Saturday, August 27, 2011

The ethical dilemma surrounding male circumcision

Male Genital Mutilation (AKA: Circumcision)

            In his essay, “Some moral minima”, Lenn Goodman (2010) makes a distinction between female genital mutilation (FGM) and circumcision, claiming that circumcision is allowable because it does not deny the male pleasure (p.92). However, this is not the case. Western origins of male (and female) circumcision began as a campaign against masturbation, since the foreskin has over 24,000 nerve endings (Darby, 2003).The process of circumcision is painful, performed without anesthesia, done without the consent of the victim, and removes a functional part of the penis- the foreskin- which provides protection against infection, and is also an erogenous zone (Saunders, 2001). It is time to stand up for our sons, and call circumcision what it is: male genital mutilation.

            Most people believe that circumcision was introduced into western societies after light was shed on the health benefits of the procedure. The truth is, it first began in the Victorian era in Britain as a way to prevent masturbation, and it included the circumcision of females (Darby, 2003). It was touted as a preventative measure to cure impotence, sterility, homosexuality, and a punishment for those caught masturbating (Darby). The key word here is “punishment.” They knew that it would desensitize the penis, lessening the pleasure of the man, and discouraging such conduct.

             Routine neonatal circumcision didn’t really take hold until approximately 1870, and the reasoning is unclear (Darby, 2003). While physicians encouraged circumcision, there does not appear to be a firm explanation as to why they supported it, other than the puritanical fears of “precocious sexual unrest” (Darby, p. 737). They claimed it would prevent impotence, syphilis, epilepsy, and other mental disease (Dekkers, 2009). At the beginning of the 20th century, it spread throughout the United States as a way to prevent venereal disease and cancer. Although the practice died off in Britain, it has become more prominent, and the social norm in the US, despite the fact the American Academy of Pediatrics has been saying since 1971 that there is no health benefit (American Academy of Pediatrics, 2005).

            Many people don’t realize that female circumcision was being promoted in the United States as late as the 1980’s, and medically unnecessary genital cutting of a minor female was not officially outlawed until 1997 (MGMbill.org, 2011). When we think about that, it seems incredible that in our own lifetime, people once considered female circumcision not only appropriate, but a way to make sex easier for a husband, a way to ease masturbation, and a cure for an assortment of different psychoses (Rathmann, 1959).

            During the 1950’s, nearly 100% of infant boys were circumcised, and those who weren’t at birth, were circumcised when they came back to the hospital for unrelated procedures, like having their tonsils removed (Denniston & Milos, 1997). By this time, hospitals had decided that circumcision was a lucrative business, and were intent on continuing the practice.  Medical textbooks actually omitted the foreskin in depictions of the male genitalia (Denniston & Milos). In books where it was shown, it was inaccurately drawn, leading many to believe an intact penis was strange or a defect (Denniston & Milos). At one point in the 1970’s, when the world embraced sexual awareness and free love, circumcision advocates did a complete turn around and claimed that female circumcision would cure frigidity, and enhance orgasm (Denniston & Milos) .

             Over time, many of the myths about the foreskin were debunked: it was a birth defect, it lead to penile cancer, it makes urinating difficult, it causes prostate cancer and cancer in women (Denniston & Milos, 1997). When the American Academy of Pediatrics publicly stated that there was no medical reason for it, circumcision lobbyists had to come up with a new theory, and decided that urinary tract infections were caused by the foreskin (Denniston & Milos). Many studies were done with circumcised and intact infants, and it did show an increased chance (1.4%) of UTIs in the intact infants, versus the .14% of those who had been circumcised (Dennsiton & Milos). None of the studies, however, took into account those who were breastfed (since breastfeeding provides antibodies), or proper care of an intact penis (Denniston & Milos). Forced retraction in itself can cause infection, and since many in the medical field had never been properly taught how to care for the foreskin, some infections came from the medical staff itself (Dennison & Milos). They also highlighted the difference as a ten percent increase, rather than acknowledging that 1.4% is only 1 ½ percent of boys studied. They pushed circumcision as a cure for something that 99% of infant males don’t even get (Denniston & Milos).

            Another big medical scare of the 1980’s was AIDS. With limited knowledge on how the virus worked, the medical field used the information they had. Since a large majority of those contracting the disease were homosexual men, it was falsely assumed that the foreskin could harbor the virus (Denniston & Milos, 1997). As with Syphilis in the 19th century, circumcision was thought to be the answer for AIDS (Denniston & Milos). Ignoring the fact that AIDS is also transmitted by infected blood (blood transfusions) and dirty needle sharing (drug use and tattoos)-situations where circumcision is not even a factor- circumcision was once again being recommended by the medical field (Denniston & Milos). Many doctors went to Africa to circumcise men in an effort to control the AIDS epidemic there (Denniston & Milos). The amazing thing is, in Africa, the ratio of intact/circumcised men with AIDS is nearly 50/50, and circumcision has done nothing to slow down the outbreaks (Intact America, 2011). In a 2007 study, ten of the eighteen African countries studied revealed that AIDS was more prevalent in men who had been circumcised, insinuating that perhaps circumcision may be adding to the problem, rather than solving it (Intact America).

            Deontology states that we have a duty to treat people with respect, and to preserve human dignity (Mosser, 2010). Mutilation is the removal or destruction of an essential part of the body. To do so without consent is in violation of the principles of human rights. The removal of a newborn’s foreskin is done while the child is strapped down, screaming, and forever changes him. The foreskin, (medically known as the prepuce in both men and women), does have a purpose: it keeps the glans moist, protects the glans against injury, protects the urethra against infection, and has multiple sexual purposes (Macris & Milos, 1994). It is estimated that 80% of the male’s erogenous zone is removed during the procedure (Macris and Milos). By definition, circumcision, either male or female, is genital mutilation, and should be treated as such. If we apply deontology, then it is clear that neonatal circumcision should not be allowed. It is simply wrong, and does not support the theory of preserving human dignity.

            Relativity argues that circumcision is a religious custom in Judaism, not a means to prevent pleasure. In Judaism, circumcision is not done for health reasons; it is a covenant with God, and means, “sign in the flesh” (Blech, 1999 p.196). It is a brand- the mark of a Jew- and what separates them from everyone else. It is no accident that the mark is on the organ that is responsible for producing future generations, which is the first of god’s laws, “Be fruitful and multiply” (Blech, p.193).

            The bris milah (circumcision ritual) takes place on the eighth day of the baby’s life, which, not so coincidentally, is also when the levels of vitamin k, a blood clotting agent, is at its highest in the newborn’s body (Blech, 1999). If the child is ill, or born premature, than the bris will be delayed until he is considered healthy enough to undergo the procedure. A specialist, a mohel, performs the circumcision, while a friend or family member is honored as the sandek- the person who holds the infant still (Blech).

            The very fact that circumcision is considered to be a brand sounds barbaric. The justification that it has been practiced for four thousand years is irrelevant, and doesn’t change the nature of what is being done to the helpless infant. Would society lie silent if a branding iron was used? Perhaps in the past, when it was necessary for Jews to hide who they were, and were being suppressed for being God’s people, having a way to stand apart from the rest of the world made sense. However, many things done historically are now considered to be not only unethical, but inconceivable. The Catholic Church castrated its choir boys for over four hundred years – as recently as the early 1900’s- to keep their voices from changing (Robinson, 2007). We would never stand for this now, even if it was justified as religious practice.

            It does appear that some Jews are rethinking circumcision. A group called JAC (Jews against circumcision) is trying to promote awareness about the fallacies of circumcision, and spreading the story of Abraham (JAC, n.d.). In the Torah, God stops Abraham from killing his son to correct the mistaken belief that God wanted us to sacrifice our children (Torah, Genesis 22). He does not want us to sacrifice any part of our children. It is actually a violation of the Torah to physically harm another person (Exodus 21:18-27). The JAC goes on to say that in the original version of the Torah, the book of J, circumcision was never even mentioned, nor was it in the three following versions, and that it was later added to curb masturbation and excess sexual activity (JAC). This revelation is similar to the demand that Catholic priests remain celibate. Celibacy was not brought up until the fourth century, and not made an official policy until the fifteenth century (Future Church, 2011). There is no commandment that requires celibacy, just like there is no commandment that requires circumcision. In fact, circumcision goes against the values of Judaism, which include: sanctity of life, kindness, and justice/responsibility (JAC).

            The JAC argues that circumcision needs to go the way of many other “traditions” in the Torah: slavery (Torah, Exod. 21:1-11 & Deut. 15:12-18), animal and human sacrifice (Lev. 4:3, 4:23) and the punishment of death for insulting your parents (Deut. 21:18-13). These behaviors have long since been deemed unethical and outlawed. In fact, we look for a history of animal torture and sacrifice when investigating serial killers, yet at one time it was commonplace. 

            As discussed before, a bris milah is a covenant with God, but how can a baby with no understanding or choice of consent be expected to make such a promise? JAC is pushing for a replacement of the bris milah, called instead a bris shalom- covenant of peace (JAC, n.d.). A bris shalom is a non-cutting naming ceremony, in which the parents commit to the mitzvos (commandments), specifically no. 41-no imprinting any marks on our bodies (Torah, Lev. 19:28) and no. 45-not making cuttings in our flesh (Deut. 16:1). The parents are promising the child to do them no harm, and treat them with respect and dignity.

            We might wonder what the men who were circumcised as infants have to say on this subject. It could be argued that they don’t know any different, and they certainly don’t remember having the procedure, but it turns out that when it comes to their penis, most men certainly do have an opinion. In the article titled, Without my Turtleneck (2010), the author claims that circumcision is akin to child abuse, and doesn’t understand why the World Health Organization and the United Nations allow it as a medical procedure (even though they acknowledge it does not have health benefits, nor do they recommend circumcision), while at the same time calls female circumcision “female genital mutilation” (para.4). He goes onto to call Dr. Kellogg, (the same one who made the cereal), who was a driving force and advocate of circumcision in the United States as a means to prevent masturbation and promote cleanliness, a “terrifying piece of work”, (para.9).

            An Inactivist website called drmomma.org asked men to write in to say how they feel about being circumcised, and how they confronted their parents about it.  Some blamed the medical system for lying to their parents, or performing the procedure without consent (Men ask, “Why was I circumcised?” 2011). Many simply wanted to know, “Why?” Why was it allowed to happen, and do their parents feel sorry?

            One anonymous father took part in a production by The Whole Network entitled, Confessions of a Circumcised American Dad, and discusses his remorse in circumcising his eldest son (2011). He himself was circumcised, and although he had questions, he trusted when his mother, a nurse, told him it was to prevent disease, and therefore cleaner, so he didn’t protest the circumcision of his first son. When his second son was on the way, he did his own research, and found that there is no medical basis for circumcision.  He felt that he had let medical fiction overcome his common sense when his first son was circumcised, and worries about the conversation that is sure to come when his children realize the difference between them. This father became emotional at the thought of what he would say to his son then; when he would have to explain why this had been allowed to happen to him (The Whole Network).

            To those who say, “I want my son to look like me”, if you had one eye, would you poke out your son’s eye? For the women who claim they find a circumcised penis more attractive, who are you to decide what someone else does to their genitals? We look at these examples and see them for what they are: outrageous. Why don’t we have the same reaction when discussing cutting off part of a baby’s penis? Call it circumcision, call it a bris- it is mutilation, it is unethical, and it is wrong. We are violating the rights of the child to human dignity, self-preservation, and changing them forever. Deontology solves this issue easily, since the requirement is to respect the life of all people, especially those who are unable to fight for themselves.










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