Ethics of circumcision

Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis. The ethics of circumcision in neonates and children is a source of much controversy. There is substantial disagreement amongst economists, bioethicists, theologians, philosophers, doctors, and political scientists over the practice, with little in the way of a general consensus beyond a belief that routine circumcision of neonates for health purposes is a cost-ineffective and ethically-problematic intervention in developed countries, and that circumcision on a consenting adult is a morally permissible action. Positions taken on the issue are heavily influenced by prevalence in the given area, religion, and culture. Some medical associations take the position that circumcision is an infringement of the child's autonomy and should be deferred until he is capable of making the decision himself. Others state that parents should be allowed to determine what is in their best interest. The Royal Australasian College of Physicians (2010) released a statement indicating that neonatal male circumcision is "generally considered an ethical procedure", provided that 1) the child's decision makers, typically the parents, are acting in the best interests of the child and are making an informed decision; and 2) the procedure is performed by a competent provider, with sufficient analgesia, and does not unnecessarily harm the child or have substantial risks. They argue that parents should be allowed to be the primary decision-makers because providers may not understand the full psychosocial benefits of circumcision. Additionally, this procedure does not present substantial harm compared to its potential benefits, so parents should be allowed full decision-making capacity as long as they are educated properly. The statement also establishes that "the option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered", and that "the ethical merit of this option is that it seeks to respect the child's physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future.