New pro-circ myth: ethics

[JohnC]

I never thought I would have to deal with an ethical argument in favour of circumcision, but we have one now, courtesy of the RACP.

As any undergraduate philosophy student knows, ethical conclusions are "ought" statements, and you cannot derive an "ought" from an "is" -- that's called the Naturalistic Fallacy. But that doesn't mean ethical positions can be completely unhinged from the real world, either, otherwise anything goes. To the extent ethics turns on the empirical, such things can investigated and evaluated.

So what does the RACP say?

The option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered. This option has recently been recommended by the Royal Dutch Medical Association. The ethical merit of this option is that it seeks to respect the child’s physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future.

So far so good, but then ...

However, deferring the decision may not always be the best option.

Really? Why not? Well, to get to the nub of this argument ...

A boy circumcised as an infant may deeply resent this when he grows older; he may want what he cannot have – not to have been circumcised. But it is also possible that a boy not circumcised as an infant (so that he can make his own decision later), may also deeply resent this. He may also want what he cannot now have – to have been circumcised as a baby.

This has a kind of superficial plausibility (if you read quickly and don't think too deeply). It suggests a symmetry between the two positions -- and since a boy may resent the decision either way, parents should be free to do whatever they think is the right thing.

But the decisions either to circumcise or to leave a boy intact are not symmetrical. First and foremost because circumcision is irreversible. Even if a boy grows up wishing he had been circumcised, he can still have his foreskin amputated at any time in the future. Not so for the victim of RIC: what's gone is gone and can never be put back.

But there is another question here: how many intact boys will grow up so fervently wishing they had been circumcised that they actually do so when older? We can put a real number on this, since adult circumcisions in Australia are performed in hospitals or day surgery centres, and those done for routine or ritual purposes are coded as such (principal diagnosis item Z41.2). The answer from data collected over a 14-year period (1994-2008): an average of 333 per annum (with a standard deviation of ±31 cases). That is, about 330 males aged 15 years or older will undergo circumcision each year for what the RACP calls "psychosocial reasons", and that's from a population of intact adults numbering about 4.5 million.

On the other hand, there were 749,611 preschool aged boys in the financial year to June 2010, about 14 per cent of whom will undergo routine or ritual circumcision -- 21,000 boys in all -- by the time they start school.

So that's 21,000 boys who no longer have a choice in the matter versus 333 adult males who still had a choice and exercised it. To suggest an ethical symmetry on the basis of this metric is beyond preposterous. As for resentment, even if we perversely asserted, arguendo, that all of those adults were resentful of their parents' decision but only 20 per cent of the boys felt that way, that's would still be a more than 10-fold imbalance.

Dutch doctors are therefore "urging a strong policy of deterrence" against routine and ritual circumcision; it's a shame their Australian counterparts, on the basis of such shoddy and unconvincing reasoning, missed the opportunity to do the same.

Sources: Medicare statistics, Health Insurance Commission. Principal diagnosis datacubes, Australian Institute of Health and Welfare. Circumcision in Australia: prevalence and effects on sexual health, Richters et al (2006). Circumcision of Male Infants, Paediatrics & Child Health Division, Royal Australasian College of Physicians (2010). Estimated Resident Population By Single Year Of Age, Australian Bureau of Statistics.

[rainbow123]

It makes me physically ill to think there are parents out there who willingly mutilate their sons. Really interesting reading that RACP article John:

"Circumcision of males is legal in Australia, New Zealand, the UK, USA and Canada.
However, routine neonatal circumcision has been declared unlawful in South Africa,
Sweden (except on religious grounds) and Finland."

Since when has Australia been BEHIND SOUTH AFRICA in human rights laws??? For shame!

This part is also a really tidy sidestep:

"A basic ethical requirement for performing a medical procedure on a child is that it can reasonably be expected to produce more benefits than burdens (in the long term) for the child."

That's how doctors get around the whole ethical dilemna of cutting a perfectly healthy and whole child. How they sleep at night I do not know. Benefits?! What a joke.

For anyone else interested in being disturbed:

http://www.racp.edu.au/index.cfm?obj...6C86100E4E3E8E

[mummykitty]

An interesting read thanks

[AM]

Adults being resentful as adults that they were NOT circ as babies? That is beyond ridiculous...

[justinonymous]

I'm not quite sure how such shoddy reasoning has worked its way into the RACP policy - I was always under the impression that the RACP was against circumcision, and now this:

In New Zealand and Australia at the present time, newborn and infant male circumcision is legal and generally considered an ethical procedure,

by whom? Brian Morris?

I've never met anyone in my life who considers it an ethical procedure.