Correspondent:

DR. JANICE LANDER

I am writing to you as one of a growing number of individuals concerned about the practice of infant male circumcision. I would like to ask two questions, if I may, in regard to "Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision."[1]

First, I would like to inquire about the following statement attributed to you by Reuters in a news release issued on December 23rd, 1997:

It is true that as adults, these newborns will not be able to retrieve the memory of their surgery and distress.

I was wondering what the basis was for this statement. It is my understanding that some individuals have in fact been able to recall perinatal events. Rima Laibow has reported that when she investigated such memories,

the medical and other factors alluded to in the memories have always been corroborated by birth records, historical, and social factors surrounding the child's birth.[2]

Second, I would like to call attention to the following sentences drawn from a recent histological study of the male foreskin:

Clearly, the penis is a complex organ with many different parts, each specialized for a specific role. The prepuce provides a large and important platform for several nerves and nerve endings.[3]

What was the justification for finding the best way to remove "a large and important platform for several nerves and nerve endings" from the genitals of 52 healthy infants? It is my understanding that non-therapeutic surgical interventions cannot be undertaken without the voluntary and informed consent of the person undergoing the intervention. Events related to the horrific practice of forced sterilization suggest that third-party authorizations do not suffice as a justification for operating on normal parts of the reproductive system.

I realize that your duties must impose a heavy workload, but I would appreciate it if you could take the time to answer my questions. I am providing copies of my letter to Drs. Margaret Somerville, David Alwin, Eike-Henner Kluge, and Leora Kuttner. Drs. Somerville, Alwin, and Kluge have made public comments regarding infant male circumcision. Dr. Kuttner is a clinical psychologist and one of Canada's leading authorities on paediatric pain.

For your information, I enclose copies of Dr. Kluge's ethical analysis of female and male circumcision, published in 1993, and a letter from Drs. Somerville and Alwin to the New England Journal of Medicine concerning a circumcision pain study carried out in Toronto.

Sincerely,
 
[signed]
 
D ennis H arrison

Enclosures (2)

References:
 
1. Lander J, Brady-Freyer B, Metcalfe JB, Nazerali S, Muttit S. Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision. JAMA 1997;278:2157-62.
2. Laibow, R. Toward a Developmental Nosology Based on Attachment Theory. Pre and Perinatal Psychology Journal 3 (1988): 12.
3. Taylor JR, Lockwood AP, Taylor AJ. The Prepuce: Specialized mucosa of the penis and its loss to circumcision. British Journal of Urology 1996;77:291-5.

Yours sincerely,
 
[signed]
 
D ennis H arrison
 

cc:	Dr. Margaret Somerville, Founding Director, McGill Centre for Medicine, Ethics and Law Dr. David Alwin, St Mary's Hospital, Montreal, Quebec Dr. Eike-Henner Kluge, Chair, Department of Philosophy, University of Victoria Dr. Leora Kuttner, Vancouver, B.C.