BMA fence-sits on circumcision

The fraught issue of non-therapeutic male circumcision is addressed in a toolkit for doctors published by the BMA.

The toolkit provides practical guidance to doctors who may be asked to refer a child for non-therapeutic male circumcision or to carry out circumcision themselves. As with other procedures involving children who lack the capacity to consent, the toolkit makes it clear that those wishing to authorise the procedure need to demonstrate that it is in the child’s best interests. It helps doctors weigh up the factors, including the law, ethical and cultural issues and health implications, that might be relevant in an assessment of ‘best interests’ in this context.

The toolkit states that doctors are under no obligation to comply with a request to circumcise a child but should not offer unsolicited opinions about their own moral views. In particular, doctors should avoid making pejorative or judgemental comments about patients’ or parents’ values or behaviour. The toolkit helpfully provides a 10-point summary guide to good practice.

Commenting on the toolkit, Peter Baker, Director of Global Action on Men’s Health, says: ‘The toolkit is undoubtedly a very useful guide for doctors. However, the BMA has missed an opportunity to take a position on the ethics of non-therapeutic male circumcision. The Royal Dutch Medical Association (KNMG), by contrast, has clearly stated that non-therapeutic circumcision in boys “is a violation of the integrity of the body”. The KNMG has not sought a ban, however, because that might drive the practice underground with obvious risks. Instead, it is calling for a dialogue between doctors’ organisations, experts and the relevant religious groups. Similarly nuanced leadership from the BMA would be very welcome.’

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