INTACT AMERICA DEMANDS AMERICAN ACADEMY OF PEDIATRICS
RETRACT ITS NEW TECHNICAL REPORT
FAVORING THE PRACTICE OF INFANT CIRCUMCISION
Group Opposed to the Non-Therapeutic Genital Cutting of All Children
Calls Report Misleading, Biased, and Unethical
FOR IMMEDIATE RELEASE
August 27, 2012
TARRYTOWN, NY—Intact America demands that the American Academy of Pediatrics (AAP) retract its Technical Report released today* extolling the benefits of neonatal male circumcision. According to Georganne Chapin, founding executive director of Intact America, the Report disregards pediatricians’ ethical obligations to their patients and promotes the benefits of circumcision through a selective and self-serving literature review. Further, by calling for public and private insurance payments for medically unnecessary circumcision, the Report promotes pediatricians’ self interest, at the cost of the safety and wellbeing of newborn baby boys and the men they will become. The Report, written by the AAP’s Task Force on Circumcision, is to go before the AAP membership at its October meeting in New Orleans. It stops short of recommending circumcision, even as it claims the surgery’s benefits outweigh the risks, and calls for parents to be the ultimate decision-makers.
The AAP Technical Report says, “Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.” In an apparent contradiction, the Report also admits that “the true incidence of complications after newborn circumcision are (sic) unknown” making all the more remarkable the Task Force’s assertion that the surgery’s “health benefits… outweigh the risks,” and that if parents ask for it, insurers should pay for it.
“The Report presents highly selective information to promote the benefits of a useless and unethical surgery, and completely ignores the rights of the child to an intact body,” says Chapin. “We believe that the AAP’s own Committee on Bioethics said it best in 1995.” In that Policy on Informed Consent, Parental Permission, and Assent in Pediatric Practice,** the Committee on Bioethics stated: “[Pediatricians] have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses… [The] pediatrician’s responsibilities to his or her patient exist independent of parental desires or proxy consent.”
Chapin noted that no medical society in the world recommends in favor of routine neonatal male circumcision. “Just as understandable revulsion of female genital mutilation has led to the outlawing of that practice, modern nations are recognizing that boys, too, have the right to an intact body.”
“The fact that the AAP Task Force is calling for third-party payment for circumcision, even though it cannot find justification for recommending the surgery, shows that a group charged with a serious evaluation of a non-therapeutic surgery is acting like a trade association on behalf of doctors’ bank accounts, rather than helping doctors to protect their newborn patients,” said Chapin. “The Report relies on flawed studies of sexually active adult African men in order to encourage American parents to subject their newborn sons to unnecessary and risky surgery to remove healthy body parts, on the assumption that the boys will engage in unsafe sexual behavior decades into the future.”
In an official response to be published later today on the Intact America website (intactamerica.org), Chapin writes, “By ignoring the substantial body of literature showing supposed “benefits” of circumcision to be nonexistent, ignoring the fact that infant circumcision violates bioethical principles and children’s rights, ignoring the fact that a growing number of European physician groups view circumcision as a violation of children’s rights, calling for increased funding for this non-therapeutic and harmful procedure, and actively soliciting other health professionals to enlist in the circumcision enterprise, the AAP is exposing itself, as well as its member physicians, to moral and legal liability for perpetrating this harmful and unethical practice."
Several recent developments have underscored the declining circumcision rate in America, where more than 80 percent of baby boys were circumcised as infants as recently as 1979, but just around half or less are today. In Germany earlier this summer, a Cologne court ruled (re 151 Ns 169/11) against a Muslim family’s decision to circumcise their four-year-old son, with a judge writing: “The body of the child is irreparably and permanently changed by a circumcision. This change contravenes the interests of the child to decide later on his religious beliefs.”
Following the German court decision, some hospitals in Switzerland and Austria ceased allowing circumcisions on their premises. In Denmark, the Prime Minister has commissioned an investigation into whether non-medical circumcision procedures violate its health code.
The Royal Dutch Medical Association has recommended against the surgery, with medical ethicist Gert Van Dijk calling circumcision “a medically unnecessary form of surgery… The patient has to give consent, but children can't give consent and we feel that is wrong and a violation of the child's rights. In our code of medical ethics, it states that you must not do harm to the patient, but with this procedure this is exactly what you're doing.”
Said Chapin, “The AAP Task Force has ignored the fact that European and other developed countries with extremely low rates of circumcision also have far lower rates of sexually-transmitted diseases than the United States, where circumcision rates are higher. Similarly, the Report fails to acknowledge that circumcision rates within the United States vary greatly by geography and demographic factors, and that there is no correlation between those subgroups’ or regions’ rates of circumcision and the health of children or adults.”
Doctors and others have joined in the criticism of the AAP.
“That the AAP is on the verge of promoting the removal of the foreskin as a more acceptable option than wholeness, and that it favors twisting the facts to give the impression that intact males are somehow defective, inferior and at risk, appears to be a thinly veiled attempt to discriminate against and marginalize intact males,” Dr. Michelle Storms, Assistant Clinical Professor at the Michigan State University College of Human Medicine and member of Intact America’s board of health professionals, said in a letter calling on the AAP to retract its new Technical Report. Storms also notes that the AAP stacked its committee with members predisposed to supporting circumcision. “This type of decision-making and skewed committee membership is abhorrent, unscientific and ultimately harmful to those people we should be most concerned with protecting our nation's children. The AAP board of directors has an obligation to do what is ethical and moral: rescind a flawed policy promoting or proclaiming benefits from unnecessary genital surgery on non-consenting minors.”
"When an organization, dedicated to 'the health of all children,' promotes unnecessary amputation of a normal body part and denies the right of children to personal autonomy, it surely will lose credibility,” commented Marilyn Milos, head of the National Organization of Circumcision Information Resource Centers (NOCIRC), and a co-founder of Intact America. “Too many parents are learning about the benefits of the foreskin and the harms and lifelong adverse consequences of circumcision, and there are now too many healthy intact males for the new AAP Report to hold sway over what parents will do. It's a shame that the Task Force’s bias has put the organization out of step with the rest of the medical world, where infant and child circumcision is considered a human rights violation."
In conjunction with the release later today of Intact America’s official response to the AAP Task Force Report, Chapin has announced a campaign to be launched this week by Intact America demanding that the AAP retract its Report on the basis that it is inaccurate, biased and misleading, that it fails to address ethical and human rights issues, and that – as a result – more boys and men will suffer the pain of circumcision and the permanent damage it causes.
Intact America was formed in 2008 to change the way America thinks about neonatal male circumcision. Intact America believes that painful and medically unnecessary surgery to remove healthy genital tissue from non-consenting baby boys violates medical ethics and human rights.
** http://pediatrics.aappublications.org/content/95/2/314.full.pdf+html; the Statement was reconfirmed in 2006.