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Dr. Ken Seethram
President, Northwest Territories Medical Association

Dear Dr. Seethram:

Re: routine infant circumcision as an insured service

I am writing to inquire about the position of the Northwest Territories Medical Association on the issue of public funding for routine infant circumcision. At the present time, the Northwest Territories are one of only two jurisdictions in Canada (the other being the province of Manitoba) that still cover routine infant circumcision under their public health care plans. All the other provinces and territories have de-insured this procedure.

I should perhaps explain my interest in this issue. I have been researching male and female circumcision for several years; my letters on this subject have been published in a number of academic journals, including the Lancet, the New England Journal of Medicine, and the Journal of Law and Medicine. I am one of the spokespersons for the Association for Genital Integrity, a Canadian group dedicated to raising awareness of the medical, ethical and legal issues raised by the practice of infant male circumcision.

The recognized authority on child health in Canada, the Canadian Paediatric Society (CPS), has opposed routine infant circumcision for decades. The current recommendation of the CPS is that "circumcision of newborns should not be routinely performed." Over the past year and a half, the Colleges of Physicians & Surgeons of Saskatchewan, British Columbia, and Manitoba have all issued statements aimed at discouraging the practice of routine infant circumcision. In a memo issued to physicians on February 20, 2002, the College of Physicians & Surgeons of Saskatchewan characterized circumcision of healthy male infants as "imprudent if not improper," and advised physicians "to respectfully decline to perform the procedure just as you respectfully decline to carry out other requested medical acts that you regard to be inappropriate."

To help me understand why the NWT government continues to pay for routine infant circumcision, I would very much appreciate it if you could clarify the position of the NWTMA on this issue. Does the NWTMA support the inclusion of routine infant circumcision on the insured services list? If so, is the NWTMA's position based on medical need, or on some other factor?

Thank you for taking the time to consider this issue.

Sincerely,

[signed]

D ennis H arrison
 

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