SUMMARY OF RECENT DEVELOPMENTS

New Brunswick
The issue of newborn circumcision has been placed under review by the College of Physicians and Surgeons of New Brunswick, the province’s medical licensing authority. The move comes after the College received a letter from a member of the Association for Genital Integrity calling attention to guidelines on circumcision released in Saskatchewan and British Columbia.

For further details, refer to an article headlined “Doctors plan to revisit circumcision issue,” Telegraph-Journal, St. John, N.B., March 16, 2005. [Full text]

BACKGROUND
Strategic correspondence with statutory bodies is an important component of the Association’s long-term plan, developed in 1999. In that year, two standard letters were sent to the medical licensing authority in each province.

One letter was sent by a local resident. The other letter, written from the perspective of a physician, was sent by Association spokesperson Dr. Arif Bhimji. The letters express concern about the lack of formal guidance on circumcision and ask a series of specific questions related to the ethical and legal implications of circumcising healthy infants.

Nearly 200 pieces of follow-up correspondence have ensued. To date, statements on circumcision have been published by the medical licensing agencies in Saskatchewan, Manitoba, and British Columbia. In New Brunswick and Ontario, statement development is under consideration.

Quebec
The Collège des médecins du Québec, established in 1847, is Canada’s oldest medical regulatory body. When asked recently by a member of the Association to consider providing guidance to Quebec physicians on infant male circumcision, the Collège gave a curt response: “Nous verrons à prendre les mesures appropriées” (we will see that appropriate measures are taken). [Full text of letter]

BACKGROUND
Male circumcision in Quebec is confined largely to the province’s Muslim, Jewish and Anglo minorities. According to recent government statistics, the incidence of infant male circumcision in Quebec hospitals is between 3 and 4 percent. Among the provinces and territories, only Nova Scotia, Newfoundland/Labrador and Nunavut have lower rates of newborn circumcision.

Ontario
According to new figures released by Ontario’s Ministry of Health and Long-Term Care, the province’s infant circumcision rate is continuing to fall steadily. Only 14.5% of male newborns were circumcised before discharge from Ontario acute care hospitals in fiscal 2003/04, compared with 15.9% in the previous fiscal year, 25.7% in 1996/97, and 60.0% in 1974/75.

Like its New Brunswick counterpart, the College of Physicians and Surgeons of Ontario is considering issuing formal guidance on circumcision, pending the outcome of a review by the Canadian Paediatric Society. [More detail]

Alberta
Although policies discouraging infant male circumcision have been introduced in the neighbouring provinces of Saskatchewan and British Columbia, the College of Physicians and Surgeons of Alberta maintains that no formal guidance on newborn circumcision is needed for doctors in Alberta. In a letter to a local resident dated March 3, 2005, the College reiterates its view that doctors must exercise sound professional judgement as a matter of course. In the opinion of the Alberta college, infant male circumcision is not a clinical area that merits special guidance.

British Columbia
Most circumcisions in the Vancouver metropolitan area are done at Pollock Circumcision Clinics, operated by Dr. Neil Pollock of New Westminster, B.C. In the wake of complaints lodged by local residents with the College of Physicians and Surgeons, Pollock Clinics have added the following provisos to their consent form:

“I have carefully considered the risks and benefits of this procedure and have discussed this with my family doctor or paediatrician or other health care professional prior to coming to see Dr. Pollock.

“I understand that according to the College of Physicians and Surgeons of BC Infant Male Circumcision manual from June 2004 that the current medical consensus is that infant male circumcision is not a recommended routine therapeutic procedure.

“I understand that I am making consent by proxy for my infant for a non-therapeutic procedure. In signing this I have present my own consent to this procedure as a parent of this child and as well if the other parent is not present I have presented a written consent from them acknowledging there is consent from both parents to proceed with this procedure.”

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