Cultural Circumcision in Eu Public Hospitals – An Ethical Discussion

Abstract

The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system. We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation. From the unique structure of patient-medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital based circumcision safer than non-medicalized alternatives. The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation

Religious circumcision, invasive rites, neutrality and equality: bearing the burdens and consequences of belief

“…As Brusa and Barilan have argued,9 the distinction between (iii) and (iv) is ‘tenuous’, with similar motivations underpinning Abrahamic and non-Abrahamic circumcising groups. For those who perform the practice for reasons (iii) and (iv), such as mainstream Jews and Muslims, the practice has little motivation in medical thinking 9.…”

“…As Brusa and Barilan have argued,9 the distinction between (iii) and (iv) is ‘tenuous’, with similar motivations underpinning Abrahamic and non-Abrahamic circumcising groups. For those who perform the practice for reasons (iii) and (iv), such as mainstream Jews and Muslims, the practice has little motivation in medical thinking 9. Even if circumcision were demonstrated conclusively to be bereft of medical benefit, the reasons for some groups to circumcise would remain: fulfilling a perceived religious obligation, constituting identity and perpetuating group membership.…”

“…Contra Brusa and Barilan,9 in addition to physical harm, invasive rites such as circumcision seem designed specifically to undermine the ability of people to leave particular groups. Gatrad and colleagues offer the following appraisal of childhood circumcision:

To leave this operation for a few years could result in the youth becoming noncompliant—because of fear of the procedure—resulting in dilution of Islamic values.

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“…Calls for equality and neutrality find some support in Brusa and Barilan, who argue that there should be no reason to prioritise particular beliefs or conceptions of the good in public health services traditionally grounded in egalitarian access to healthcare 34. However, they dismiss claims of practical similarities between circumcision and female genital cutting on the basis that women are more vulnerable to gender oppression and that circumcision has been adopted in ‘democratic countries’, ‘signifying that only male circumcision is a tolerable practice, even if it is errant and harmful’ 9. The ethnocentricity of the second claim has been challenged by those who draw parallels between male and female forms of genital cutting both to oppose the former and to minimise sensationalism regarding the latter 34.…”

Infant circumcision: the last stand for the dead dogma of parental (sovereignal) rights

“…Circumcision proponents have argued that infant circumcision is analogous to activities commonly accepted to be within parental authority, such as clipping fingernails, giving haircuts, v allowing participation in snow sports or contact sports,23 24 and authorising vaccination 25 26. While these activities certainly are compatible with the aim of guarding the child from needless harm, guiding his development, and looking after his best interests overall, the analogy with infant circumcision is strained.…”