I certainly don't want to tread on anyone's religious beliefs, particularly during the holiday season, but while we're all contemplating age old practices, I've just got to speak out against routine neonatal circumcision, after examining medical circumcision in the last issue. Although not routine in Britain and many European countries, 80-90 per cent of American boys are still circumcised, as are one sixth of the entire world's male population, mainly on religious grounds.
In America, the one to three day old newborn is strapped down on a padded circumcision mould and a Gomco clamp is applied to his penis, which crushes and cuts off blood to the foreskin. This has been hailed as "bloodless" surgery, thus avoiding the need for sutures.
At a Jewish bris, or naming ceremony, the eight day old baby is held down, usually by the godfather, and the non medical mohel tears away the foreskin from the glans with a blunt probe, and then amputates the foreskin with a double edged knife. The sensitive inner layer of skin covering the glans is then torn with sharp fingernails or cut open with scissors. The penis is bandaged, the baby is named and the party continues.
The baby, according to Shelton Kartun, a Jew writing for Norm UK, an organisation against circumcision, "will either be screaming hysterically or totally quiet in a state of absolute shock."
In up to 96 per cent of cases, this is performed without any anaesthetic.
The justification for any lack of pain relief in this modern day and age has been variously that newborns feel little or no pain from circumcision, particularly from modern surgical techniques, or even that the baby won't have any lasting memory of it, anyway. A recent randomised, controlled trial comparing babies given anaesthesia during circumcision with those given a placebo found that without exception, the babies who did not receive anaesthetic suffered "great distress during and following the circumcision". Two newborns began choking and stopped breathing.
Some studies show that pain after circumcision remains in the memory, disturbing feeding, sleep and the ability to be aroused (Hawdon in Bailliere's Clinical Paediatrics, 1995; 3 no 3). This "memory" appears to create a lower pain threshold in the future. Some researchers have suggested that the early memory of pain may disrupt a child's adaptation to his environment, ability to bond and long term psychological development (N Eng J Med, 1987; 317: 1321-9).
There is no sound medical reason for circumcision. The supposed proof that circumcision prevents penile cancer is based on a 1932 study. A higher incidence of penile cancer exists in America, where most men are circumcised, than in Denmark, where only 2 per cent are circumcised. The other great argument, that it prevents urinary infection, is not based upon any controlled research. Nor has it been proven to prevent sexually transmitted diseases.
In the Jewish religion, complete amputation of the foreskin is a perversion by ancient rabbis of the biblical commandment in Genesis 17, says Shelton Kartun, who has studied Judiasm and circumcision for 20 years. God asked Abraham to remove only the very tip of the foreskin as a sign of the covenant between the Jewish people and God. Only a small scar was required. The glans was to remain protected.
In North America, the only ones who benefit from circumcision are the doctors; it's a big bread and butter money spinner and a primary source of human skin grown in the lab for grafting. According to Dr John Warren, of NORM, circumcision of a healthy child breaches 10 articles of the UN Convention of the Rights of the Child. While many of us are thinking about one infant boy this time of year, isn't it time we stopped and thought about what we are still doing to infant boys the world over?