Media information:  Ya-Ting Liu at (O) 917-438-4627 or (c ) 908-227-0686 [email protected]
M+R Strategic Services, Inc. New York, NY August, 24, 2009




Medical Ethics, Human Rights Argue Studies of Adult Men in Africa Cannot Be Extrapolated to Infants in America on the Chance They Will Engage in Unsafe Behavior Decades Later

Doctors, health practitioners and medical ethicists gathered in Atlanta today to urge the Centers for Disease Control to examine all the facts before recommending in favor of subjecting newborn baby boys to circumcision, a medically unnecessary surgery that violates medical ethics and the human rights of non-consenting infants.

Intact America, which created the website as a clearinghouse for information on male circumcision, came to the CDC’s conference on HIV to call on the agency to study the ethics, risks and facts about circumcision, which the American Medical Association calls “non-therapeutic.” No major medical association in America – not the AMA, not the American Academy of Pediatrics and so far not the CDC – recommends in favor of circumcision, seeing no medical benefits to justify an endorsement of the painful and risky removal of healthy functional tissue from a baby boy.

Intact America contracted with a mobile billboard company to travel around the conference site in downtown Atlanta with the message “Tell the CDC circumcising babies doesn’t prevent HIV.”

“The CDC is moving down a path towards an indefensible recommendation in favor of subjecting newborn baby boys to unnecessary and potentially risky surgery with no medical benefit,” said Georganne Chapin, a health care executive who heads Intact America. “Preventing HIV requires use of a condom or other safe sexual practices. Those same African studies that suggest circumcision could help slow female to male HIV transmission also found unacceptable levels of male to female transmission, because circumcision is not the answer.”

Medical ethics states that surgery requires a health benefit to the patient, or informed consent, neither of which is present in neonatal male circumcision. 

“More and more parents and health professionals are coming to understand that male circumcision is medically unnecessary and ethically wrong,” said Chapin, noting that the percentage of American babies undergoing circumcision has dropped from 90 percent thirty years ago to less than 60 percent today.

Even with the drop in circumcision rates, the United States is the only industrialized country (except South Korea) which still circumcises a majority of its baby boys for non-religious reasons. By comparison, the rate is below 5 percent in some European countries. The drop in the circumcision rate in America is attributable to a combination of factors – an increase in immigration from areas such as Latin America, the Caribbean and Asia where circumcision is rare and the growing awareness by parents and health professionals, including pediatricians, obstetricians and nurses who refuse to participate in the surgery on ethical ground.

Another factor the decline of circumcision is the cost the surgery imposes on public health systems.

John W. Travis, MD, MPH, founder of the first wellness center in the United States, pointed out that rates of circumcision go down when public funding for the surgery is disallowed, whether in Great Britain when the national health plan ceased funding, or in as many as 16 states in the US when Medicaid funding authorization was ended. This underscores the fact that circumcision is a cultural, as opposed to medically necessary surgery.

“Infant male circumcision is medically unnecessary, ethically indefensible, and, at a time when the country is struggling to reform our health care system, adds billions of dollars annually to cost of that system,” said Travis. “It would be unconscionable for the CDC to use African studies of adult men to recommend surgery on infant boys who cannot consent to the removal of healthy bodily tissue, on the chance they might engage in unsafe sexual activity twenty years into the future.”

One recent HIV study of circumcision and adult men in Africa had to be ended prematurely because researchers found increased instances of HIV being contracted by women, an indication that the men were not taking precautions such as using a condom, which is the universally recognized means to minimize HIV transmission. Just last week, the AMA issued a paper on a study in Uganda ended prematurely because of higher incidences of women contracting HIV from men who were not using condoms.

Condom use after male circumcision is essential for HIV prevention, the researchers reported in the AMA report, underscoring the point that circumcision is not a preventative for HIV transmission.

Soraya Miré, the Somali filmmaker who has been a leading global voice against forced female circumcision, argues that male circumcision presents the same ethical and human rights challenges as the banned practice of female circumcision.

“The same universal human right to an intact body that I have fought for on behalf of women and girls must apply to boys as well, especially those who are too young to make an informed decision about the integrity of their bodies,” said Miré. “We need to ask ourselves, how can it be wrong to surgically alter the genitals of a baby girl without her consent but okay to surgically alter the genitals of a baby boy.”

Miré also rejects the argument that criticizing circumcision amounts to criticizing parents who have circumcised their sons in the past.

“African parents do not circumcise their girls because they want to hurt or oppress them,” said Miré. “They do it for many of the same reasons that American parents circumcise their sons – because they think it’s cleaner and healthier, because they think the child will be shunned or scorned if she is left intact, and because the mother is circumcised so the daughter should be, too.  In other words, African parents go along with a cultural practice they never thought to question, just as many Americans do not think about the practice of circumcising their boys.”

One panel at the CDC conference will feature an Israeli pioneer of assembly-line circumcisions, developed to handle Russian and Ethiopian immigrants to that country. Inon Schenker, the head of Operation Abraham, will present plans to increase the rates of circumcision among Hispanics and African Americans, groups described as “non-circumcising communities.”

A paper published in May by a CDC official indicated that Hispanics are the demographic group with the lowest circumcision rate in America. That report noted that there are dramatic regional differences as well, with the highest circumcision rates in the Midwest and the lowest in California and the Southwest.

That paper revealed that the CDC plans its own demonstration project in two sexually transmitted disease clinics among adult men engaged in high risk heterosexual behavior. Again, Intact America argues that studies of adult men cannot be extrapolated to recommending unnecessary surgery to remove healthy functioning tissue from a baby boy on the grounds he might engage in unsafe sexual behavior decades into the future.

Robert Van Howe, MD, a Michigan pediatrician and professor at the Michigan State University medical school, is one of many doctors who refuses to perform circumcision, seeing it as a violation of his oath to do no harm.

“Physicians have an obligation to look after the well-being of their patients. The child is the patient, not the parent.  Neonatal circumcision is definitely not in the patients’ best interest,” said Dr. Van Howe, noting that the surgery yields more harm than benefit for the baby boy who cannot give informed consent. “It is a violation of the child’s most basic human rights, and a violation of a physician’s oath to do no harm.”