AMERICAN JOURNAL OF BIOETHICS, Volume 3, Number 2: Pages 1f-3f.
Spring 2003.

Respect for Bodily Integrity: A Catholic Perspective on Circumcision in Catholic Hospitals

Petrina Fadel, New York State Right to Life Committee, Inc.

Slosar and O'Brien (2003) seek guidance on the ethics of elective infant circumcisions at Catholic hospitals from Michael Benatar and David Benatar, two non-Catholics, instead of from the Catholic Catechism teaching on "Respect for bodily integrity" and the New Testament. They would do well to read the writings of two Jesuit priests, Fr. Paquin, S.J. (1957), and Fr. Healey, S.J. (1956), who independently found that because routine circumcisions are not medically defensible, they are morally objectionable.

Slosar and O'Brien claim that No. 2297 of the Catechism of the Catholic Church (1994) applies only "within the context of kidnapping, hostage-taking, and torture," even though the concluding sentence speaks of respect for bodily integrity within a medical context. They mistakenly equate the terms therapeutic and prophylactic (preventative). Finally, they rely on an outmoded position statement of the American Academy of Pediatrics Task Force on Circumcision (1989), one that has been replaced by a newer statement (American Academy of Pediatrics Task Force on Circumcision 1999).

No. 2297 of the Catechism, "Respect for bodily integrity," states in part: "Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law." The American Heritage Dictionary defines amputate as "To cut off (a part of the body), esp. by surgery," and it defines therapeutic as "Having healing or curative powers." In 1999 the American Academy of Pediatrics described circumcision as "amputation of the foreskin," and the American Medical Association called elective circumcision "non-therapeutic" (Council on Scientific Affairs 1999). Elective circumcisions are directly intended, nontherapeutic amputations of healthy foreskins. As such, they do violate the moral law.

There are no medical indications for circumcision in the newborn period (Committee on Fetus and Newborn 1971; 1977; Fetus and Newborn Committee 1975). In 1999 the American Academy of Pediatrics, after studying nearly 40 years of research, concluded "these data are not sufficient to recommend routine neonatal circumcision." No national medical group in the world today recommends infant circumcision. Although Slosar and O'Brien claim a health benefit, Medicaid programs in 11 states (five within the past year, including Missouri, home of Ascension Health) have dropped funding of nontherapeutic circumcisions. The Birthing and Care Program of the Catholic Archdiocese of Washington, D.C., likewise does not cover circumcisions.

Slosar and O'Brien defend circumcision by citing Directive 33 of the Ethical and Religious Directives for Catholic Health Care Services (ERD; Conference of Catholic Bishops 2001), which discusses only "therapeutic procedures," not "non-therapeutic procedures" such as elective infant circumcision. Directive 29 supports respect for bodily integrity, stating that "All persons served by Catholic health care have the right and duty to protect and preserve their bodily and functional integrity." The 1977 ERD, Directive 33, states that "unnecessary procedures, whether diagnostic or therapeutic, are morally objectionable.

A procedure is unnecessary when no proportionate reason justifies it." The chair of Applied Health Care Ethics in Oregon, who is also a Catholic priest, wrote that he doubted any proportionate reason justified the circumcision of male infants, but he was sure he had heard many attempts. Slosar and O'Brien's commentary is one such attempt. Male neonatal circumcision has no proven medical utility and cannot support the use of "proportionate reason" to override the child's right to bodily integrity and the hospital's duty to protect that right.

The primary reason American parents choose circumcision is to make the baby "look like" the circumcised father (Brown 1987). This egocentric reason clearly does not take into account "the best interests of the child" or the numerous risks of the surgery. Catholic hospitals don't accept the parental-choice line for abortions. Neither should they promote this line for nontherapeutic circumcisions. Hospitals and physicians profit from circumcisions (Mansfield 1995). The June 22, 1987 Boston Globe quoted Thomas Wiswell, M.D., as saying:

I have some good friends who are obstetricians outside the military, and they look at a foreskin and almost see a $125 price tag on it. Each one is that much money. Heck, if you do 10 a week, that's over $1,000 a week, and they don't take that much time. (Lehman 1987)

Profit should never dictate morality, but in the case of nontherapeutic circumcision it does. In 1999 the American Academy of Pediatrics found that neonatal circumcisions in the United States added between $150 and $270 million annually to healthcare costs.

A Catholic mother from Indiana told me of her experience giving birth in a Catholic hospital. Three times doctors and nurses at the hospital solicited her to circumcise her son, even though she told them the first time that her decision was no. Solicitation and coercion for this unnecessary surgery is unethical, sexist, and must stop.

A man born and circumcised at a Catholic hospital described to me his feelings this way:

I am a man who has lived all of his life with the results of a circumcision done at birth. There does not a day go by that I don't feel a deep sense of loss and disfigurement as a result of this loss of the most sensitive tissue on my body. How can anyone deny the feelings of millions of men like me who were denied the right to a natural and normal sexuality for their entire life? I will never have any idea what has been taken from me, but I do know that I was damaged for life physically, sexually, emotionally, and spiritually by the horrible "nonsense" committed by a medical doctor who needed some quick and easy money for his Cadillac payment and didn't care about the damage done to me. I was born in a Catholic hospital in Kansas City, Missouri, in December of 1940, and I learned about sexual abuse by Catholic institutions as soon as I was born. Sex and violence met for the first time in my life in the few hours after birth in a Catholic hospital.

Slosar and O'Brien claim they "are unaware of the Catholic Church explicitly addressing the practice of circumcising male infants in any of its official teachings." In Acts 15:10, St. Peter, the first pope, told the Jewish Christians who were advocating circumcision of the Gentiles, "And now are you going to correct God by burdening the Gentiles with a yoke that neither we nor our fathers were able to bear?" (The Way 1979). Circumcision during Peter's century typically involved removing only the tip of the foreskin, not the complete foreskin as is done today (Ritter 2002).

The Church spoke forcefully about circumcision at the Council of Florence (1438-1445). Pope Eugene IV (1442) issued a Papal Bull which states in part,

Therefore it strictly orders all who glory in the name of Christian, not to practise circumcision either before or after baptism, since whether or not they place their hope in it, it cannot possibly be observed without loss of eternal salvation.

The letter to the Corinthians (1 Corinthians 12:18) reiterates God's genius as man's Creator. "But that isn't the way God has made us. He has made many parts for our bodies and has put each part just where he wants it" (The Way 1979).

In Matthew 11:25 Jesus prayed, "O Father, Lord of heaven and earth, thank you for hiding the truth from those who think themselves so wise, and for revealing it to little children" (The Way 1979). Slosar, O'Brien, and the Benatars might consider themselves wise about circumcision, but little children strapped to a Circumstraint™ and undergoing the procedure know otherwise.

Nothing in Catholic doctrine requires Catholic hospitals to provide nontherapeutic infant circumcisions. To the contrary, the Catechism teaches that nontherapeutic amputations violate the moral law. An infant's foreskin belongs first and foremost to the infant-not to his parents, not to the hospital, not to the physician, and not to companies that want amputated foreskins to develop other products. Companies that do this are reminiscent of the Nazis who used the skins of murdered Jews to make lampshades. The American Heritage Dictionary (1982) defines mutilate as: "1. To cut off or destroy a limb or essential part. 2. to render imperfect by excising or radically altering a part." The foreskin is a protective and sexual organ that covers and protects the sterile urinary tract environment; contains tens of thousands of specialized, erogenous nerve endings; and provides the sliding and gliding mechanism that allows for nonabrasive, lubricating, normal sexual intercourse for both the male and female. All that is lost with circumcision. In addition, circumcision has been shown to cause erectile dysfunction (Coursey 1991; Fink 2002).

Pope John Paul II, in "The Gospel of Life" (1995), no. 3, wrote about "New threats to human life." He included mutilation among the threats by repeating the words of the Second Vatican Council:

Whatever is opposed to life itself, such as any type of murder, genocide, abortion, euthanasia, or willful self-destruction, whatever violates the integrity of the human person, such as mutilation, torments inflicted on body or mind, attempts to coerce the will itself; whatever insults human dignity, such as subhuman living conditions, arbitrary imprisonment, deportation, slavery, prostitution, the selling of women and children; as well as disgraceful working conditions, where people are treated as mere instruments of gain rather than as free and responsible persons; all these things and others like them are infamies indeed. They poison human society, and they do more harm to those who practice them than to those who suffer from the injury. Moreover, they are a supreme dishonor to the Creator.

Hospitals and physicians who perform nontherapeutic circumcisions on nonconsenting infants must stop violating the integrity of those infants, stop tormenting their bodies, stop insulting their human dignity, and stop using them as instruments of financial gain. The time is long overdue for all hospitals to take the only morally acceptable action and stop this practice.

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(File revised 20 February 2005)