Medical and Legal Positions on Circumcision

No medical association in the world recommends routine infant circumcision. Medical associations from cutting cultures tend to view circumcision has having slight benefits, whereas medical associations from non-cutting cultures tend to recognize circumcision as a human rights violation and take active stances against the practice.

United States

American Academy of Pediatrics - 2012

The AAP issued a new policy statement in 2012 that was widely criticized in its own journal. The new policy statement states that the benefits of circumcision outweighs the risks, but not enough to recommend routine infant circumcision. Curiously, the AAP admits that the risks are “unknown.” However, the AAP does recommend that third-party insurance cover routine infant circumcisions and gives the green light for the American Congress of Obstetricians and Gynecologists (who perform roughly 70% of all routine infant circumcisions) to continue to perform routine infant circumcisions.

“Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.”
Task Force on Circumcision. Circumcision policy statement. Pediatrics 2012;130:585-6. DOI: 10.1542/peds.2012-1989

“The true incidence of complications after newborn circumcision is unknown...”
Task Force on Circumcision. Male circumcision. Pediatrics 2012;130:e756-e785. DOI: 10.1542/peds.2012-1990

Criticism

ARC's Steven Svoboda published a response together with Robert Van Howe in the Journal of Medical Ethics:

“The policy statement and technical report suffer from several troubling deficiencies, ultimately undermining their credibility. These deficiencies include the exclusion of important topics and discussions, an incomplete and apparently partisan excursion through the medical literature, improper analysis of the available information, poorly documented and often inaccurate presentation of relevant findings, and conclusions that are not supported by the evidence given.”
Svoboda JS, et al. Out of Step: Fatal Flaws in the Latest AAP Policy Report on Neonatal Circumcision. J Med Ethics 2013;00:1–8. doi:10.1136/medethics-2013-101346

A group of over 30 physicians from Europe and Canada also published a critical response in Pediatrics:

“Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia.”
Frisch, et al. Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision. Pediatrics 2012. 2013 Apr;131(4):796-800. DOI: 10.1542/peds.2012-2896

Royal Australian College of Physicians - 2010

Recommendation against routine infant circumcision:

After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand.
Circumcision - RACP Position Statement September 2010

Royal Dutch Medical Association (KNMG) - 2010

KNMG regards the non-therapeutic circumcision of male minors as a violation of physical integrity, a constitutional right that protects individuals against unwanted internal or external physical modifications. According to the KNMG, minors should only be subjected to medical procedures in the event of illness or abnormalities, or if a convincing case can be made that the procedure is in the interests of the child (such as vaccination).

Read more: http://knmg.artsennet.nl/Publicaties/KNMGpublicatie/Niettherapeutische-c...

German Pediatrics Association - 2012

Religious rules must not influence doctors in the way they care for their patients – and in this case underage children deserve special care. Boys have, according to our sense of justice, the same basic constitutional legal rights to physical integrity as girls, they must not be disadvantaged due to their sex (Art. 3 GG - of the German Constitution). The parents right to educate and freedom of religion end here, where the rights to physical integrity of an underage person and child who is incapable of giving consent are infringed (Art. 2 GG), without there being a clear medical indication. This is applicable according to the opinion of all paediatric associations in Germany and applies to other injuries to intact body surfaces such as piercing, tattooing and ear piercing.

Announcement: http://arclaw.org/announcements/german-pediatric-association-cites-arc-s...

English translation: http://arclaw.org/sites/default/files/BVKJ_Statement_Official_Translatio...

Original in German: http://www.rz-etelsen.net/Hartmann%20-%20German%20Statement.pdf

Nordic Ombudsmen - 2013

Norway, Sweden, Finland, Denmark, Iceland, Greenland

Circumcision, performed without a medical indication, on a person who is incapable of giving consent, violates fundamental medical-ethical principles, not least because the procedure is irreversible, painful and may cause serious complications. There are no health-related reasons for circumcising young boys in the Nordic countries. Circumstances that may make circumcision advantageous for adult men are of little relevance to young boys in the Nordic countries, and on these matters the boys will have the opportunity to decide for themselves when they reach the age and maturity required to give consent.

Announcement: http://arclaw.org/news/exciting-news-norway-five-nordic-childrens-ombuds...

Nordic Sexology Association

Unless there are compelling medical reasons to operate before a boy reaches an age and a level of maturity at which he is capable of providing informed consent, the decision to alter the appearance, sensitivity and functionality of the penis should be left to its owner, thus upholding his fundamental rights to protection and bodily integrity.

http://arclaw.org/sites/default/files/2013-10-10-nacs-statement-on-ritual-circumcision-of-boys-press-release.pdf

Council of Europe - 2013

The Parliamentary Assembly is particularly worried about a category of violation of the physical integrity of children, which supporters of the procedures tend to present as beneficial to the children themselves despite clear evidence to the contrary. This includes, among others, female genital mutilation, the circumcision of young boys for religious reasons, early childhood medical interventions in the case of intersex children, and the submission to, or coercion of, children into piercings, tattoos or plastic surgery.

Announcement: http://arclaw.org/announcements/more-good-news-europe-council-europe-con...

Norway Union of Nurses - 2014

Decision to stop performing circumcisions on healthy children.

Swedish Medical Association - 2014

The Swedish Medical Association's Code of Ethics and Liability Council now stands unanimously behind a statement about ending male circumcision without prior consent. It should be done when the boy is no less than 12 or 13 years of age, in a hospital and for information about the pain and the risks that surgery entails.

References:
http://www.huffingtonpost.com/2014/01/27/circumcision-ban-sweden-denmark...
http://www.fyens.dk/article/2445175:Udland--Svenske-laeger-vil-skaerpe-r... (Danish)