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Correspondent: CHILDREN'S ADVOCATES (Identical letter sent to children's advocate in each province by local resident)
Dear (name of Children's Advocate): I am writing in regard to an issue that has become a matter of increasing public concern in recent years: infant male circumcision. I have been researching this subject for some time, and I seek your assistance in clarifying a number of points. First I would like to present a summary of relevant information:
In light of the above information, I seek your professional opinion on the following issues:
Please contact me at (telephone number) if you require further information or would like to speak to me about this request. Yours sincerely,
Replies [B.C.| Alta.| Sask.| Man.| Ont.| Que.| N.B.| P.E.I.| N.S.| Nfld.] — BRITISH COLUMBIA — January 25, 2000 [A staff member from the office of the children's advocate telephoned to indicate that most of the questions being asked did not come within the purview of the children's advocate, and that a reply would not likely be forthcoming].
March 9, 2000 Dear Ms. Preston: I wrote to you on January 19th in regard to circumcision of boys. To date, I have received no reply, though a member of your staff did contact me a few days later via telephone to tell me that the questions I was asking may not come within your purview. It is my understanding that the Child, Youth and Family Advocate is an independent officer of the British Columbia Legislature who is responsible for protecting the rights of children and youth. It seems to me, therefore, that you would be able to judge whether or not a particular type of treatment infringes on a child's rights. I realize that infant male circumcision remains a controversial issue, and many people are afraid to comment on it for fear of reprisal. Fortunately, there are always a few courageous individuals willing to speak out. One such person is Dr. Margaret Somerville, Founding Director of the McGill Centre for Medicine, Ethics and Law. For your information, I enclose a copy of a letter on the subject of neonatal circumcision that Dr. Somerville wrote recently to Dr. M. VanAndel, Deputy Registrar of the B.C. College of Physicians and Surgeons. I also enclose copies of two letters Dr. Somerville wrote to Dr. Robin Walker, a member of the Fetus and Newborn Committee of the Canadian Paediatric Society. Note the following statement on page 2 of the first letter, dated November 10, 1997: The present law would prohibit circumcision on a child unless the persons consenting to this and the physician carrying it out can show it is justified.On page 2 of the second letter, dated January 28, 1998, Dr. Somerville writes: [A] non-therapeutic surgical intervention ... is only legally justified with the voluntary and informed consent of the person who undergoes the intervention. Infants cannot give such a consent...Dr. Shaun Peck, B.C. Deputy Provincial Health Officer, stated in a letter dated November 5, 1998, that infant male circumcision has no medical indication. I enclose a copy of this letter for your consideration. In your professional opinion, is it ethical and legal to perform surgery on a child if the surgery is not medically indicated? Radio Sweden recently informed its listeners that a report prepared for the Swedish National Board of Health has characterized circumcision of boys for non-medical reasons as a violation of the United Nations Convention on the Rights of the Child. I enclose a copy of that news item for your information. Sadly, human beings have shown extraordinary ingenuity in finding ways to make children suffer. Socially approved mutilations have ranged from head deformation to foot binding, with the sex organs, as the seat of pleasure, being singled out for particularly heavy attack. These various mutilations have had one thing in common: all have been viewed as harmless, or even beneficial, by the societies that have practised them. For example, the British Medical Journal reported in its August 3, 1996 issue (p. 249) that Dr. Saed Thabet, a professor of gynaecology at Ain Shams University in Cairo, believes female circumcision is necessary for health reasons. I hope that as an individual working to protect children's rights, you will be prepared to examine the ethical, legal, and human rights issues raised by the circumcision of children for non-medical reasons. I would very much appreciate a response to my letter of January 19, 2000. Please contact me at [phone no.] if you would like to speak to me about this request. Sincerely,
April 25, 2000 Dear Mr. H arrison: I am writing in response to your two letters, dated January 19th and March 9th, 2000 in which you request my assistance in raising concerns about male circumcision. I have received both your letters and the material that you sent to me. I am not in a position to answer your questions. Clearly, this is an area that requires specific knowledge and expertise which neither I nor my staff possess. The focus of the work of my office is on the BC Government's provision of social services for children, youth and families. While this encompasses a wide range of issues facing these children and youth, male circumcision is not one of them. All of the work we do is based on a belief that children and youth have basic rights as articulated in the UN Convention on the Rights of the Child. You raise concerns about the violation of the rights of children in your information so I can understand why you hoped I might be of assistance in your work. However, I am not able to assist as with the resources available to the Advocate's Office it is important that we remain focused on the social service needs of children and youth. Yours truly,
May 2, 2000 Dear Ms. Preston: Thank you for your letter of April 25, 2000 in response to my concerns about infant male circumcision. I appreciate your taking the time to reply. Male circumcision may not be one of the issues that you face on a daily basis, but there may be a danger in compartmentalizing children's rights. If we are not prepared to defend children's rights to their own bodies, will any of their rights be secure? It is clear that you are a strong supporter of children's rights as set out in the UN Convention on the Rights of the Child (UNCRC). It is also apparent that your office lacks the resources to pursue an active campaign aimed at determining the level of support for children's rights among professional organizations. Therefore, I have drafted a sample letter to the College of Physicians and Surgeons of B.C. and the B.C. Medical Association that could be sent on your letterhead and over your signature. The letter aims at clarifying the position of these professional bodies on the issue at hand. Specifically, the letter inquires if infant male circumcision contravenes certain provisions of the UNCRC. All you have to do is review the content of the letter, sign it, send it, and await the response. This will enable you to investigate this issue in a preliminary fashion with a minimum of resource allocation. I trust this is satisfactory, and I look forward to sharing in the responses that you receive. Sincerely,
[proposed letter] Dr. Thomas F. Handley, Registrar
Dr. Ian Courtice, President
Dear __________: I have received inquiries concerning the practice of infant male circumcision, and wish to broaden my understanding of this issue. Specifically, I would like to determine whether or not infant male circumcision contravenes any of the following provisions of the UN Convention on the Rights of the Child (UNCRC):
I seek your professional opinion on the following points:
Thank you for your assistance in this matter. I welcome any additional comments that you might have. — ALBERTA — February 7, 2000 Dear Mr. Falk: Mr. Rechner is away on vacation so I am responding to your recent correspondence to him. The Children's Advocate is mandated to advocate on behalf of children who are in receipt of child protection services. Our knowledge and skills relate to assisting them, or to represent their interests, when decisions are being made on their behalf. Your questions, which you would like to have considered, are focused on definitions of child abuse and circumcision practices. These are questions that you might direct to others who may hold the professional opinions which you seek. You may also want to study the provisions of Alberta's Child Welfare Act which provides the criteria applied in this province for determining when a child has been abused sufficient to warrant state intervention. Sincerely,
— SASKATCHEWAN — March 8, 2000 Dear Mr. H arrison: Thank you for your letter of January 19, 2000. Dr. Parker-Loewen has asked me to respond given the nature of the questions you have raised. Before I address some of the points in your letter, I thought that I might first of all talk about the role of the Children's Advocate. The Children's Advocate has a variety of legislated duties and functions. One of those duties, in general terms, is to promote the interests and well-being of children. It is apparent from the content of your letter and the questions that you raise that you are also interested in this issue. The questions that you have asked are complex, usually case specific and are in the nature of legal advice. Insofar as the latter is concerned, it is the practice of this office not to dispense legal advice. I am therefore not able to provide the legal opinions you seek. The "right" of parents to permit or withhold medical procedures for their children is not without considerable controversy. As you point out the courts have intervened in some cases and ordered a medical procedure to be performed on a child where parents, for religious reasons, have chosen otherwise. In other instances courts have prevented medical procedures notwithstanding parental consent and in still others have acquiesced in parental choices, where the choice was not to go ahead with a medical procedure. You ask "what is child abuse." This is a colloquial term to describe a variety of behaviours directed at children but one that is not recognized in law. The law uses terms such as assault, or assault causing bodily harm or sexual assault. In other words, there is a variety of behaviours, ranging from the criminal to the quasi-criminal, that would be captured by the colloquial use of that term. As you can see, the issues involving medical procedures, consent and the abuse of children are complex and challenging. I thank you for your interest. Yours truly,
— MANITOBA — Note—the Manitoba letter was slightly modified. April 3, 2000 Dear [name withheld]: Thank you for your letter of March 24, 2000. The Office of the Children's Advocate is an independent office of Manitoba's Legislative Assembly. Our role is to represent the rights, interests and viewpoints of children and youth whose lives are affected by the Child and Family Services system. Unfortunately our mandate does not extend beyond that system. I have enclosed one of our pamphlets which will further explain our role. Beyond contacting the Minister of Health I would suggest you contact the College of Physicians and Surgeons. Perhaps the college would be the most appropriate forum to provide the information you have collected to doctors throughout Manitoba. Sincerely,
— ONTARIO — Awaiting reply. — QUEBEC — — NEW BRUNSWICK — Awaiting reply. — PRINCE EDWARD ISLAND — Awaiting reply. — NOVA SCOTIA — Awaiting reply. — NEWFOUNDLAND — Awaiting reply.
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