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Correspondent:

MEDICAL BOARD OF QUEENSLAND


 
11 August 2002

Mr Jim O’Dempsey
Executive Officer
Medical Board of Queensland
GPO Box 2438
Brisbane, Queensland 4001
AUSTRALIA

Dear Mr O’Dempsey:

A Queensland case involving circumcision of two young boys has received international publicity. The boys were circumcised contrary to the mother's wishes and without her knowledge. Since I regard circumcision as an important issue of ethics and human rights, I'm writing to request clarification of the Medical Board of Queensland's position on non-therapeutic circumcision of minors. Specifically, I would be grateful for answers to the following questions:

  1. Does the Medical Board agree with the position of the Australasian Association of Paediatric Surgeons, which "does not support the routine circumcision of male neonates, infants or children in Australia"?
     
  2. Does the Medical Board believe it is ethical for physicians to excise normal tissue from non-consenting persons for non-therapeutic purposes?
     
  3. Does the Medical Board agree with the conclusion of the Queensland Law Reform Commission that "consent by parents to the procedure being performed may be invalid in light of the common law's restrictions on the ability of parents to consent to the non-therapeutic treatment of children"?
I would very much appreciate answers to the above questions at your earliest convenience. For your information, I enclose a memo on routine circumcision issued to physicians earlier this year by the Saskatchewan College of Physicians and Surgeons, the medical licensing authority in the province of Saskatchewan.

Sincerely,
 
[signed]
 
D ennis H arrison
 


30 August 2002

Dear Sir

Thank you for your letter of 11 August 2002 seeking clarification regarding the Board's stance on routine circumcision of infants and minors.

The Medical Board of Queensland is established under the Medical Practitioners Registration Act 2001 for the purpose of administering the provisions of that Act and achieving the stated objectives of the legislation. These are the protection of the public by ensuring health care is delivered by registrants in a professional, safe and competent way, upholding the standards of practice within the profession, and maintaining public confidence in the profession.

The Board is aware of recent news reports concerning the alleged circumcisions of two boys on the authority of the father alone, however no complaints regarding such an incident have been passed to the Board.

With regard to the broader issue of the appropriateness, or legality of infant circumcision the Medical Board has previously noted the Australasian Association of Paediatric Surgeons' guidelines for circumcision, as well as other material on this topic. The Board however does not consider that it falls within its role and functions to make determination on this procedure or to lead community debate on the subject, while male infant circumcision remains a widely accepted procedure which does not contravene any specific legislative provision.

The Board is conscious that medical procedures and treatments are occasionally controversial and even become discredited in time. Evaluating such procedures and treatments is not however a function of the Medical Board.

Yours sincerely,
 
[signed]
 
M Demy-Geroe
Deputy Registrar
 


8 September 2002

Dear Mr Demy-Geroe

Thank you for your letter of 30 August 2002, in which you provide some clarification of the Board's stance on routine circumcision of infants and minors. You state that the Board's functions include protecting the public and upholding the standards of practice within the profession.

According to statistics available on the Health Insurance Commission's Web site, the incidence of neonatal circumcision in Queensland is several times higher than it is in some other states, such as Victoria and Western Australia. In general, marked variations in surgical rates raise concerns about access to care, treatment appropriateness, and quality and cost of care. Does the relatively high use of neonatal circumcision in Queensland perhaps indicate that Queensland physicians are not as up-to-date on the latest literature and guidelines on circumcision as practitioners in other states? In light of the Board's statutory obligation to protect the public and uphold the standards of practice within the profession, I trust the Board will investigate the relatively high use of neonatal circumcision in Queensland.

For your information, a five-week-old infant died in British Columbia on August 22nd two days after he was circumcised. I enclose a copy of a news report describing this tragic incident, as well as a copy of an article in the current issue of the Canadian Medical Association Journal outlining further measures being taken in Canada to curb the practice of routine infant circumcision. As you can see from the article, the medical board in the province of Saskatchewan is asking family doctors to consider the physical risk to the patient and the legal risk to the physician before becoming involved in the routine circumcision of infants. Similar warnings are likely to be issued by medical boards in other Canadian jurisdictions.

Sincerely
 
[signed]
 
D ennis H arrison
 


1 November 2002

Dear Mr H arrison

Thank you for your letter of 8 September 2002 regarding circumcision of infants and minors.

Your further comments will be placed before the Board for information and kept on file.

Yours sincerely,
 
[signed]
 
M Demy-Geroe

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