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Dear [name withheld]:

Thank you for your letter dated March 23, 2000 on the topic of infant male circumcision. You should know that the definition of a child in need of protection is defined by statute in the Child and Family Services Act. This statute is a provincial responsibility. As such, I have discussed your issue with Ms. Bev Ann Murray, Acting Executive Director of Child, Family and Community Development and have transferred this issue to her for a response.

Should you require, Ms. Murray can be reached at [address] [phone no.].

Your sincerely,
[signed]
J. Lance Barber,
Chief Executive Officer
Winnipeg Child & Family Services
 
 
 

Dear [name withheld]:

Thank you for your letter and expression of concern with respect to male circumcision. However, I believe that the more appropriate place to make your case is within the political system of Manitoba. Individual child welfare agencies are only in a position of enforcing the law, not making it. You may also wish to share your concerns with Ms. Bev Ann Murray, Acting Director of Child, Family and Community Support or with the Provincial Advisory Committee on Child Abuse.

Sincerely,
 
[signed]
 
Janet Shindle
Executive Director
Child & Family Services of Central Manitoba
 
 
 

Dear [name withheld]:

I am responding to your letter of March 23, 2000, which was addressed to Mr. Lance Barber, Chief Executive Officer of Winnipeg Child and Family Services. The letter was referred to me because Mr. Barber identified the issue of male circumcision as one of provincial concern.

The information you have included in your letter is a helpful resource for a review of the topic. You have raised several issues:

1. the general lack of information available to health professionals and parents on the topic of male circumcision;
    
2. the apparent discrimination which boys experience with respect to circumcision; and
    
3. the definition of "child abuse" used by Child and Family Services.

1. Improving the knowledge of health professionals and parents on this topic is a matter for professional organizations and community groups. In Manitoba, the College of Physicians and Surgeons is responsible for setting and maintaining standards of care by physicians. Your concerns about this aspect of circumcision should be addressed to Dr. Bill Pope, the Registrar of the College of Physicians and Surgeons. The other aspect of this topic relates to how a consensus on a health issue is developed and maintained. I would respectfully suggest that you bring the articles you provided to the attention of Manitoba Health and the Regional Health Authorities, as these bodies are responsible for public education on important topics such as the one you have raised. Currently, male circumcision is an insured benefit in the list of procedures paid by Manitoba Health to registered physicians.
    
2. As you have observed in your letter, there is a difference in how circumcision is regarded with respect to gender. This is both a socio-cultural issue and a matter for medical discourse. Circumcision is sanctioned by some socio-cultural groups, but not by others. In addition, the medical community disagrees about the need for circumcision. Some authors see it as a procedure with no clear value; others have concluded differently based on concerns about STDs, HIV, and cancer. Currently, the decision regarding male circumcision is between the parent(s) and the physician.
    
3. Child abuse in Manitoba is defined as:
    
   "an act or omission by any person where the act or omission results in
    
   • physical injury to the child,
   • emotional disability of a permanent nature in the child or is likely to result in such disability, or
   • sexual exploitation of the child with or without the child's consent."

In summary, I take your concerns seriously and am prepared to participate in public discourse and legislative review, as appropriate.

Thank you for bringing this issue to our attention.

Yours sincerely,
 
[signed]
 
Bev Ann Murray
Acting Executive Director
Child Protection and Support Services
Province of Manitoba
 

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