Dr. Amy Tuteur, a blogger on the blog Science Based Medicine, has posted a pro-circumcision blog entry discussing the recently published article in the Archives of Pediatrics and Adolescent Medicine. She urges the American Academy of Pediatrics to reconsider its fence-sitting position on neonatal circumcision in favor of the procedure in light of the African RCTs viz HIV and the data churning of said studies to produce pro-circ findings on HPV. She's taking heat in the comments, and not just from laypeople.
Dr. Tuteur argues that she's merely interested in the science while ignoring or brushing off as irrelevant any reliance on ethical principles and practice to guide the discussion. She has claimed that she isn't in favor of circumcision, but rather only that parents be given the opportunity to learn all the current arguments in favor despite headlining her piece "The Case for Neonatal Circumcision" and ending her discussion thusly, "The AAP should heed the authors' call [to recommend neonatal circumcision]."
The Achives of Pediatrics article is authored by two of the usual suspects, Gray and Quinn, and several of their colleagues. Essentially, it's an argument in favor of circumcision on thin grounds and without any significant reference to why it is better to impose circumcision on those who cannot say no as opposed to presenting the arguments at an age of understanding for the affected male to decide one way or another, and if in agreement, to give his informed consent.
I would encourage interested parties to head on over and read the article, which as of this writing has inspired 229 comments. Many of the commenters are doctors or scientists with a lot to say on the issue.
At this stage of my own involvement in this issue, I tend to write sparsely because I often feel as if I'm repeating myself. Therefore, I'm always thrilled when someone else speaks eloquently and in so doing expresses my own distilled views on the matter.
Fortunately, Martin Robbins over on the The Lay Scientist has responded to Dr. Tuteur in a very thorough fashion. For me and my focus, this statement says it all: "If you're going to advocate making a permanent alteration to the appearance of somebody's genitals, without waiting for them to be old enough to decide for themselves and consent to it, then you had better have a bloody good, watertight, and immediately urgent reason for doing so."
At some point, the scientific and medical communities are going to have to realize that you can't just ignore all other considerations just because you have established yourself as an expert in the field. One's alleged expertness may be trumped by how we organize our society.
We have shifted many formerly parental decisions to the child, such as who and when to marry. Other decisions have been shifted to society as a whole as expressed through legislation, such as what age children can drink alcohol. It's time to shift the decision regarding permanent and irreversible genital surgery from parents to the young man an infant will one day become.
(Also worthy of your attention are two recent statements by professional medical associations that properly focus on the ethics side of this discussion. The College of Physicians and Surgeons of British Columbia has concluded that "routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended." The Royal Australasian College of Physicians has issued preliminary guidance, stating flatly that neonatal circumcision is not recommended in infancy.)
