G E O R G E   H I L L
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                   E-mail DYKS96A@prodigy.com
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                        Fax: 504-381-8200
                         26 August 1996




Maurice E. Keenan, MD
President of the Executive Committee
The American Academy of Pediatrics
16 Bristol Road
West Newton, MA  02165

Joe M. Sanders, Jr.
Executive Director
American Academy of Pediatrics
141 Northwest Point Boulevard
P. O. Box 927
Elk Grove Village, IL  60009-0927

Re: Composition, mission, and name of task force on
    circumcision.

Gentlemen:

     I understand the Executive Committee is to appoint a task
force on circumcision.  I would like to share with you my
thoughts about the mission and composition of the task force.

     The damage circumcision causes to health[1], sexuality[2],
and emotional development[3] is now well documented.  It is no
longer a matter for debate.  Furthermore, the alleged health
benefits have been disproved.  The anatomy, histology, and
functions of the foreskin are known in greater detail than ever
before.[4]  The prestigious Fetus and Newborn Committee of the
Canadian Paediatric Society has re-examined the recent medical
literature.   It could find no convincing reason to circumcise
but did find many convincing reasons not to circumcise.[5]

     Since the formation of the United Nations at the end of
World War II, there have been many advances in our understanding
of human rights and medical ethics.  It is now clear that
circumcision of non-consenting children violates human rights and
medical ethics.  The traditional American practice of unnecessary
circumcision of non-consenting children that was introduced in
the late 19th century stands in direct violation of the UN
International Covenant on the Rights of the Child (1989) and the
American Medical Association's Principles of Medical Ethics
(1992).[6]

     Documentation of the damage circumcision causes is now
available to the public on the Internet World Wide Web.

     Today, many thousands of men circumcised as babies have
become aware of the sexual damage done to them.  They have
restored their foreskins and experienced a rebirth of sexual
sensation that circumcision denied them.  These men bear witness
to the harmful effects of circumcision on human sexual
response.[7]  They are angered by the injury done to them.

     Foreskin restoration is a growing movement.  The Joy of
Uncircumcising! by Jim Bigelow, Ph. D.,[8] is now in its second
edition.  The popular press is now featuring articles on foreskin
restoration.[9]

     In this climate, the unnecessary circumcision of
non-consenting minors is unacceptable.

     Another "pros and cons" statement on circumcision will not
be enough.  The mission of the task force on circumcision must
be redefined.  It must be given the mission of calling a halt to
the non-therapeutic non-consensual circumcision of minors.  This
would bring American practice into compliance with international
law and medical practice.

     This will require a strong, unambiguous statement from the
AAP.  A program of physician and hospital re-education must be
developed and instituted.  This program must encompass the entire
medical community, including hospitals, obstetricians, family
practitioners, and general practitioners.  Medical schools must
incorporate new information into their curricula.
Doctors-in-training must no longer be required to perform
circumcisions.

     There are no valid medical issues concerning circumcision.
However, there are valid issues in the realm of medical ethics,
human rights, and non-proxy patient informed consent law.  There
must therefore be strong representation from the Committee on
Bioethics.

     The task force would benefit by the inclusion of doctors
whose foreskins are intact.  Only an intact male can fully
understand and appreciate the functions of the foreskin.

     The name of the task force is important because it denotes
its mission and purpose.  Task Force on Circumcision is
inappropriate.  I suggest Task Force on Foreskin Function,
Protection, and Care.

     The educational program must retrain doctors to use
conservative non-invasive therapies for minor foreskin problems
that preserve foreskin tissue.  There are many reports of
American pediatricians who are unaware of the normal care of
healthy intact boys.  They frequently give contraindicated advice
to parents.  This needs to be rectified.  Failure to keep abreast
of advances and to put modern effective conservative treatments
into practice is malpractice and shows lack of ethics.

     The American Academy of Pediatrics has historically
championed the needs and rights of the child.[10,11,12]  Let us
see the AAP return to its proper role as a leader in advancing
and protecting the real interests of children.

                              Very truly yours



                              George Hill

Enclosure

References:

 1. Williams N, Kapila L. Complications of circumcision.
    Br J Surg 1993; 80:1231-1236.

 2. Warren J, Bigelow J. The case against circumcision. 
    Br J Sex Med. Sept/Oct 1994:6-8.

 3. Cansever G. Psychological effects of circumcision. Br
    J Med Psychol. 1965; 38:321-331.

 4. Taylor JR, Lockwood AP, Taylor AJ. The prepuce:
    specialized mucosa and its loss to circumcision.
    Br J Urol 1996; 77:291-295.

 5. Fetus and Newborn Committee, Canadian Paediatric
    Society.  Neonatal Circumcision Revisited. Can Med
    Assoc J 1996; 154:769-780.

 6. Bigelow J. The Joy of Uncircumcising!, 2nd Ed 1995.
    Hourglass Book Publishing, Aptos, CA  95001.

 7. Warren, J et al. Circumcision of children (letter).
    Br J Med 1996; 312:377.

 8. Denniston, GC. Circumcision and the code of ethics.
    Humane Health Care International 1996 12

 9. Penis Page, Penthouse. August 1996.

10. American Academy of Pediatrics Committee on Bioethics.
    Religious exemptions from child abuse statutes.
    Pediatrics 1988; 81:169-171.

11. Haggerty RJ. The Convention on the Rights of the
    Child: It's time for the United States to ratify.
    Pediatrics 1994; 94:746.

12. American Academy of Pediatrics Committee on Bioethics.
    Informed consent, parental permission, and assent in
    pediatric practice. Pediatrics 1995; 95:314-317.

cc: Child Rights Organizations
    Human Rights Organizations
    Medical Ethics Organizations
    Medical Journals
    Medical Ethics Journals
    AMA
    ACOG
    AAFP
    AHA
    ACP
    CPA
    WWW


(file revised 7 July 2003)

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