Medicaid Coverage of Circumcision Spreads Harm to the Poor

Green, Lawrence W.; McAllister, Ryan; Peterson, Kent W.; Travis, John W.

doi:10.2105/ajph.2008.156463

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…These misrepresent credible research, and cite questionable websites, superseded publications, outlier studies, non-peer-reviewed book chapters and discredited paediatric policy statements (Schoen, Oehrli, Colby, & Machin, 2000; Morris, Bailis, Castellsague, Wiswell, & Halperin, 2006; Morris et al, 2012b). Opposition to infant medical MC in the USA (Green, McAllister, Peterson, & Travis, 2009) has seen Medicaid coverage decline, posing a danger to public health (Leibowitz, Desmond, & Belin, 2009; Morris, Bailis, Waskett, Wiswell, & Halperin, 2009). …”

Section: Introductionmentioning

confidence: 99%

Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

et al. 2012

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“…The information that medical practitioners must provide to parents before obtaining informed consent for NMC includes (1) a list of common conditions prevented or substantially reduced by NMC that pose a risk to the health and well-being of the boy during infancy and childhood and (2) procedural risks that are low (0.4%) for NMC but are 20 times higher when circumcision is performed between 1 and 10 years and 10 times higher after the age of 10 [100]. Moreover, (3) NMC obviates the need to seek specialist treatment for later foreskin disease; (4) the costs of later MC, often for medical need and for treatment of a wide array of conditions that NMC protects against, are substantially higher than the cost of NMC [54,93,[169][170][171][172][173]; (5) the health parity rights of the poor in protecting their children's health [87,88], while contradicting arguments to the contrary [141], which have been disputed [142]. In the US, states that lack Medicaid coverage have NMC rates 24% points lower than states with Medicare coverage [87].…”

Section: Consent In the Form Of Substituted Judgmentmentioning

confidence: 99%

Neonatal Male Circumcision: Clearly Beneficial for Public Health or an Ethical Dilemma? A Systematic Review

Morris,

Rivin,

Sheldon

et al. 2024

Cureus

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Contrasting ethical and legal arguments have been made concerning neonatal male circumcision (NMC) that merit the first systematic review on this topic. We performed PRISMA-compliant keyword searches of PubMed, EMBASE, SCOPUS, LexisNexis, and other databases and identified 61 articles that met the inclusion criteria. In the bibliographies of these articles, we identified 58 more relevant articles and 28 internet items. We found high-quality evidence that NMC is a low-risk procedure that provides immediate and lifetime medical and health benefits and only rarely leads to later adverse effects on sexual function or pleasure. Given this evidence, we conclude that discouraging or denying NMC is unethical from the perspective of the United Nations Convention on the Rights of the Child, which emphasizes the right to health. Further, case law supports the legality of NMC. We found, conversely, that the ethical arguments against NMC rely on distortions of the medical evidence. Thus, NMC, by experienced operators using available safety precautions, appears to be both legal and ethical. Consistent with this conclusion, all of the evidence-based pediatric policies that we reviewed describe NMC as low-risk and beneficial to public health. We calculated that a reduction in NMC in the United States from 80% to 10% would substantially increase the cases of adverse medical conditions. The present findings thus support the evidence-based NMC policy statements and are inconsistent with the non-evidence-based policies that discourage NMC. On balance, the arguments and evidence reviewed here indicate that NMC is a medically beneficial and ethical public health intervention early in life because it reduces suffering, deaths, cases, and costs of treating adverse medical conditions throughout the lifetimes of circumcised individuals.

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“…Legal, human rights and other arguments (presented below) have been invoked in opposing EIMC . Evaluation of those arguments have revealed flaws .…”

Section: Physical Harmmentioning

confidence: 99%

“…Legal, human rights and other arguments (presented below) have been invoked in opposing EIMC. 26,69,320,[357][358][359][360][361][362] Evaluation of those arguments have revealed flaws. 342,[363][364][365][366][367][368][369][370][371][372][373][374] Arguments criticizing the AAP's policy statement on ethical and legal grounds 1,2,26,311,320,357,375,376 were followed by evaluations undermining the arguments used.…”

Section: Ethical and Legal Issuesmentioning

confidence: 99%

Critical evaluation of arguments opposing male circumcision: A systematic review

Morris

Moreton²,

Krieger

2019

J Evidence Based Medicine

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Objective To systematically evaluate evidence against male circumcision (MC). Methods We searched PubMed, Google Scholar, EMBASE and Cochrane databases. Results Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high‐quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high‐quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk‐benefit analyses reported that benefits exceed risks by 100‐200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low‐risk, high‐benefit interventions such as MC for better health. Expert evaluations of case‐law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost‐saving to health systems. Conclusions Arguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

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Medicaid Coverage of Circumcision Spreads Harm to the Poor

Cited by 7 publications

References 8 publications

Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

Neonatal Male Circumcision: Clearly Beneficial for Public Health or an Ethical Dilemma? A Systematic Review

Critical evaluation of arguments opposing male circumcision: A systematic review

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