[CIRP Note: Letter in response to article entitled Suffer little children? by Mr Nigel Zoltie, MB, ChB, FRCS(Eng), FFAEM, MAE, MEWI, which appeared in the BMA News Review on 8 August 1998. Mr Zoltie is chair of the Association of Reform and Liberal Mohelim.]

Parental wishes are not the determining factor

Nigel Zoltie makes a valuable contribution to the debate about whether circumcision should be allowed, and whether doctors should participate, but incorrectly states that parents have ultimate decision-making powers.

Decisions like this are inseparable from decisions about what is best for the child. Whatever treatments doctors provide for children must be in their best interests.

But assessment of best interests is not based only on what parents want for their children. Parental responsibility only gives the right to do what is reasonable to promote the welfare of the child.

The BMA ethics committee is writing a book for doctors on consent to and refusal of treatment that will give clear guidelines on these issues.

Michael Wilks, chairman
BMA medical ethics committee