Circumcision: Is the GMC Wrong?

GP Magazine: Page 44, 27 June 1997.

Note:

GP Magazine is distributed to General Practitioners within the United Kingdom. The GMC is the General Medical Council, the medical regulatory body of the United Kingdom.

LETTERS

I note with interest that Lotte Newman has enthusiastically endorsed the new GMC guidelines on circumcision (GP, June 6).

I have two main concerns:-

It may be impossible to obtain valid consent for the circumcision of healthy infants.
The right to religious freedom cannot override the need for protection of the rights and freedoms of others.

There is no doubt that parents have a power to give proxy consent to removal of an incompetent child's foreskin, or any other tissue, where strictly necessary for therapeutic reasons. However, where the removal of tissue is not necessary for the treatment or diagnosis of disease, a parent only has the legal power of consent to a procedure which causes negligible risk and minimal burden¹.

Male circumcision causes at least a 2 per cent risk of significant complications², removes specialised tissue³ and may be later regretted by the subject⁴. It therefore meets neither the requirement for negligible risk nor that for minimal burden.

How could the GMC could escape the conclusion that it is impossible for doctors to obtain valid consent for the non-therapeutic circumcision of healthy infants?

The GMC claim that the requirements of the UN Convention on the Rights of the Child must be balanced against the requirements for religious freedom. The European Convention of Human Rights,Article 9(2) states however:-

Freedom to manifest one's religion or beliefs shall be subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedom of others.

Since doctors cannot obtain valid consent for the circumcision of healthy unconsenting male children, and the practice is an infringement of the right to bodily integrity, it appears contrary to national and international law.

It is difficult to see how the GMC could fail to recognise the circumcision of such children as serious professional misconduct forwhich doctors should have their registrations revoked.

Dr John Dalton
Frizington, Cumbria

References

Human Tissue: Ethical and Legal Issues, Paragraph 7.8, Nuffield Council on Bioethics, 1995.
N Williams and L Kapila. Complications of circumcision. Brit J Surg 1993;80:1231- 1236.
Taylor JR, Lockwood and Taylor AJ. The prepuce: specialised mucosa of the penis and its loss to circumcision. Brit J Urol 1996;77:291-295.
Warren JP et al. Circumcision of children. BMJ Letters 1996;312:377.

Citation:

Dalton J. Circumcision: Is the GMC wrong? GP, 27 June 1997:44.

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