Academic Articles

Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury

J. Steven Svoboda, Esq., MS, JD
AMA Journal of Ethics, August 2017

Nontherapeutic circumcision (NTC) of male infants and boys is a common but misunderstood form of iatrogenic injury that causes harm by removing functional tissue that has known erogenous, protective, and immunological properties, regardless of whether the surgery generates complications.

Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non-Therapeutic Circumcision

Robert Darby, Kennedy Institute of Ethics Journal, 2015

Complications are not the only harms of circumcision: the AAP and other parties debating the pros and cons of circumcision should conceptualize their analysis more broadly as risk of harm vs. prospect of benefit, thereby factoring in the value of the foreskin to the individual and the physical and ethical harms of removing it from a non-consenting child.

Is Circumcision Legal?


Thus, a battle is unfolding in courts and legislatures as to the legality of circumcision. Amidst all of the divisiveness and hyperbole, we need to ask, what are the relevant facts, legal issues, and what is the applicable law?

Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns

Gregory J Boyle and George Hill, Journal of Law and Medicine, 2011

What does the frequently cited “60% relative reduction” in HIV infections actually mean? Across all three female-to-male trials, of the 5,411 men subjected to male circumcision, 64 (1.18%) became HIV-positive. Among the 5,497 controls, 137 (2.49%) became HIV-positive, so the absolute decrease in HIV infection was only 1.31%, which is not statistically significant.

A CDC-requested, Evidence-based Critique of the Centers for Disease Control and Prevention 2014 Draft on Male Circumcision: How Ideology and Selective Science Lead to Superficial, Culturally-biased Recommendations by the CDC

Robert S. Van Howe, MD, MS, FAAP
Professor and Interim Chair of Pediatrics
Central Michigan University College of Medicine

In effect, the CDC, by making the recommendations it has, is asking clinicians and health care providers to misinform their patients, and by doing so, commit medical malpractice. As a consequence, the recommendations for the intended audience of health care providers are inconsistent with the medical evidence, reckless, and dangerous. The CDC should eliminate this draft and approach the topic using an evidence-based approach.

Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision

Morten Frisch, MD, PhD, et al. PEDIATRICS Volume 131, Number 4, April 2013

Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia.

Fine-touch Pressure Thresholds in the Adult Penis

Morris L. Sorrells, et al., British Journal of Urology, 2007

When compared to the most sensitive area of the circumcised penis, several locations on the [intact] penis (the rim of the preputial orifice, dorsal and ventral, the frenulum near the ridged band, and the frenulum at the muco-cutaneous junction) that are missing from the circumcised penis were significantly more sensitive.

The Psychological Impact of Circumcision

Ronald Goldman, PhD, BJU INTERNATIONAL, Volume 83, Suppl. 1: Pages 93-102, January 1999

There is strong evidence that circumcision is overwhelmingly painful and traumatic… The potential negative impact of circumcision on the mother-child relationship is evident from some mothers’ distressed responses and from the infants’ behavioural changes. The disrupted mother-infant bond has far-reaching developmental implications…

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