Protection of Infant Boys from Wrongful Circumcision in American Hospitals

Introduction. Parents should carefully consider the advantages, disadvantages, and risks of both non-circumcision and circumcision for their son well before the due date. The American Academy of Pediatrics clearly states that circumcision is an elective non-essential procedure, which means it is neither necessary nor desirable for your son's health. Parents will be given little time at the hospital to make up their minds on a complex matter that will affect their son for all of his life. This file is addressed to the needs of parents who do not wish the surgical procedure of circumcision performed on their son.

There are many and persistent reports of boys being circumcised in hospitals in the United States against their parents' wishes.

For about 30 years informed consent by a parent has been required by law before a circumcision can be legally performed in most jurisdictions. A circumcision cannot lawfully be performed in most jurisdictions unless a consent form is executed by one of the parents. Performance of circumcision without a signed informed consent is a wrongful circumcision. This is a tort for which money damages may be collected. For example, a jury in Montgomery, Alabama awarded $65,000 in money damages to a boy who was wrongfully circumcised. Click here for more legal information

It is almost certain you will be presented with such an informed consent form upon arrival at the hospital. It is not necessary to sign this form to be admitted to the hospital.

Some unenlightened hospitals still regard circumcision as a routine procedure. In such a hospital, management and staff assume that a newborn boy will be circumcised. Such hospitals tend to put newborn boys on a circumcision assembly line automatically.

Some other hospitals regard neonatal circumcision as a "profit center" and do everything possible to push parents into a circumcision. A 1995 study shows that the hospital stay for mother and baby is about six hours longer on average when the baby is to circumcised. This runs up hospital charges and results in more profit for the hospital. This study estimated additional charges of about 234 to 527 million dollars per year from the longer stay in hospital and that was only for the United States. This is in addition to the estimated 200 to 250 million dollars per year in doctor's fees. Many hospitals still want their share of this bonanza. Click here for more information.

Obstetricians usually get from $75 to as much as $400 for a circumcision. Some are understandably eager to do as many circumcisions as possible regardless of the injurious effect. A busy OB can easily make the payments on his BMW with circumcisions. Click here for more information on doctor's fees.

Typically, all neonate males are put on the uniquely American assembly line for circumcision. Your son inadvertently may wind up on the same circumcision assembly line unless you take extraordinary measures to protect him.

Unfortunately, extraordinary measures are sometimes necessary to protect an infant boy in hospital from unwanted and unnecessary circumcision by neglect, carelessness, greed, and/or malicious intent and to guarantee that your baby boy emerges from the hospital intact and uninjured. You will not truly know what sort of institution you have selected until after your birth experience is behind you.

A number of means have been devised to accomplish this end. This file will discuss the various options available to parents to protect their newborn son from unwanted circumcision. If you take these precautions it is extremely unlikely that your son will suffer a wrongful circumcision. Moreover, a paper trail will be in place that would be beneficial to your case should a wrongful circumcision occur in spite of all precautions, and you elect to bring a suit on behalf of your son.

Protective Tactics. Parents who do not want their infant son subjected to unnecessary and unwanted circumcision should make plans well in advance of the delivery date to provide for his protection while in the hospital.

Consider home birth with the assistance of a midwife. At home you will be in control of the situation and no circumcision will occur. Home birth is not an option for everyone and so many will elect to go to a hospital.

If you elect to give birth in hospital, write a certified letter - return receipt requested to the attending obstetrician. Inform him/her of your opposition to circumcision, that you do not desire to have your son circumcised. Furthermore, inform him/her of your intention to bring legal action if your son should be wrongfully circumcised for damages resulting from the wrongful circumcision. Wrongful circumcision is a tort for which damages may be recovered. It is an act of battery with intent to maim since it disfigures the appearance of the body. A sample letter has been prepared for your guidance.

Write a similar letter to the hospital. Inform the hospital of your expected delivery date. Again, a sample letter has been prepared for your guidance.

Purchase a set of NOCIRC T-shirts in newborn size for your son to wear in hospital. This should inform all hospital personnel of your desires. NOCIRC T-shirts are available from NOCIRC, P. O. Box 2512, San Anselmo, CA 94979-2512, USA; Fax: 415-488-9660; Telephone: 415-488-9883.

Take Post-its® to the hospital, write NOCIRC on them and stick a few on your son's crib.

Circumcision Consent Forms. Circumcision consent forms are usually included with the admission forms. These forms are signed when the mother arrives at the hospital with labor contractions. Understandably, she is less likely to read each form carefully and may sign whatever is put in front of her. Mothers who are opposed to circumcision must be careful to NOT sign this consent form. This will usually (but not always) prevent the child from being circumcised. As an additional precaution you may write NO CIRCUMCISION on every form in bold letters. NOHARMM has devised a Non-Circumcision Notification Form which you may download and print. You may also complete this form and take with you to the hospital as additional protection for your son. You may include this form with the other documents upon admission.

Need for bodyguard.Opt for "rooming-in" if it is available. Keep your son in the sight of one parent at all times. Mothers who expect to give birth by caesarean section may be incapacitated for some period of time. The father or some trusted relative or friend should be appointed to stay with the infant boy during this time. At least one boy was wrongfully circumcised while the mother was recovering from her C-section. There are reports of boys being taken away for some other reason and coming back circumcised.

Coercive Tactics. Many hospitals seem to instruct staff to push circumcision on parents. Hospitals in the United States have fired nurses who dare to tell the truth about circumcision to parents. Be prepared to have nurses and others make you feel like a freak from outer space if you refuse circumcision. They may tell you that "Everybody does it." This is part of their psychological ploy. Do not fall for it. Circumcision is falling into disfavor. In 1996, 40 percent of boys were preserved intact in the US and that percentage increases every year.

You may be asked many times, "Don't you want your baby circumcised?" Be prepared to say "No, I don't want my baby circumcised!" a thousand times,

Circumcision Refusal Form The circumcision refusal form is a recent innovation. This seems to be a device designed to intimidate and frighten parents into signing the circumcision consent form. There is no legal reason to sign a circumcision refusal form. No other surgical or hospital procedure requires a refusal form. Do not be surprised if you are presented with a circumcision refusal form. You may sign it if you so desire but you are not legally required to do so. Sadly, the American Academy of Pediatrics Task Force on Circumcision finds it necessary to state that "parents should not be coerced by medical professionals to make this choice."

You may think of additional precautions to protect your son.

Newborn physical examination. Typically, newborn infants receive an examination from a pediatrician or other physician while still in hospital. Many physicians improperly believe that the foreskin of a intact, non-circumcised male infants must be forcably retracted and the glans penis examined. Forcible retraction of the newborn prepuce is guaranteed to cause pain and possible injury to your son as the newborn prepuce is usually too narrow to permit retraction, and furthermore, is fused with the underlying glans penis. (See Normal Development for more information on the newborn prepuce.) Premature retraction will cause the foreskin to be ripped from the glans and raw surfaces will be formed which when they heal will cause adhesions. In addition the raw surfaces are more prone to infection. Your son's bodyguard should be present at this examination. The physician should be advised that no retraction of the foreskin is to be done. Premature retraction of a newborn foreskin is medical malpractice and grounds for legal action.

Freedom to leave. Remember you are not a prisoner in the hospital. Hospital procedures, rules, regulations, discharge policies are made for the benefit and protection of the hospital and not for you or your baby. You may leave or take your son out of hospital at anytime, regardless of hospital "procedure," "rules," "regulations," or discharge policies, as soon as your physical condition and/or your son's physical condition permits. There is little doubt that you will be more comfortable in the security and safety of your home away from the many dangers that tend to lurk in hospitals.

After leaving the hospital.You may also need to protect your son's intact penis when he visits the pediatrician. Medical Doctors in the US are poorly trained in the care of the complete penis. There are many reports of forcible premature retraction of the foreskin. This is also a tort for which money damages apply. Mothers Against Circumcision has webpublished an Intact Care Agreement written by Jennifer Gardner that you may consider using to protect your son during his office visits.

An abbreviated check list of precautions for parents in the United States has been prepared. Print out the checklist for ready reference.

This material is under © copyright by George Hill (1996, 1999, 2000, 2002) but it may be freely copied and distributed as long as it is copied and distributed in its entirety without additions, changes or modifications.

(File revised 16 March 2002)

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