that a baby boy’s skull was fractured during a ritual circumcision performed on a kitchen table in Bristol. Now Dr Antony Lempert GP, Director of the <a href="http://www.secularmedicalforum.org.uk/?page_id=27">Secular Medical Forum</a>, will be calling on the BMA to debate the banning of non-therapeutic circumcision in the UK at the start of its annual meeting. Other cases that have helped push the issue up the agenda include the case of a Salford midwife who will be tried for manslaughter later this year after a boy she circumcised bled to death, and a report in The Journal of Public Health that found that nearly 1 in 2 Muslim boys circumcised in an Islamic school in Oxford ended up with medical complications. There is currently a growing demand across Northern Europe to outlaw medically unnecessary circumcision of boys, with the junior party in <a href="http://www.circumstitions.com/news/news45.html#norway-ban">Norway’s coalition government</a> calling for a ban earlier this month, and medical associations in<a href="http://www.circumstitions.com/news/news45.html#finland-nolaw2"> Finland</a>, Sweden and The Netherlands also opposing the practice. Britain’s leading anti-circumcision charity, <a href="http://www.norm-uk.org/">NORM UK</a>, is heading for Rotterdam next week for an international conference on the Doctor and the Foreskin (subtitled Circumcision: Forbid, deter or encourage?) The <a href="http://endmalecircumcision.blogspot.com.au/">Campaign to End Unnecessary Male Circumcision</a> estimates that more than half a million boys living in the UK will be subjected to medically unnecessary circumcision before their 16th birthday. And the anti-circumcision movement is growing in the UK with campaigners from the group <a href="http://www.mendocomplain.com/">Men Do Complain</a> planning to protest outside the British Medical Association’s Annual Representatives Meeting in Bournemouth next week. The campaign founder, Richard Duncker, says they will be protesting because “cutting the genitals of healthy boys who cannot consent is profoundly unethical”. Another group, Genital Autonomy, is planning a mini-conference in at Keele University in July to bring together leading experts and practitioners to debate “How Can We Prevent unnecessary Male Circumcision”. Source: <a href="http://www.healthmatters.org.uk/?p=1324">Medics urged to ban circumcision as baby boy bleeds to death</a>, Health Matters (UK), June 2012 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Circumcision and the law: News from Australia and around the world darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> A report by the Tasmanian Law Reform Institute has condemned the open slather approach to non-therapeutic circumcision of male minors and recommended much tighter regulation of the practice. The report analyses the borderline legal status of circumcision in Australia and the risks this uncertainty creates for both boys and circumcision practitioners, and makes fourteen recommendations for reform. These include a proposal for the outright prohibition of medically unnecessary circumcision of “incapable minors” (infants and young boys), with an exception for recognized religious and ethnic groups who traditionally practise circumcision (Jewish, Muslim and some Aboriginal communities). The report also recommends that circumcision always require the authorization of both parents, and that if parents disagree about whether a boy should be circumcised the operation may not be performed unless authorized by a court. It also proposes uniform standards of competence, disclosure and operational procedure for providers of circumcision services. The report has been hailed by child health and human rights experts as an impressive first step towards giving boys some degree of protection against needless destruction of their foreskins. Dr Robert Darby told Circumcision Information Australia that the report was a trailblazing effort that raised the discussion of non-therapeutic circumcision of minors to a new level. “For its scientific precision, its comprehensiveness, its human rights and bioethical awareness, and the good sense and practicality of its recommendations, the report could hardly have been bettered”, Dr Darby said. “Even though the recommendations apply only to Tasmania, any reforms there will set a new benchmark that other states will have to consider, and by which their own efforts at child protection will be judged. Coming on top of <a href="https://www.circinfo.org/Circumcision_and_law.html">the Cologne decision</a> that non-therapeutic circumcision is bodily harm, the TLRI report further revolutionizes the debate: the issue is no longer whether circumcision has so called “health benefits”, but whether it is legally and morally permissible.” Dr Darby said that a particularly valuable recommendation was to extend the time allowed for an individual who believes he has been harmed by circumcision to bring a legal action for damages against his circumciser. "This proposal recognises the sad (but often suppressed) truth that many men resent having been circumcised and would have preferred to go through life with an entire penis, or at least to make their own decision on such a personal matter. Existing legal rules, however, make it very difficult for them to seek legal redress, leaving the false impression that most men "don't mind" one way or the other. You can be pretty sure that if the playing field is made a little bit more level, the lawsuits will start to flow thick and fast." <h2>Non-therapeutic male circumcision: Recommendations for reform</h2> The recommendations of the Tasmania Law Reform Institute report on circumcision are as follows. 1. The Institute supports the enactment of legislation to reform the law governing circumcision. 2. The Institute recommends reform to provide a clear legislative basis for the legality of circumcision performed at the request of an adult or capable minor. 3. The Institute recommends the enactment of a new and separate offence generally prohibiting the circumcision of incapable minors in Tasmania. The new legislation ought to create an exception for the performance of some well-established religious or ethnicity motivated circumcision on incapable minors. 4. The Institute recommends the enactment of legislation to require joint parental authorisation for the circumcision of an incapable minor. 5. The Institute recommends the enactment of a law to require court authorisation for a circumcision whenever parents disagree about the desirability of performing a circumcision. 6. The Institute does not recommend the enactment of legislation mandating court authorisation for the circumcision of minors. 7. The Institute recommends the enactment of a law to require that all circumcisers provide accurate information as to: <ul> <li>the financial cost of the procedure;</li> <li>the non-therapeutic nature of the operation;</li> <li>the purpose and function of the foreskin;</li> <li>the procedure itself;</li> <li>the procedure’s effect on the functioning of the penis;</li> <li>the risks of the procedure;</li> <li>the nature and significance of the evidenced prophylactic benefits of circumcision in an Australian context;</li> <li>the potential for children to grow up into adults who resent their circumcision (this may include a discussion of the common rationales and prevalence of circumcision);</li> </ul> <ul> <li>the availability of the procedure in adulthood;</li> <li>the legality of the procedure.</li> </ul> 8. The Institute recommends that health policy, community and industry leaders use non-legislative avenues of reform to improve the dissemination of accurate information on the known and potential effects and significance of circumcision. 9. The Institute recommends the enactment of a criminal law that sets general principles against which to judge the acceptability of a circumciser’s practice. These principles should set minimum standards that all circumcisers of incapable minors must meet in the provision of their service. Parliament should give an existing health regulatory body the responsibility of formulating regulations to qualify the general standards set in statute. The Institute recommends the setting of standards as to matters such as: <ul> <li>the pain relief provided;</li> <li>the instruments used;</li> <li>the skill of the person performing the operation;</li> <li>the skill with which the procedure is performed;</li> <li>the adequacy of the wound care and post-procedure monitoring.</li> </ul> The standards set by statute and in regulations ought to reflect the minimum standards the community would expect circumcisers to meet at the time of the operation in the circumstance in which they are operating. In particular, the standards should ensure that no minor be put at a needlessly high risk of pain or complication from a circumcision. 10. The Institute recommends further investigation into whether the law governing the use and sale of human tissue would benefit from reform. 11. The Institute does not recommend reform to the law regulating the commercial aspects of a circumciser’s service. 12. The Institute recommends the enactment of reform to create a uniform period in which individuals harmed by a circumcision as a minor may bring an action against their circumciser. This period should extend for an appropriate time after the harmed person has reached the age of majority. This new limitation period should be enacted in a provision in a new Circumcision Act. 13. The Institute recommends the enactment of legislation to require circumcisers to transmit information relevant to actions that may be brought for harm they cause to a minor to an appropriate government authority. 14. The Institute does not recommend the enactment of a no-fault compensation scheme for harm caused by a circumcision performed upon an incapable minor. <a href="http://www.utas.edu.au/law-reform/publications" rel="noopener" target="_blank">The full report is available from the TLRI website</a> <a href="https://theconversation.edu.au/tasmanian-report-calls-for-groundbreaking-reform-of-circumcision-law-9105" rel="noopener" target="_blank">Warwick Marshall summarises the TLRI report at The Conversation</a> <a href="http://eprints.utas.edu.au/11729/" rel="noopener" target="_blank">Warwick Marshall, Master of Laws thesis on legal status of circumcision in Australia</a> <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2276538" rel="noopener" target="_blank">Dr Robert's Darby's submission to the TLRI circumcision inquiry at SSRN network</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Tasmanian law report recommends regulation of circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h1>The 2012 HELSINKI DECLARATION on the RIGHT to GENITAL AUTONOMY</h1> Whereas it is the fundamental and inherent right of each human being to security of the person without regard to age, sex, gender, ethnicity or religion as articulated in the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights and the Convention on the Rights of the Child. Now we declare the existence of a fundamental right of each human being a Right of Genital Autonomy, that is the right to: <ul> <li>personal control of their own genital and reproductive organs; and</li> <li>protection from medically unnecessary genital modification and other irreversible reproductive interventions.</li> </ul> We declare that consistent with the Right of Genital Autonomy the only person who may consent to medically unnecessary genital modification and other irreversible reproductive interventions is: <ul> <li>in the case of a person who is competent to give free and informed consent, being fully informed about the nature, the risks and benefits of the intervention – the person undergoing the intervention; and</li> <li>in the case of an incompetent person including a young child – only a properly constituted public authority or tribunal appointed to balance the human rights and the best interests of the person after considering the views of family members, professionals and an independent advocate for the person.</li> </ul> We recognise the fundamental right of parents and guardians to freedom of thought, conscience and religion. Those rights of parents and guardians are not absolute, they are limited by the same fundamental human rights of others, in particular their children. We declare that healthy genital and reproductive organs are natural, normal, functional parts of the human body. Governments and healthcare providers have a duty to educate parents and children about non-invasive hygiene, care of genital and reproductive organs, and to explain their anatomical and physiological development and function. We encourage and support further research into the adverse consequences of such interventions. We oppose research and experimentation that involves the performance of medically unnecessary modification and other irreversible medical interventions affecting genital and reproductive organs upon non-consenting children and adults. We call on all governments to acknowledge the right of genital autonomy for every child and adult, that is, the right to: <ul> <li>personal control of their own genital and reproductive organs; and</li> <li>protection from medically unnecessary genital modification and other irreversible reproductive interventions.</li> </ul> We call on all States members to the <a href="http://arclaw.org/human-rights-violations-table">Convention on the Rights of the Child</a> to honour their commitments under that instrument in particular Articles 2, 12, 14, 19 and 24. Declaration adopted by the 12th International Symposium on Law, Genital Autonomy & Children’s Rights, Helsinki, Finland, 29 September to 3 October 2012 Further information about the Helsinki conference <a href="http://www.genitalautonomy.org/" rel="noopener" target="_blank">Genital Autonomy Europe</a> <a href="http://www.nocirc.org/symposia/" rel="noopener" target="_blank">Nocirc conferences details</a> <a href="http://www.bayareaintactivists.org/node/134" rel="noopener" target="_blank">Conference summary by Lloyd Schofield</a> <a href="https://www.circinfo.org/Genital_integrity_conference.html" rel="noopener" target="_blank">Genital Autonomy Conference 2011</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Helsinki conference on the right to genital autonomy darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h1>Personal freedom and religious tradition</h1> <h3>German-Turkish Green MP defends Cologne circumcision judgement and criticises politicians for caving in to religious pressure</h3> The following op-ed in the Frankfurter Allgemeine Zeitung was written by Memet Kilic, Green member of the German parliament. Despite his Turkish-Muslim background, he supports the Cologne judgement that non-therapeutic circumcision of a non-consenting minor is unlawful under German law, and criticise the Merkel government for steam-rolling a bill to make circumcision of children legal whenever desired by their parents. He points out that the bill privileges certain religious groups by allowing them to have circumcisions performed without anaesthetic or the presence of a medical practitioner - conditions otherwise mandated under health regulations. As he argues, in a secular state laws that apply to everybody; they should not, therefore, be written to suit the requirements of particular sub-cultures. <h2>Freedom is more important than tradition</h2> The Federal Government wants to legalise circumcision of boys in Germany. This Thursday the Bundestag debated the first reading of the Bill. The question is whether a secular State should align its laws with religious traditions? by Memet Kilic The discussion that began with the Cologne judgement on circumcision has ended with a cutting short (a circumcision) of the debate. The Federal Government wants to settle the matter quickly with a new law to be passed this year. Despite understanding the sensitivities regarding Jewish life and culture, it surprises me that the preoccupation with freedom of religion and parental responsibility have dominated the debate to such an extent. The child’s welfare, universally applicable human rights, and the relationship of the secular state to religious communities have not been given sufficient consideration. Should it not be reasonable for religious communities in a modern, secular state to reconsider their traditions and, in given cases, to adapt them to our constitutional order? Is it not the case that basic rights and freedoms determine the rules for living together in our heterogeneous society, not the customs and traditions of particular sub-cultures? Discussion of this issue is taking place more widely than Germany. The Federal Government feels it is under pressure from the criticism that Germany is the only country that is questioning this Jewish tradition. The accusation is unfair. Intensive discussions about the permissibility of circumcision are taking place in many European and other countries. In only one European country – Sweden – is there legislation regulating circumcision of boys, a law passed in 2001. As we learn from Sweden, public debate has not been restrained by legal regulation of the practice. To give one instance, the Chairman of the Ethics Committee of the Swedish Paediatric Association has recommended a general ban on all forms of circumcision of boys that are not medically indicated. In early 2012 the Finnish Minister of Justice lodged a bill to place circumcision under strict conditions. In Norway, political discussion of this topic was sparked after a two-week-old infant died following ritual circumcision in May 2012. Meanwhile, members of the Norwegian coalition party Senterpartiet have put forward a bill to ban religiously-motivated circumcisions. In Denmark circumcision may be performed only after information about the risks has been provided by a doctor or in the presence of a doctor. There is active discussion of these questions in the United Kingdom. Increasingly, the legal community views circumcision as a violation of the European Convention on Human Rights. Circumcision is not the interests of the child In Austria, circumcision falls under a reservation and may only be performed by a qualified medical practitioner. In Switzerland, although the law prohibits injuries to the female genitalia only, there is a lively discussion about the conditions under which male circumcision should also be prosecuted as a crime. Legal experts are not united on the question of whether parental consent can legitimize bodily injury to a child and whether the criterion of “vulnerability” or defenceless is met. A Dutch court was criticised in 2007 because it had failed to justify why circumcision should not be seen as a severe form of bodily injury (in violation of Article 3 of the European Convention on Human Rights). In the same year, a juvenile court judge in Zutphen held that circumcision was not in the interests of the child, because the procedure was irreversible and not medically necessary. Customs that are harmful to health With the ratification of the United Nations Convention on the Rights of the Child in 1992 the primacy of the child’s welfare was enshrined in a human rights treaty for the first time. The Convention obliges signatories to abolish traditional customs which are harmful to the health of children. On this basis, in 2000 the Federal Government enshrined the right to a violence-free upbringing in the German civil code. I fear that we are risking these achievements if we set aside the right to physical integrity in favor of parental responsibility and adult freedom of religious practice. The Bill is not religion-neutral If we justify infant circumcision on the basis of parental responsibility, on what basis will parents be restrained from forbidding their children to take swimming lessons at school? In that case, as well as with circumcision, parents are convinced that they are acting for the good of their children. The Bill is manifestly not religion-neutral. Infants under six months of age may be circumcised without anesthesia and without the presence of a physician, despite the fact that both are considered necessary in circumcision for non-religious reasons. In a secular state governed by rule of law, religions are not entitled to define or limit universally valid human rights. Freedom of religion is not an absolute right, but a part of a general freedom of belief. Article 2 of our Constitution gives every individual a right to physical integrity and to free personal development. These rights are not negotiable. <a href="http://www.faz.net/aktuell/politik/inland/gastbeitrag-zur-beschneidung-freiheit-ist-wichtiger-als-tradition-11967472.html" rel="noopener" target="_blank">German original in Frankfurter Allgemeine Zeitung, 22 November 2012</a> Memet Kilic is a member of the Bundestag and spokesman on immigration and integration issues for the Greens fraction, Group 90. <h3>Highlights from the Cologne judgement</h3> The right of the parents to raise their child in their religious faith does not take precedence over the right of the child to bodily integrity and self-determination. The act of the defendant was not justified by consent, either. Consent by the four-year-old was not given and could not be given due to a lack of intellectual maturity. The consent of the parents was given, but could not justify the infliction of bodily harm. Circumcision of a boy unable to consent to the operation is not in accordance with the best interests of the child even for the purposes of avoiding a possible exclusion from their religious community and the parental right of education. The fundamental rights of the parents in Art. 4(1) and Art. 6(2) of the Basic Law (GG) are restricted by the fundamental right of the child to bodily integrity and self-determination According to s 1627 1st sentence of the German Civil Code (BGB), the right of care covers only educational measures which are in the best interests of the child. According to the prevailing opinion within academic commentary … the circumcision of a boy unable to consent to the operation is not in accordance with the best interests of the child even for the purposes of avoiding a possible exclusion from their religious community and the parental right of education. The principle of proportionality must be taken into account when striking the balance between these rights. The infringement of the bodily integrity caused by a circumcision for purposes of religious education is unreasonable in the sense of proportionality, even if necessary to that end, because of the value judgment expressed in s 1631(2) 1st sentence BGB. Moreover, the circumcision changes the child's body permanently and irreparably. This change runs contrary to the interests of the child in deciding his religious affiliation independently later in life. Relevant provisions of German Civil Code Section 1627 Exercise of parental custody: The parents must exercise the parental custody on their own responsibility and in mutual agreement for the best interests of the child. In the case of differences of opinion, they must attempt to agree. Section 1631 Contents and limits of care for the person of the child (1) The care for the person of the child includes without limitation the duty and the right to care for, bring up and supervise the child and to specify its abode. (2) Children have a right to non-violent upbringing. Physical punishments, psychological injuries and other degrading measures are inadmissible. (3) The family court is to support the parents, on application, in exercising care for the person of the child in suitable cases. Landgericht Koln. 7 May 2012 Urteil 151 Ns 169/11. Available at URL: http://www.justiz.nrw.de/ nrwe/lgs/koeln/lg_koeln/j2012/151_Ns_ 169_11_Urteil_20120507.html. English translation at http://www.dur.ac.uk/ resources/ilm/CircumcisionJudgment LGCologne7May20121.pdf </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource German MP defends Cologne circumcision judgement darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> Hot on the heels of a resolution of the Finnish Greens that non-therapeutic circumcision of children should be prohibited, a district court in Cologne, Germany, has ruled that non-therapeutic circumcision of children, even when performed for religious reasons at the request of a boy’s parents, is unlawful, and that those responsible are guilty of inflicting bodily harm. The case arose from a 4-year old boy circumcised by an Islamic doctor who later suffered severe bleeding requiring emergency medical care. The case has far-reaching implications for the future of medically unnecessary circumcision of minors and the human rights of children. The following article is translated from the German newspaper, Financial Times. German court: Religiously motivated circumcision is unlawful A judgment of the District Court of Cologne [refers to] a widespread medical intervention carried out for religious reasons. According to this judgement, (non-therapeutic) circumcision of boys will in future be regarded as personal injury. Those who circumcise boys for religious reasons make themselves liable to prosecution for assault causing bodily injury. This is the decision of the Cologne regional court, in a landmark ruling that has come to the attention of the Financial Times Germany. In its judgment, the Court made it clear that neither the rights of the parents nor the freedom of religion guaranteed in the basic law can justify this intervention. Thus, for the first time a German court places circumcision as a religious custom under the threat of penalty. Each year, several thousand boys in their first years of life are circumcised in Germany at the request of the parents. In the United States, even the majority of all boys are circumcised largely independently of religion directly after birth. Massive resistance to this practice has now developed. Worldwide around a quarter of all men are circumcised. For decades doctors in Germany operated in a legal grey area when they circumcised boys for purely religious reasons, without medical necessity. Up till now, however, they could rely on the claim that they did not know that religiously-motivated circumcision was unlawful. Even if a court accepted that there had been personal injury, the doctor would be acquitted because of legal technicalities. The Cologne decision has now eliminated this possibility. Holm Putzke from the University of Passau said “The decision is extremely important especially for doctors because they have legal certainty now for the first time.” The legal expert has called for an explicit prohibition of non-therapeutic circumcision for years. “In the past courts – like politicians – have been afraid to act out of fear of being accused of anti-semitism and hostility to religion”, said Putzke. “This decision could influence not only future case law, but lead to a change of consciousness and greater respect for the fundamental rights of children.” Muslim and Jewish organizations have so far rejected suggestions that circumcision of children is unlawful. They regard a ban as “serious interference with the right to the free exercise of religion”. They did not respond immediately to requests for comment on the Cologne court’s decision, but wanted time to consider the judgment. The judgment is likely to provoke discussions. For years struggle politicians and welfare associations have struggled to improve the integration of the Muslim population. In 2006 Wolfgang Schäuble, as Minister for the Interior, convened an Islamic Conference on his own initiative. The former German President Christian Wulff said: “Islam belongs to Germany.” His successor Joachim Gauck also commented: “Muslims who live here are part of Germany." Some Muslims are now likely to regard the Cologne decision as a step backwards. Experts assume that more cases like this will come before the courts. Eventually the question could be settled by specific regulations governing religiously motivated circumcision issued by the Federal Constitutional Court. In the Cologne case, a Muslim physician circumcised a four-year old boy at the request of the parents. Two days later he suffered severe haemorrhage, and the mother brought the boy in for emergency medical care. The public prosecutor’s office was informed of this and pressed charges against the circumciser. After the medical legal tribunal ruled the procedure to be legal the prosecutor lodged an appeal. As a result of this, the Court assessed the circumcision as “serious and irreversible impairment of physical integrity”. Source: Matthias Ruch, <a href="http://www.ftd.de/politik/deutschland/%3Akoerperverletzung-gericht-stellt-religioese-beschneidung-unter-strafe/70054618.html">Court: religious circumcision is punishable</a>, Financial Times (Germany), 25 June 2012 <h3>Circumcision of boys “an assault”: Melbourne Age</h3> The following report of the decision was published in the Melbourne Age. A GERMAN court has ruled that circumcising young boys represents grievous bodily harm, a decision that could have significant repercussions for religious groups. The president of the Central Council of Jews in Germany condemned the decision by the regional court in Cologne as '”an unprecedented and dramatic intrusion on the self-determination of religious communities” and called on the German parliament to pass legislation protecting circumcision as a religious practice. The case centred on a four-year-old boy whose Muslim parents had him circumcised by a doctor, which led to medical complications. Advertisement: Story continues below. The doctor was charged with grievous bodily harm but acquitted by a lower court, which judged he had acted within the law as the parents had given their consent. On appeal, the regional court also acquitted the doctor, but for different reasons. It upheld the original charge of grievous bodily harm, but ruled that the doctor was innocent as there was too much confusion on the legal situation. Although Muslims and Jews circumcise infant boys as a religious practice and many other people do so for health reasons, the court found that the child's “fundamental right to bodily integrity” was more important than the parents’ rights. “The body of the child is irreparably and permanently changed by a circumcision,” it said. ''This change contravenes the interests of the child to decide later on his religious beliefs.” According to the court, the religious freedom “would not be unduly impaired”, because the child could later decide whether to have the circumcision. Germany has no law against male circumcision, as there is against female genital cutting. Experts said the decision would not be enforceable in other jurisdictions. But the legal uncertainty and threat of prosecution could lead doctors to decline to perform the procedure. Holm Putzke, a criminal law expert at the University of Passau, said the ruling was not binding for other courts, but could send a welcome signal. “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate,” he told the German news agency DPA. Source: <a href="http://www.theage.com.au/world/circumcision-on-boys-assault-court-rules-20120627-212rw.html">Circumcision on boys assault, court rules</a>, The Age (Melbourne) 28 June 2012 <h3>Court ruling on circumcision is final: German legal expert</h3> The following analysis of the Cologne court ruling by the German legal expert <a href="http://www.holmputzke.de/">Dr Holm Putzke</a>, professor of law at <a href="http://www.jura.uni-passau.de/">University of Passau</a>, was published as an interview in German Turkish News, 26 June 2012. An edited English translation follows Opinion: Doctors should refuse to perform religious circumcision The District Court of Cologne has recently ruled that the circumcision of boys, even for religious reasons, shall henceforth be considered a crime. ... Criminal law professor Dr. Holm Putzke of the University of Passau evaluates the judgment in an interview for the German Turkish News. For him, the ruling is an appeal to parents to deliberate whether such interventions are really necessary. German Turkish News: How do you interpret the ruling of the Cologne Court? Is this a landmark decision? Holm Putzke: Although the Cologne District Court generally follows prevailing opinion in the legal and medical literature, this ruling does represent an important turning point. For the first time, a court has declared – no ifs and/or buts about it – that medically unnecessary circumcision on non-consenting boys is illegal, and in fact is punishable by law. Prior to this decision, the legal situation was unclear for lack of a clear judicial decision. ... German Turkish News: Could you say it's a specific feature of Western democratic societies that the legal right to physical integrity is trumps the right to religious freedom? Holm Putzke: There’s no blanket answer to that. Protecting religious freedom is important and necessary, just as it’s essential to protect the physical safety of persons, especially children. It would be a queer understanding of religious freedom if religions were simply allowed to physically injure people in the name of their faith and thereby circumvent the prevailing statutory laws of German society. ... German Turkish News: What does this ruling now mean for doctors? Should doctors basically refuse to perform circumcisions for religious reasons? Holm Putzke: Two Munich doctors, Maximilian Stehr and HansGeorg Dietz, collaborated with me on an article in 2008 that was published in the German Medical Journal regarding the criminalization of religious circumcisions on boys. Since then, more and more doctors have refused to participate in medically unnecessary circumcisions of non-consenting boys. This is primarily because the surgery carries risks, and confers absolutely no health benefits in childhood. After the Cologne ruling, doctors can now be threatened with criminal prosecution, and without going into too much detail, the inherent illegality – of the act of circumcising boys who don’t need it – will likely impact doctors’ liability insurance. If doctors are presented with a request to perform a religiously-motivated circumcision, they would do well to advise the parents of the legal situation in this country, as well as the risks of surgery itself, and refuse to perform the surgery. At the same time, doctors should clearly point out that circumcision should be postponed until the individual in question can decide about the procedure himself. German Turkish News: What message does this ruling send to the religious communities? Holm Putzke: The message is: Think about, really reflect, whether it is really necessary to put a small, often utterly frightened boy through surgery that has no medical necessity and that carries risks, or whether you can hold off on this or opt for some other ritual that symbolically fulfils the religious intent. ... German Turkish News: Do you expect there to be an appeal? Holm Putzke: This was already an appellate decision. Since the state bar apparently has decided not to consider any further appeals, the judgment is final. There is no way to challenge this ruling. This message is especially true for individuals or organizations that might viscerally attack this decision just to declare their outrage and disgust. German Turkish News: Do you expect more lawsuits because of similar incidents? Holm Putzke: I won't hazard an answer. Conceivably a storm of indignation from religious groups might initially discourage other prosecutors from bringing such cases. But in the long run the solid arguments will prevail. And those arguments pretty clearly now say that children should not have their genitals forcibly violated. Rather, they can make a decision at an appropriate age about whether they want it or not. Prof. Dr. Holm Putzke, LL.M. teaches Criminal Law at the University of Passau. Since the 2008 publication of his essay "The Criminal Relevance of Circumcision of Boys," he has made many other contributions to the subject and has participated in the public debate on the criminalization of circumcision of minors that is not medically indicated. Source: <a href="http://www.deutsch-tuerkische-nachrichten.de/2012/06/455709/nach-urteil-%E2%80%9Eaerzte-sollten-religioese-beschneidung-ablehnen%E2%80%9C/">DeutschTurkischeNachrichten, 26 June 2012</a> <h3>Implications of German circumcision decision for Britain (and Australia?)</h3> Dr John Warren’s letter to The Times Doctors throughout Europe, where there is no tradition of infant male circumcision in medical practice, have been faced in recent years by an increasing demand for this service, due to the immigration of families from other parts of the world where male circumcision has been a cultural norm. There is confusion over how to respond to this demand, both among the medical and also the legal professions. The ruling in Germany, reported in The Times on 28 June, illustrates this problem. In this case a state court ruled that circumcision on non-medical grounds of a child amounted to grievous bodily harm. In The Netherlands, the Royal Dutch Medical Association has issued a report stating that non-therapeutic circumcision of underage boys amounts to a violation of a child’s physical integrity, and so contravenes Article 8 of the European Convention of Human Rights and Article 11 of the Dutch constitution. In Norway, the Centre Party has proposed an outright ban on non-therapeutic male circumcision of under-age boys, provoking a heated debate. Here in the UK , there has so far been little debate, despite the fact that large numbers of boys are being circumcised for non-therapeutic reasons, some within the NHS, some in private clinics, and some by non-medically qualified operators. It is impossible to determine accurately how many. However, the medical literature shows a complication rate of anywhere between 2 and 20%. These do not include late problems discovered by adult men who were circumcised as infants, and our records at NORM-UK include many examples of both physical and psychological problems that appear to result from this operation. Earlier this month (June) the Westminster coroner gave a verdict of accidental death in the case of a one month old baby boy who died of haemorrhage from his wound two days after circumcision. The General Medical Council does not have a position on the issue of non-therapeutic male circumcision of children. It states: We do not have general authority to determine public policy on issues that arise within medical practice – these are matters for society as a whole to determine, through the parliamentary process. There are four principles of medical ethics: autonomy, beneficence, non-maleficence and justice. Clearly a child’s autonomy is breached by a non-therapeutic procedure permanently altering his anatomy. Regarding beneficence, no medical organisation in the world recommends routine infant circumcision for health reasons. Non-maleficence refers to not doing harm; the possibility of complications mentioned above shows that there is considerable potential for harm from this procedure. Justice asks the question ‘is it fair?’ Would you do the same to a girl? Would you do the same to an adult male without his consent, that is tie him down and forcibly remove his foreskin, possibly without anaesthesia? In my view the UK needs a debate involving doctors, lawyers, ethicists, politicians, representatives of religions and the wider public on the subject of non-therapeutic circumcision of underage boys. And the General Medical Council should consider coming off the fence and consider carefully whether its lack of position on this topic is consistent with its role: to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. Dr John Warren Chairman NORM-UK This letter was sent to The Times (London), but not published. <h3>Professor Holm Putzke’s interview with Bavarian Radio</h3> “Protection from violence is more important than religious rites” Because of an article four years ago, he finds himself now seriously threatened: Professor Holm Putzke of the University of Passau speaks out against the circumcision of boys. The recent judgment of the District Court in Cologne rests on his findings. “It’s really a question of postponing a religious act,” he explains in an interview with Bavarian Radio. BR.de: How do you view the judgment of the District Court in Cologne? Holm Putzke: The judgment of the District Court in Cologne is correct. The court came to its conclusion, after an intensive analysis of the jurisprudential debate, that religious freedom ends where physical safety of children is irreparably impacted, in this case due to unnecessary and risky surgical procedures. It should be self-evident that we simply don't allow this in a society that emphasizes the protection of children from forceful or violent acts. The verdict The District Court in Cologne determined that the circumcision of a minor boy for religious reasons in June 2012 was an injury. The judges argued that religious circumcision is a permanent and irreversible intrusion on the child. Jewish and Muslim groups criticized the decision as impermissible encroachment on the freedom of religion. BR.de: What significance does it have? Holm Putzke: It’s a brave decision, because the wave of indignation was predictable and the climate of discussion almost always suffers when it comes to any criticism of religion. Despite the this ruling being non-binding on other courts or prosecutors, the ruling could send a signal and - more importantly - finally lead to a long-overdue public discussion. BR.de: Isn’t this a very western, and therefore one-sided, view of things? Holm Putzke: It's not actually a one-sided view of things, because the court doesn’t simply make an assertion. Rather, it reaches a judgment after a careful weighing of the constitutionally protected rights to self-determination and bodily integrity against the parents’ right to free exercise of religion. You also can't really say this is a “typically western” view, since in other parts of the world enlightened people are thinking the same way. BR.de: What does the ruling now mean for doctors? Should they decline to do circumcisions for religious reasons? Holm Putzke: The risk of doctors being held criminally liable in case of complications, or losing their insurance coverage, is now elevated. However, as a doctor I wouldn't simply decline to do these circumcisions because they’re religiously-motivated, but rather because performing medically unnecessary surgery on children who can not defend themselves is ethically incompatible with the medical profession. BR.de: What message do the court judgment and your legal commentaries send to the religious communities? Holm Putzke: The point of my early 2008 article, dealing with legal culpability in the religious circumcision of boys, was not to criminalize doctors and parents, or really even religious groups. Rather, I was hoping that a broad public debate might get underway about how much religiously motivated violence against children is tolerable. Neither the judgment nor the overall viewpoint it favors prevents anyone from exercising their religion. It’s not about discrimination against religious groups or the total prevention of religious practice; it's really just about postponing a religious act. BR.de: Is this whole thing a typical German debate? How do you think this topic will be handled in Europe and globally? Holm Putzke: In other countries, especially in the United States, there has been a strong movement for decades that criticizes medically unnecessary circumcision on non-consenting children as unethical. Even Israel has seen intense debate over whether religious circumcision of children is ethically justifiable. I have received numerous letters from Israel, where parents have told me that despite their ongoing religious affiliation to Judaism they've abstained from infant circumcision, and prefer to wait until their child is able to make his own independent decision about it. So it seems that if it’s supposed to always be the case, as the Central Council of Jews here in Germany claims, that infant religious circumcision remains essential and indisputable in Judaism... then they're really only telling half the story. BR.de: There’s a good chance you’re going to be reviled and threatened over this ruling. How do you plan to handle it? [Threats to Professor Putzke have included drowning and forcible circumcision.] Holm Putzke: It would be naive to think that my critiques, and the skeptical views of what is by now the majority in the medical and law professions, will only be discussed in a rational, calm and composed manner. Any criticism of religion has always triggered emotional reactions. Insults and threats don’t bother me really, if for no other reason than some people are simply hiding behind them when they can't express their displeasure any differently. Good arguments, however, are much more likely to impress me. Source: <a href="http://www.br.de/themen/aktuell/inhalt/interview-beschneidung-putzke100.html">Bayrische Rundfunk, 29 June 2012</a> <h3>Information on Professor Putzke</h3> <a href="http://www.holmputzke.de/" rel="noopener" target="_blank">Homepage</a> Publications Zirkumzision bei nicht einwilligungsfähigen Jungen: strafrechtliche Konsequenzen auch bei religiöser Begründung; in: Deutsches Ärzteblatt 2008, A 1778–1780 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) <a href="http://www.aerzteblatt.de/archiv/61273">Full text here (in German)</a> Strafbarkeit der Zirkumzision von Jungen. Medizinrechtliche Aspekte eines umstrittenen ärztlichen Eingriffs (Liability to penalty for circumcision in boys. Medico-legal aspects of a controversial medical intervention); in: Monatsschrift Kinderheilkunde 8/2008, S. 783–788 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) <a href="http://www.holmputzke.de/images/stories/pdf2008_mschr_kinderheilkunde_zirkumzision.pdf">Full text (PDF) here (in German)</a> ABSTRACT in ENGLISH Often (pediatric) surgeons or (pediatric) urologists have to face the request for circumcision of a minor male by persons having the care and custody in absence of a medical indication. This review points out the imperative of refraining from such a procedure to avoid being a possible addressee of a claim according to civil law or even being accused in a lawsuit later. The attending physician who performs the circumcision without medical indication on a minor male, incurs a penalty according to § 223 para. 1 German Criminal Code, even though the person having the custody of the child signed the informed consent to that procedure. Lacking the cognizance of disposition about the legally protected interest of the child (physical inviolability), the consent is namely not effective. In this article not only the german current legal status is demonstrated, but arguments for the legitimacy of a male circumcision (treatment of phimosis, prevention of different diseases, religious aspects) are discussed. <h3>“Physical integrity is of the highest value”:</h3> <h2> <a id="maxim" name="maxim"></a>Circumcision requires consent of the individual</h2> The following interview with Munich paediatric surgeon Maximilian Stehr appeared in Deutsche Welle, 17 July 2012 Children have to be old enough to give their consent to a religious circumcision, says leading pediatrician Maximilian Stehr. But the law does not need to be changed. Maximilian Stehr is a pediatric surgeon at the University Hospital in Munich and chair of the working group on pediatric urology at the Germany Association for Pediatric Surgery. DW: What has been the effect as far as pediatricians are concerned of the ruling by the court in Cologne regarding the religious circumcision of boys who are not yet able to give informed consent? Maximilian Stehr: To start with, one should note that this ruling has not changed the law, it has merely interpreted existing law and applied it. There has of course been an effect on colleagues working in the field of pediatric surgery and urology in that the ruling has led to a public discussion, and, should similar charges be brought against a doctor in future, it will not be possible to argue [as in this case] that the doctor could not be expected to know that his actions were illegal. I know of many doctors who are currently not carrying out any circumcisions of boys who are not able to give informed consent. What is your advice to doctors who ask whether they should carry out this operation? I've always given the same advice, even before this ruling. I've always held the view that this medical intervention cannot be regarded as conforming to current law or current medical ethics. And so I continue to advise doctors not to carry out this operation; instead, if religiously-motivated circumcision is to be carried out, it should only be carried out at an age when the child or the young person is able to permit it himself or at least consent to it. Would you see the issue of the inability of the child to give its consent as a bigger issue than that of the child's physical integrity? I don't think you can separate the two. Physical integrity is certainly the highest value. That goes without question. There are certainly medical conditions and situations in which people want to decide for themselves that they would like to change something about their body. That is standard procedure in cosmetic surgery - it's the same in pediatric surgery, for example, when we correct protruding ears. For that, the child has to be able to judge for itself the seriousness of the operation, as well as its risks and side-effects, and that is only possible when the child is 14 or 16 years old. How far is this an issue of medical ethics? Medical ethics is very closely related to the Hippocratic Oath. All our actions as doctors must work towards healing and towards the benefit of the patient to the best of our knowledge and conscience. A further principle is never to cause any harm. Both these principles are imperiled when one carries out the circumcision of a boy who is unable to give consent. That means it's an unnecessary operation? It is an unnecessary operation. All the benefits which are said to come from circumcision, some of which are certainly valid - for example, concerning sexual infections or penile cancer or the development of tumors - are all reasons which argue for circumcision as a possible preventative measure - but not at this age. The German government wants to find a speedy solution to the problem, and it has hinted that it plans to introduce a law which will continue to permit religious circumcision. Would you consider that any solution must include restrictions as to age? I don't see any reason to pass a new law - one just has to apply existing law and existing medical ethics. There's no need for anything else. Then you come to the situation we have at the moment, that, if one wants to carry out such an operation which has no medical justification, it requires the consent of the patient. I would find extremely dangerous if there were to be a special law to permit such an operation to be carried out on, for example, Jewish children. That would go entirely against the principle of equal treatment. One could then certainly argue that this in itself would be discrimination. Currently, though, it's the case that the parents can decide, since they have legal custody. The legal custody of the parents only allows decisions which are clearly for the benefit of the child. That's why I consider this medical intervention to be illegal. It can only be dealt with if the religious communities can agree that the operation can be delayed until the child is old enough to decide for itself or to give its consent. There has to be a compromise, but I don't see any compromise possible which involves special laws for specific religious communities or other groups. That would go against the principle of equal treatment and would backfire in the end. Source: <a href="http://www.dw.de/dw/article/0,,16101556,00.html">Wait until later, say paediatricians</a>, by Dagmar Breitenbach and Joanna Impey, Deutsche Welle, 17 July 2012 <h3>Further discussion of Cologne court circumcision judgement</h3> Brian Earp, <a href="http://blog.practicalethics.ox.ac.uk/2012/06/religion-is-no-excuse-for-mutilating-your-babys-penis/">Religion is no excuse for mutilating your baby’s penis</a>, Practical Ethics Blog, 28 June 2012 Andrew Sullivan, <a href="http://andrewsullivan.thedailybeast.com/2012/06/germany-bans-circumcision.html">Cologne decision a victory for religious freedom</a>, Daily Beast, 27 June 2012 Kerre Woodham, <a href="http://www.nzherald.co.nz/opinion/news/article.cfm?c_id=466&objectid=10816649">Spare the children</a>, New Zealand Herald, 1 July 2012 <a href="http://intactnews.org/" rel="noopener" target="_blank">Humanistic Judaism increasingly critical of child circumcision</a>, IntactNews, 30 June 2012 Jewish Journalist Larry Derfner, <a href="http://972mag.com/stand-up-for-your-son-say-no-to-ritual-circumcision/49669">Stand up for your son: Say ‘no’ to ritual circumcision</a>, 972Mag, 29 June 2012 Robert Darby, <a href="http://www.onlineopinion.com.au/view.asp?article=13841">Non-therapeutic circumcision of minors: A legal and ethical minefield</a>, On-Line Opinion, 9 July 2012 <a href="http://www.openforum.com.au/content/should-circumcision-be-illegal" rel="noopener" target="_blank">Open slather, illegal or regulated: The new debate on male circumcision</a>, Open Forum, 16 July 2012 Dr Maximilian Stehr, <a href="http://www.spiegel.de/international/germany/commentary-circumcision-without-medical-justification-is-wrong-a-846395.html">Circumcision without medical necessity is wrong</a>, Spiegel International, 26 July 2012 <a href="http://www.circumstitions.com/news/news47.html#germany-illegal25" rel="noopener" target="_blank">Turkish-German politician supports circumcision restriction</a> (“Boys should decide at age 14”), TagesZeitung magazine, Berlin, 26 July 2012 Kenneth Houston, <a href="http://www.irishtimes.com/newspaper/opinion/2012/0731/1224321157056.html">Male genital mutilation a gross breach of baby's bodily integrit</a>y, Irish Times, 31 July 2012. <a href="http://ethxblog.blogspot.co.nz/2012/07/against-male-cicumcision-for-religious.html" rel="noopener" target="_blank">Against male circumcision on religious or cultural grounds</a>, Udo Schuklenk's Ethx Blog, 31 July 2012 Anthony Levin, <a href="http://www.thepunch.com.au/articles/we-must-bring-religion-in-on-the-push-to-ban-circumcision/?from=scroller&pos=3&referrer=article&link=text">We must bring religion in on the push to ban circumcision</a>, The Punch, 8 August 2012 <a href="http://pro-kinderrechte.de/faq-english/" rel="noopener" target="_blank">Pro-Kinderrechte - In favour of the rights of children</a> (in German; FAQ in English) Toby Lichtig, <a href="http://newhumanist.org.uk/2856/circumcision-time-to-cut-it-out">Circumcision: Time to cut it out?</a> New Humanist, Sept/Oct 2012 Brian D. Earp and Robert Darby, <a href="http://theconversation.edu.au/tradition-vs-individual-rights-the-current-debate-on-circumcision-10199">Tradition vs individual rights: The current debate on circumcision</a>, The Conversation, 2 November 2012 The Cologne decision has generated immense debate, especially in Europe, and new developments and commentary appear too fast to record. To keep up to date, check out the news pages of <a href="http://www.circumstitions.com/">Circumstitions.com</a> and <a href="http://circumstitionsnews.blogspot.co.nz/">Circumcision News Blogspot</a> <h2>German circumcision law shows political opportunism, not ethical principle</h2> In the wake of the Cologne court’s decision that non-therapeutic circumcision of minors constituted bodily harm and a violation of the child’s physical integrity and religious freedom and was thus unlawful, the German parliament passed a law clarifying the legality of circumcision. In an article published in the international journal Bioethics, Diana Aurenque and Urban Wiesing argue that the law was a response to political lobbying and ignored accepted principles of human rights and bioethics. Assessing the balance of benefits and harms from circumcision, the authors conclude that circumcision provides no benefits to the child as a child, but only risks and harms. ABSTRACT: The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the ‘child as a child’ and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany’s unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues – as in the case of religious circumcision. Diana Aurenque and Urban Wiesing, German law on circumcision and its debate: How an ethical And legal issue turned political. <a href="http://onlinelibrary.wiley.com/doi/10.1111/bioe.12077/abstract">Bioethics, early view, 23 December 2013</a>. See also the <a href="https://www.circinfo.org/Journal_of_medical_ethics_July13.html">article by Reinhard Merkel and Holm Putzke</a> in the July 2013 edition of the Journal of Medical Ethics. <h2>Finland: Parents’ power vs rights of the child</h2> Meanwhile in Finland there is a growing gulf between legal regulators, who want to tolerate minority cultural practices, and doctors and bioethical experts who consider circumcision of boys to be genital mutilation, no different in ethical and moral terms from female genital mutilation. Recently the Finland Greens passed a resolution that all non-therapeutic circumcision of minors should be stopped. The following commentary is from a Helsinki newspaper. The issue of circumcisions performed on boys for religious and cultural reasons has reached a stage in Finland in which it is difficult to find a solution that is acceptable to all. The Green League voted in favour of a resolution at its party congress a week ago that such procedures should be phased out in Finland either through advice or, if necessary, through legislation. Finns Party MP Vesa-Matti Sarakkala submitted a legislative initiative in Parliament calling for an outright ban on circumcisions. Earlier in the spring the issue was also taken up by Minister of Justice Anna-Maja Henriksson (Swed. People’s Party). In her view, the procedures should be permitted, but legislation, or at least guidelines from the ministerial level are needed on who may perform the circumcisions and under what circumstances. There are problems involved in both permitting and prohibiting the operations, but there are also problems involved in the Finnish status quo, which has no specific legislation to back it up. It is estimated that hundreds of non-medical circumcisions are performed on boys each year, but the circumstances under which they might be permitted, and when they would be classified as criminal assault are unclear. A basic guideline has been the decision handed down by the Supreme Court in 2008, in which the religiously motivated circumcision performed on a Muslim boy was not considered a crime, as it was performed in a medically sound manner. The decision has been interpreted in such a way that non-medical circumcisions have been seen as permissible as long as they are performed by a doctor. However, last year Helsinki District Court took a tougher line. The court ruled, among other things, that the person undergoing the procedure should understand what is happening. This means that circumcision of small children would not be allowed. The court based its decision on the <a href="http://conventions.coe.int/Treaty/en/Treaties/html/164.htm">Convention on Human Rights and Biomedicine</a> of the Council of Europe, which was adopted by Finland only after the Supreme Court’s decision. The case is still in the Court of Appeals, and it is too early to say if the Supreme Court will rule on it someday. As long as no legislation is passed, or case law established, cases will end up in court. The situation causes uncertainty among parents who do not know if they could face charges. If the surgeries are banned, there is a danger that they will be performed abroad, or that quacks might be enlisted for the purpose, and that if complications occur, the parents might be afraid to take their children in for treatment. In addition, both the Jewish and Muslim communities oppose any ban. However, if the procedures are permitted, Finland will be giving its approval to medically unnecessary surgery that interferes with the integrity of the body. The Finnish Medical Association takes the stand that child circumcisions are in conflict with medical ethics. The Ministry of Social Affairs and Health favours a compromise. It does not take a stand in either direction on the issue of legislation, but it is preparing a set of guidelines for health care professionals. Ministry official Marie Kolimaa is not disclosing the content or schedule of the guidelines. “There are many things that remain open”, she says. This is certainly easy to believe. A number of thorny questions need to be considered: <ul> <li>Should public health care be used for the performance of a religious ritual?</li> <li>What if all doctors refuse on ethical grounds?</li> <li>If the procedures are consigned to the private sector, is it still possible to get a public subsidy?</li> </ul> There is also the question of basic principles, which the Greens also referred to. Should Finland seek to act in such a way that non-medical circumcisions of boys would become less common, or be eliminated completely? If so, what would be the means to that end? Source: Irina Vähäsarja, <a href="http://www.hs.fi/english/article/NEWS+ANALYSIS+Finland+lacks+policy+on+religiously-mandated+male+circumcision/1329104229469">Finland lacks policy on religiously-mandated male circumcision</a>, Helsingin Sanomat International edition, 28 May 2012 <h2>Comment by CIA: Circumcision the only issue that unites Jews and Muslims</h2> Defence of their right to commit an act of violence against their children seems to be the only issue that distracts Jewish and Muslim adults from their need to commit violence against each other. Yet there is a major difference between Jewish and Muslim circumcision practices: for a devout Jewish parent who follows all the rules laid down in the Torah, there is a passage in Genesis that appears to require them to circumcise their male children on the eighth day (and also their servants and employees, though this is not insisted upon these days). Circumcision is (or should be) performed by a Mohel as a religious ceremony, analogous to baptism, with a service, liturgy, ritual and celebration following a set pattern. There are no such requirements in the Muslim scriptures: the Koran makes no mention of circumcision, and the only words from the prophet Mohammed recorded on the subject state that is desirable or meritorious for both men and women as a sign of piety and commitment to the faith. Unlike in Judaism, there is no liturgy or religious ceremony associated with the operation, which (these days) is normally carried out by a doctor in a sterile clinical setting, and no ritual elements at all. In other words, there is no obligation placed on parents to circumcise their children; circumcision is merely an act of faith that a devout Muslim might be expected to elect for himself. It follows that there is no valid reason why children of Muslim parents should not be protected from circumcision until they are old enough to decide the matter for themselves. Those who talk about the right to religious freedom forget that the treaties and declarations that guarantee such freedom extend it to everybody, irrespective of age: children have their own entitlement to religious freedom. As to the question of assault, there can be little doubt that forcible circumcision of an adult would be a criminal assault occasioning actual bodily harm; if that is the case, at what age does the same action become a legal and acceptable practice? Would it be legal to forcibly circumcise a 15-year old boy? What about a 10-year old? A 5-year old? From a logical point of view, if to circumcise an adult without his informed consent is a criminal assault, it must be equally wrong to perform the same action on a minor. To argue otherwise would be to imply that while it is wrong to commit sexual assault or rape on an adult, it would be perfectly OK to rape a child. Society has decided the contrary: that assaults on defenceless children are far more wicked than the same assaults on adults. Why should cutting of a boy’s genitals be regarded any differently? The words of Holm Putzke, a criminal law expert at the University of Passau, get to the heart of the matter: “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate.” </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource German court rules non-therapeutic circumcision unlawful darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> The Supreme Court of Canada has dismissed the appeal of a British Columbia man who tried to circumcise his four-year-old son on his kitchen floor with a carpet-cutting blade. The boy needed corrective surgery to repair the severe damage arising from the attack. In a 7-0 ruling, the justices left intact a Court of Appeal ruling that convicted the man of aggravated assault and assault with a weapon. The man was convicted at trial in October 2009 of criminal negligence causing bodily harm and acquitted on the two assault charges. The appeal court restored convictions on the assault counts and stayed the negligence charge, conditional on the conviction for aggravated assault. The man's appeal to the Supreme Court sought to have the assault charges thrown out again, but the justices dismissed the case. The original trial was told the man felt that his religious beliefs required that his son be circumcised. Doctors advised him to wait until the child was older and stronger before performing the procedure. The Crown dismissed the religious reasoning. “This is a case about child abuse,” the Crown argued. "This is not a case about the applicant’s religious freedom or circumcision generally." Source: Father who circumcised his son on the kitchen floor loses high court appeal, <a href="http://www.montrealgazette.com/news/Father+circumcised+kitchen+floor+loses+high+court+appeal/7561185/story.html">Montreal Gazette, 16 November 2012</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Canada Supreme Court: circumcision "aggravated assault" and child abuse darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> In a hard hitting editorial that raises the spectre of neocolonialism, the South African Medical Journal has condemned the push for mass circumcision of African men as the solution to the nation’s HIV-AIDS problem. The editorial, by the journal editor Professor Daniel Ncayiyana, reviews the evidence for the claim that circumcision reduces the risk of female-to-male infection, and finds it less conclusive than assumed (and far less significant than regularly proclaimed in sensationalist newspaper headlines). The weakness of the case arises partly because the three clinical trials on which it is based were terminated prematurely, and partly because surveys show no consistency in the pattern of HIV infection among circumcised and uncircumcised men. (In some places there is little difference, and in some the incidence of HIV is higher in circumcised men.) There is certainly nothing in the results of the trials to justify the wild claim that circumcision provides “lifelong protection” against HIV; the most that could be said is that in areas of high HIV prevalence circumcision reduces the risk of female-to-male transmission in unprotected intercourse. Despite the much-touted “60 per cent” figure, nobody really knows the extent of the risk reduction in real world situations. Circumcision provides no protection to homosexual men or injecting drug users, and may increase the risk of male-to-female transmission. The editorial warns that an excessive and disproportionate focus on expensive surgical interventions such as circumcision will discourage condom use (known to be 90 per cent effective against HIV transmission) and deplete the resources needed in other critical health areas (such as malaria and tuberculosis). Already there is evidence that many men believe that the chief advantage of circumcision is that they will no longer have to wear condoms. At the same time, promoters of the circumcision solution still insist on condom use even after circumcision. Clearly, as Van Howe and Storms point out, this demand implies lack of faith in their own prescription: “Circumcision is either inadequate (otherwise there would be no need for continued condom use) or redundant (as condoms provide nearly complete protection).” * The editorial urges South Africa to follow the recommendation of the Australian Federation of AIDS Organisations, which has rejected circumcision and reiterated that “correct and consistent condom use … is the most effective means of reducing female-to-male transmission, and vice-versa.” ** Raising the spectre of human rights abuses and colonialism, the editorial is particularly concerned at the push for universal circumcision of infants and children, despite the fact that the South African Children’s Act specifically prohibits circumcision of boys under the age of 16 years. The editorial notes that much of the push for circumcision in Africa comes not from native Africans, but from international aid agencies dominated by United States funders and policy-makers, and that many programs are funded by the vastly wealthy Bill and Melinda Gates Foundation. It comments that it is “curious and even worrisome that the campaign to circumcise African men seems to be driven by donor funding and research from the North.” Mutilation of African native bodies by white and Arab slave traders and other exploiters was a sad feature of African experience in the dark days of colonialism, before the various nations achieved independence. In more modern times, western pharmaceutical companies have treated African and other “Third World” peoples as convenient guinea pigs on which to test their drugs – often with tragic results. It is strange to see such similar practices being revived and enforced by benevolent white medical missionaries, but their determination to carve their mark on the bodies of African men certainly looks like a new and particularly insidious form of cultural imperialism. Source: “Editorial: The illusive promise of circumcision to prevent female-to-male HIV infection: Not the way to go for South Africa”. <a href="http://www.samj.org.za/index.php/samj/issue/view/119/showToc">South African Medical Journal, Vol. 101, November 2011, 775-776</a>. References * Van Howe RS, Storms MR. <a href="http://www.publichealthinafrica.org/index.php/jphia/article/view/jphia.2011.e4/html_9">How the circumcision solution in Africa will increase HIV infections</a>. Journal of Public Health in Africa 2011;2:e4. doi:10.4081/jphia.2011.e4 A study of Nigerian prostitutes in 1988 found that, after counselling sessions, condom use increased markedly and that even occasional condom use had a significant protective effect: of 28 women who never used a condom, only eight escaped infection with HIV; but of 50 women who used them in approximately one third of sexual encounters, 27 (54 per cent) avoided infection. It is instructive to compare this with the results of the recent clinical trials of circumcision, which reported a risk reduction of between 50 and 60 per cent: about the same as the risk reduction achieved by condom use 30 per cent of the time. See E.N. Ngugi et al, “Prevention of transmission of human immunodeficiency virus in Africa: Effectiveness of condom promotion and health education among prostitutes”. Lancet, Vol. 332, No. 8616, 15 October 1988, 887-890. ** Australian Federation of AIDS Organizations. Male circumcision has no role in the Australian HIV epidemic. Briefing Paper, 23 July 2007. Available at http://www.afao.org.au/__data/assets/pdf_file/0019/4528/BP0709_Circumcision.pdf </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource South African medical journal condemns circumcision push as medical colonialism darby