REUTERS HEALTH, 4 April 2003.

UK doctors advised on ethics of circumcision

Last Updated: 2003-04-04 1:00:16 -0400 (Reuters Health)

LONDON (Reuters Health) - The British Medical Association (BMA) issued new circumcision guidelines on Friday in an effort to help doctors negotiate the ethics of what it calls an increasingly controversial area.

The guidance says there is significant disagreement about whether circumcision is beneficial, harmful or neutral when it comes to boys' health, and that parents have the right to make choices about what is in their child's best interest.

Circumcision for medical purposes is rarely controversial, the BMA says, but it points out that the British Association of Paediatric Surgeons advises that there is rarely a clinical need for the procedure.

In the case of non-therapeutic circumcision for religious or cultural reasons, the ethical situation is less straightforward.

"Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA's membership," the document says.

"The medical harms or benefits have not been unequivocally proven except to the extent that there are clear risks of harm if the procedure is done inexpertly."

It is legal to perform non-therapeutic circumcision so long as it is done competently, is thought to be in the child's best interests and valid consent has been obtained, the BMA says.

Boys old enough to express a view should be involved in the decision about being circumcised, but if they are not old enough, then both parents should agree.

"If a child presents with only one parent, the doctor must make every effort to contact the other parent in order to seek consent," the guidelines say.

Doctors who have a conscientious objection are under no obligation to comply with a request to circumcise a child. They should explain this to the child and his parents, the BMA concludes.

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(File prepared 30 April 2003)