Infant male circumcision - background information

INFANT MALE CIRCUMCISION:
BACKGROUND INFORMATION

Prepared by Dennis Harrison
October 26, 2000

Medical organizations throughout the world agree that circumcision is not required for an infant's mental or physical health. The Canadian Paediatric Society recommends that "circumcision of newborns should not be routinely performed." The American Academy of Pediatrics advises that the "data are not sufficient to recommend routine neonatal circumcision."
In a 1986 decision called Re Eve, [1986] 2 S.C.R. 388, the Supreme Court of Canada affirmed that parents can legally consent to a surgical operation on their child only if the operation is required for the child's mental or physical health. In the Eve case, the court was asked whether a parent and/or court could authorize the sterilization of a young girl with an intellectual disability who was legally incapable of giving personal informed consent. The court found that the proposed sterilization was not required to protect the girl's mental or physical health but was sought for the social reason of contraception. Another crucial factor was that the procedure was permanent and irreversible in its effects. Given these two factors, the court decided that no parent and no court could legally authorize the procedure. Insofar as circumcision is an invasive, irreversible procedure which is not required for an infant's mental or physical health, it would seem on the basis of Eve that a parent cannot legally give the consent necessary to perform it.
The foreskin is made up of specialized sexual tissue that "provides a large and important platform for several nerves and nerve endings." (J. R. Taylor et al., The prepuce: specialized mucosa of the penis and its loss to circumcision, British Journal of Urology, 77:291-295, 1996). Work in progress suggests that the foreskin triggers sexual reflexes.
Two of Canada's leading medical ethicists, Dr. Margaret A. Somerville (founding director of the McGill Centre for Medicine, Ethics and Law), and Dr. Eike-Henner Kluge (founding director of the department of Ethics and Legal Affairs at the Canadian Medical Association), have stated that routine neonatal circumcision presents serious ethical and legal difficulties because the operation is not medically required.
The courts have placed limits on the ability of parents to make decisions regarding medical treatment of their children, even when the parents are motivated by deep-felt religious beliefs. In M.(R.E.D.) v. Alberta (Director, Child Welfare Act) (1986), 32 D.L.R. (4th) 394, 4 R.F.L. (3d) 363, [1987] 1 W.W.R. 327, 47 Alta. L.R. (2d) 380, 74 A.R. 23, the presiding Justice ruled

...that with regard to s. 7 of the Charter, the Act did not deprive the child S of the right to life: it protected that right. Assuming that the parents had a right under the same Charter provision to be free from state intervention, there had to be a balancing of protected but competing rights. The child's right to life took precedence over any competing right of the parents. The right to freedom of religion guaranteed by s. 2 of the Charter was not without qualification, despite its fundamental nature.