Mother's battle to circumcise is in courtBY KATE COSCARELLI
A 3-year-old boy is caught in a legal tornado that could change the way parents care for their children.
Tomorrow, that twister is set to touch down in Superior Court Judge Paul Armstrong's Somerville courtroom at a hearing to determine if a circumcision is medically warranted for Matthew Price.
The case, part of the ongoing divorce proceedings between Jennifer and James Price, has grabbed the attention of legal scholars, medical societies, media outlets and attorneys around the country.
Matthew's physical health is the centerpiece of the hearing. But also significant are the possibilities that the judge's decision could affect how doctors deal with patients, how separated parents make health care decisions for their children and how involved the courts should be in either issue.
"It raises an interesting question of the scope of judicial intervention when estranged parents are in dispute about the welfare of the child," said Norman Cantor, a family law professor at Rutgers School of Law in Newark.
The case started with a divorce.
Five years into his parents' marriage, Matthew was born about 1 p.m. on Aug. 18, 1997, at John F. Kennedy Hospital in Edison. The boy was not circumcised.
Soon after Matthew's birth, the Price's marriage started to disintegrate. Jennifer Price of Clinton filed for divorce in March. The Prices currently have joint custody of their son.
Then came the irritations—two of them—of Matthew's penis that left him swollen and in pain, sending him to the emergency room.
"He complains of pain and burning during urination," wrote Matthew's pediatrician, Grace Calimlim of Bridgewater. In her estimation, the problem was chronic and could be dealt with through circumcision. A second doctor, pediatric urologist Joseph Barone, agreed.
Matthew's parents were hopelessly divided.
Jennifer Price's attorney now says her client had wanted a circumcision performed at birth, but gave in to her husband's wishes.
James Price continues to object to circumcision. The Raritan man underwent several painful surgeries as a small child to correct a malformed urethra and says he wouldn't want his son to experience the same thing. He has also cited concerns about the possibility that Matthew could experience reduced sexual pleasure.
"I believe God made Matthew perfect and if he isn't broke, don't fix him," the father wrote in a letter to the judge.
So the matter went to court.
In August, Judge Paul Armstrong took the suggestions of the boy's physicians and ordered a circumcision.
"The surgery is minor and will give Matthew the best chance to alleviate his problem," wrote Armstrong.
Jennifer Price feels the same way, said her attorney, Ronald Heymann.
"It has been her belief, and continues to be her belief, that circumcision is Matthew's best option," said Heymann.
However, James Price threatened legal action against the doctor and the surgery was canceled. The group returned to court and the judge stuck with his original decision.
An appellate division panel agreed with Armstrong.
State Supreme Court Justice Peter Verniero issued an emergency stay the following day, and on Oct. 31 the justices voted to send the matter back to Armstrong for a full hearing.
For the purposes of the hearing, Edward O'Donnell, an attorney from the infamous Baby M trial, and Robert Pickens, a well-respected Princeton physician, have been assigned to act as independent experts on Matthew's behalf.
As is often the case with divorcing parents, medical decisions must be made by the courts. But usually those decisions are of life- threatening matters.
The crux of the debate now hinges over the idea that the judge will decide if the procedure is "medically necessary" as the Supreme Court suggested it should be in its opinion.
It is an intentionally vague term, say court watchers. And in this case it probably means medically appropriate, rather than lifesaving.
"I am not at all sure it was intended to be taken literally as setting down the standard of absolute necessity for the medical procedure," said Cantor.
Legal analysts worry the case might set a volatile precedent that could send disputing parents to court to debate whether their child should receive antibiotics or braces -- minor health issues that have always been left up to the custodial parent to decide. In this case, Jennifer Price is the custodial parent.
"I do worry about that (potential) if there is not some strong reason why the court has to make this decision rather than leaving it to the parents to work it out," said law professor John DeWitt Gregory of Hofstra University School of Law on Long Island.
But the case is a double-edged sword. Doctors say if the judge decides the circumcision isn't warranted, despite medical testimony, it undercuts their authority.
The Medical Society of New Jersey and the Urology Society of New Jersey object to the intervention of the courts in the absence of extraordinary circumstances and suggest the treating physicians should be heard. The court should not become a "super-doctor."
"Is a court to involve itself in deciding whether a splinter should be removed with a needle or a tweezer? . . . Obviously not," the societies wrote in a friend-of-the-court brief.
Circumcision is a relatively routine operation "with no real chance of permanent physical or psychological damage to the patient," the brief continued.
This case also is believed to be a national landmark in the debate over circumcision. The practice of routine circumcision has come under scrutiny in the last year.
Last March, the American Academy of Pediatrics stepped back from its position that the procedure be done routinely at birth. About 64 percent of the nation's boys are circumcised shortly after birth, according to the National Center for Health Statistics.
The revised statement said removing the foreskin had medical benefits, but the advantages are not so compelling that every newborn should undergo the surgery.
The National Organization of Circumcision Information Resource Centers, a nonprofit California-based group, advocates that circumcision is mutilation that is a $2.1 billion industry in the United States. Boys should be allowed to make the decision about the surgery on their own, they argue.
"Matthew does not need a circumcision. He would suffer irreparable physical, sexual and emotional injury if subjected to a penile surgery," argued NOCIRC in a legal brief filed earlier this week. Because the attorney did not secure the proper paperwork, it has not yet been determined if the brief will be considered by the judge.
Attorneys in the case have expressed concern that larger issues have been raised, perhaps overshadowing what is in Matthew's best interest.
"This matter before the court is of a most intimate and personal nature to Matthew," O'Donnell wrote in a legal brief. "As a 3-year-old child, he is not yet old enough to understand the medical attention this matter has generated."
Kate Coscarelli covers Somerset County courts. She may be reached at <firstname.lastname@example.org> or (908)429-3017.
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