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These comments are made in response to the GMC document 'Draft guidance for doctors who are asked to perform circumcision on boys for religious or cultural reasons'.

1. 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.
2. 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.
3. 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.]