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Correspondent: ALBERTA CHILDREN"S ADVOCATE April 8, 1998 Mr. Bob Rechner
Dear Mr. Rechner: I'm writing to express my concerns in regard to a medical study that was conducted recently in Edmonton. The study compared several different methods of pain control for infant male circumcision. I enclose an information package containing further details. None of the 52 infants involved in the study required medical treatment, yet all underwent surgery to remove an erotogenic part of the reproductive system. The study was not halted until some infants in the placebo group were traumatized to the point of danger. According to the researchers, the placebo group represented standard practice. A similar study -- conducted previously in Toronto -- drew criticism from Drs. Margaret Somerville and David Alwin. A copy of a joint letter which Drs. Somerville and Alwin wrote to the New England Journal of Medicine is included in the information package. A child cannot be subjected to invasive surgery unless the surgery confers a medical benefit; the law seems clear on that point. The Canadian Paediatric Society concluded in 1996, after an exhaustive review of the literature, that neonatal circumcision confers no net medical benefit. Hence it is doubtful that neonatal circumcision can be legally performed. Nevertheless, the practice continues. The act of removing normal body parts without medical need and without the consent of the person undergoing the surgery also appears to breach the provisions of international treaties to which Canada is a State Party. For instance, Article 7 of the International Covenant on Civil and Political Rights, ratified by Canada in May, 1976, provides that No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.The circumcision of children for religious reasons poses special problems. However, the vast majority of infant circumcisions performed in Alberta and elsewhere in Canada have nothing to do with religion, and have no medical indication. Consequently it seems that infants are being severely traumatized for no apparent reason. I look forward to hearing your comments on this disturbing issue. Sincerely,
April 16, 1998 Dear Mr. H arrison: I recently received your letter dated April 8, 1998, and the information you enclosed regarding infant male circumcision. I assume you sent this to me presuming that I might be in a position to advocate for change in this area of medical practice. The mandate of the Children's Advocate in Alberta is contained within the Child Welfare Act and pertains specifically to those children receiving services under the Act. I would concur with Ms. Peggy Hartman that the issues you raise would be appropriately directed to The College of Physicians and Surgeons of Alberta. I did find the material most interesting and disturbing. Yours truly,
September 29, 1999 Mr. Bob Rechner
Dear Mr. Rechner: I wrote you on April 8, 1998, to express my concerns in regard to a medical experiment undertaken by the University of Alberta. The experiment involved measuring pain responses in infants undergoing non-therapeutic circumcision. You suggested that I direct my concerns to the College of Physicians and Surgeons. I wrote to Dr. Larry Ohlhauser, Registrar of the College of Physicians and Surgeons of Alberta, on February 12, 1998 and November 13, 1998. I have received no response to either letter. I also wrote to Dr. Donald Morrish, Chair of the Research Ethics Board that approved the study. Dr. Morrish assured me that the study was ethical and legal, but so far has declined to furnish evidence of this. For your information, I enclose copies of the correspondence I have had with Drs. Ohlhauser and Morrish. I also enclose copies of two letters from Dr. Margaret A. Somerville, Founding Director of the McGill Centre for Medicine, Ethics and Law, to Dr. Robin Walker, a member of the Canadian Paediatric Society's Fetus and Newborn Committee and co-author of that society's position statement on neonatal circumcision. Dr. Somerville, one of Canada's leading ethicists, outlines the ethical and legal status of neonatal circumcision. Note the following sentence on page one of the letter dated November 10, 1997: "...although adults can consent to have a non-therapeutic intervention carried out on themselves...in general, they may not consent to having such interventions carried out on their children." On page one of the letter dated January 28, 1998, Dr. Somerville writes: "...a physician would need to show infant circumcision was medically necessary before it would be [legally] justified." The researchers at the University of Alberta expressly stated that infant circumcision was not medically necessary. Would you consider writing to Dr. Ohlhauser with a request that he respond to the following question, contained in my letter of November 13, 1998: Before subjecting any child to an invasive surgical intervention, should a physician not establish that the intervention is medically required? Sincerely,
October 12, 1999 Dear Mr. H arrison: I received your letter of September 29, 1999. It is unfortunate that Dr. Ohlhauser has not replied to your letter of February 12, 1998 and November 13, 1998. I suspect that the issue of infant male circumcision which you so vigorously oppose is one that the medical establishment finds to be somewhat of an embarrassment. The continuation of this customary practice in the face of information that apparently finds no sound medical basis for the routine performance of the procedure, is not likely easily defended other than as a matter of tradition. While I am sympathetic to your cause, I must decline your request that I write to Dr. Ohlhauser as this issue is beyond the scope of my office. I would offer, however, a further suggestion that you write to the new president of the Alberta Medical Association, Dr. David Bond. Yours truly,
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