Re: Infant male circumcision

I would like to draw attention to some troubling issues raised by a study carried out recently in Edmonton. News media around the world reported on December 23rd that researchers from the University of Alberta, who were testing various methods of pain control for circumcision, took the unusual step of terminating their study early rather than subjecting more infants to this agonizing procedure without anesthesia.

Of the eleven infants in the unanesthetized control group, two became seriously ill immediately after circumcision. One of them had an episode which included vomiting, abnormal posture (lack of tone in limbs), and several periods of apnea (cessation of breathing, one period lasting more than 25 seconds). The other infant had a choking episode with apnea. I understand that the episodes suffered by both infants met the criteria for what are known in pediatric medicine as ALTEs, or “apparent life threatening events.” I enclose a copy of the CNN report for your consideration.

A study conducted at the University of Toronto earlier this year found that even when topical anesthetic is used, circumcision is traumatic enough to have long-lasting adverse effects on the developing brain.

Researchers from the University of Manitoba reported last year in the British Journal of Urology that the foreskin is a complex anatomical structure containing dense concentrations of specialized nerve endings. The main effect of circumcision is to diminish the amount of sensory input that can originate in the penis and thus limit the pleasure that can be obtained from sexual activity. It was for this reason that allopathic physicians introduced circumcision into the practice of medicine during the Victorian era.

The Canadian Paediatric Society, which comprises the leading body of experts on this subject in our country, recommends that circumcision of newborns not be routinely performed.

Although there seems to be a substantial measure of agreement in Canadian medical circles that infant circumcision is inadvisable, and according to Statistics Canada only about 25 percent of male infants across the country are still being circumcised, practitioners nevertheless feel obliged to perform the procedure if parents demand it. Ms. Barbara Brady-Fryer, M.N., who is a member of the team which conducted the Edmonton study, puts it this way: “...male neonatal circumcision is not illegal. The choice to access this optional procedure belongs to the child’s parent or guardian.” (Bioethics Bulletin, Division of Bioethics, University of Alberta, Vol. 7, No. 1, March, 1995).

I would be grateful if you could clarify for me whether or not Ms. Brady-Fryer is correct in her interpretation of the law. Is it legal to circumcise a healthy individual on the basis of a third-party authorization? Further, what are the legal implications, if any, of confining healthy human beings or other animals for the purpose of using them as subjects in experiments involving amputations of normal body parts without anesthetic?

I would appreciate it if you could shed some light on these questions.

Sincerely,
 
[signed]
 
D ennis H arrison

Enclosure: Circumcision study halted due to trauma

Dear Mr. H arrison:

Re: Infant Circumcision

Your letter dated December 27, 1997 to the Honourable Jon Havelock, QC, Minister of Justice and Attorney General of Alberta, has been referred to me for consideration and reply.

In your letter you seek a legal opinion on some issues respecting the performance of infant circumcision. However, this Department is able to provide legal opinions only to Government departments and agencies, and is not in a position to provide such opinions to members of the public. Because of the issues you raise, and its mandate within the medical sphere, I think it would be more appropriate for you to contact the College of Physicians and Surgeons of Alberta, whose offices are located at 9th Floor, 10180 - 101 Street, Edmonton T5J 3S4, if you wish to pursue these issues.

Yours truly,
 
[signed]
 
Peggy M. Hartman
Director of Civil and Family Legal Services

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