Nation’s Leading Pediatric Group Gives Circumcision Benefits a Thumbs Up
The circumcision of baby boys has more health benefits
than risks and should be covered by insurers, says a new policy statement from
the American Academy of Pediatrics.
The statement replaces a more neutral stance held by the
doctors' group since 1999. But it stops short of recommending infant
circumcision as a routine procedure. Instead, it says the final decision rests
with parents -- who, increasingly, are leaving U.S. hospitals with
uncircumcised sons. The infant circumcision rate was about 56% in 2008, says
the federal Centers for Disease Control and Prevention. Rates peaked at about
80% in the 1970s and 1980s, said a report last week from researchers at Johns
Hopkins University. That report said falling circumcision rates could
ultimately cost billions of U.S. health care dollars. It also said 18 states
Medicaid programs have stopped covering the procedure.
Male circumcision involves removing the foreskin from the
penis. For some families, it's a religious or cultural tradition. But groups
that oppose it see it as an unneeded surgery and a violation of a baby boy's
rights. A recent effort to ban circumcision in San Francisco failed. But one
German court has banned the procedure in a part of that country, outraging
Muslim and Jewish groups.
"With circumcision, there clearly are very strong
traditions and cultural values that come into play," says Douglas Diekema,
a pediatrician and bioethicist at Seattle Children's Hospital. He was on the
committee that wrote the new statement.
But the committee also had to consider growing evidence
that the foreskin can be a hiding place for viruses and bacteria and that
circumcision can help prevent some infections -- including urinary tract
infections in babies and HIV infection in sexually active teens and men. Even penile
cancer, though it it is rare disease, is less common in circumcised men,
Diekema says.
"There's potential for significant medical
benefits," he says, along with some risks, including bleeding and pain. In
a detailed report accompanying the policy statement, the committee says all
babies being circumcised should get medicine to prevent pain and that the
procedure should only be done by "trained and competent
practitioners" using sterile techniques.
The statement also says "complications are
infrequent; most are minor, and severe complications are rare." Recovery
takes longer and complications are more common when the procedure is done in
grown men, it adds -- addressing the common suggestion that parents should let
boys grow up to make their own choices on the matter.
The bottom line, according to the pediatricians:
"Parents ultimately should decide whether circumcision is in the best
interests of their male child. They will need to weigh medical information in
the context of their own religious, ethical, and cultural beliefs and
practices. The medical benefits alone may not outweigh these other
considerations for individual families."
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