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

• Published in: Kennedy Institute of Ethics journal Vol. 25; no. 1; pp. 1 - 34
• Main Author: Darby, Robert
• Format: Journal Article
• Language: English
• Published: United States Johns Hopkins University Press 01.03.2015
• Subjects: Anatomy & physiology; Australia; Bioethics; Children & youth; Childrens health; Choice Behavior - ethics; Circumcision; Circumcision, Female - adverse effects; Circumcision, Female - ethics; Circumcision, Female - psychology; Circumcision, Male - adverse effects; Circumcision, Male - ethics; Circumcision, Male - history; Circumcision, Male - psychology; Coitus - physiology; Coitus - psychology; Decision making; Ethics, Medical - history; Female; Foreskin - physiology; Foreskin - surgery; History, 19th Century; History, 20th Century; Human Rights; Humans; Male; Masculinity; Masturbation; Medical ethics; Newborn babies; Parental Consent - ethics; Pediatrics; Pediatrics - standards; Pediatrics - trends; Personal Autonomy; Practice Guidelines as Topic; Punishment; Rape; Religion and Medicine; Risk Assessment; Self Concept; Societies, Medical; Surgical outcomes; Task forces; United Kingdom; United States
• ISSN: 1054-6863; 1086-3249; 1086-3249
• DOI: 10.1353/ken.2015.0004

Much of the contemporary debate about the propriety of non-therapeutic circumcision of male infants and boys revolves around the question of risks vs. With its headline conclusion that the benefits outweigh the risks, the current circumcision policy of the American Academy of Pediatrics [AAP] (released 2012) is a typical instance of this line of thought. Since the AAP states that it cannot assess the true incidence of complications, however, critics have pointed out that this conclusion is unwarranted. In this paper it is argued that the AAP's conclusion is untenable not only for empirical reasons related to lack of data, but also for logical and conceptual reasons: the concept of risk employed-risk of surgical complications-is too narrow to be useful in the circumcision debate. 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.