Statement on behalf of the British Association of
Paediatric Surgeons
concerning Male Ritual
Circumcision.
These comments are
made in response to the GMC document 'Draft guidance for doctors
who are asked to perform circumcision on boys for religious
or cultural reasons'.
- The British Association of Paediatric Surgeons (BAPS)
recognises that male circumcision is required in certain
religious and cultural groups and that decisions concerning
the legality or otherwise of performing the procedure must
lie with society and be determined by Parliament. Not
withstanding this, it is the majority opinion that the
practice should be discouraged by education.
- The BAPS considered that the optimum circumstances for
the procedure to be performed is in hospital under general
anaesthesia, particularly in view of recent research regarding the
long term effects of the pain endured. The Association
considers that when the operation is performed by a doctor
it should be carried out in hospital.
- The BAPS wish to see more precise statements regarding
the phrase 'a good standard of care.' (This would be
less of an issue if all procedures were performed in
hospital).
- Where a practitioner is operating outside a hospital
this activity must be registered with the Health Authority
covering the geographical area.
- Before commencing operating, the practitioner must
undergo, or demonstrate that he/she has undergone,
appropriate training for the operation including attention
to analgesia. (The BAPS does not consider local anaesthetic
to be adequate but realises it is not in a position to
legislate.) The practitioner must also undergo periodic
retraining in the procedure.
- Any practitioner performing this operation must be in a
position to provide all the necessary postoperative care
should any complication arise.
- The requirement
of obtaining consent from both parents is often not
practical. This is not done in hospital and should not be a
requirement. However it should be pointed out that in
certain circumstances it may be prudent so to do. Consent
for surgery should also be obtained from a competent
minor.
- The BAPS do not
agree that a practitioner must refer the patient to
a colleague who will perform the operation. It may be
appropriate in Primary Care for the doctor to make such a
recommendation, but it should not be a requirement in
Secondary Care. Moreover, it could be considered unethical
for a hospital practitioner to make such a referral as this
is the right of the general practitioner to chose to whom
the patient is referred.
A.E.MacKinnon.
1/3/97
[CIRP Note: The BAPS has issued an additional
statement regarding
religious circumcision in July, 2001. In 2006, CIRP believes
that this statement is outmoded.]