Guidance Needed on Circumcision Method
New medico-legal statistics have highlighted the need for clear GP guidance on the issue of male circumcision.
The publication of figures from the Medical Defence Union [UK] last week, comes as the General Medical Council [UK] reinforced its advice to doctors asked to perform the operation.
According to the statistics, the MDU has opened 50 files relating to allegation of medical negligence involving male circumcision over a six-year period. Most cases involve GPs.
Head of risk management at the MDU, Dr Stephen Green, said the number of complaints was rising by about 15 per cent a year, in line with other complaints. However, he told GP: This issue is of particular concern. The complaints are of a serious nature if you are operating on a child and potentially damaging his sexual performance for the rest of his life. The GMC is concerned about the level or complaints reaching them and our experience mirrors theirs very closely. Eighteen of the 50 files involved religious circumcision. According to the MDU, complaints arose after patients sustained amputation or damage to the distal glans penis and damage to the urethral meatus, haemorrhage and poor cosmetic results.
Many of the cases involved a lack of written consent and parental understanding of pre- and post-operative information, ineffective analgesia or anaesthesia, and poor surgical technique. These issues were addressed in GMC guidance drafted earlier this year (GP, June 6). and stating that GPs unwilling to perform the operation should inform patients [sic] that they could see another doctor.
When it was first proposed, the advice caused a storm of protest from GPs across the country concerned with the ethical nature of circumcision an issue which the GMC has left for MPs to resolve.
A US paediatrician has advocated universal circumcision, a move which would cost the NHS 10 million.
Claiming that circumcision protects against STDs and penile cancer, Dr Edgar Schoen said: `Particularly in the face of an expanding worldwide AIDS epidemic, these benefits are a powerful argument in favour of encouraging universal newborn circumcision. (Archives of Disease in Children, September)
[The Medical Defence Union Ltd., 192 Althincham Road, Manchester M22 4RZ]
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