Circumcision

Doctors Anwar, Munawar, and Anwar plead for NHS resources to be diverted towards increasing the provision of religious circumcision.1 Apart from their theological justifications, their main arguments seem to relate to the risks associated with the procedure being carried out by inexperienced practitioners and that ‘it is not our duty to tell a patient which decision to make, but merely to carry out said decision to the best of our ability.’ This is an extraordinary argument, and we are left wondering how the authors would respond to a request for amputation of a healthy limb, female genital mutilation, or assisted suicide.

There is no medical justification for circumcising healthy neonates in the UK. While some argue that there might be a small health benefit in countries with endemic HIV infection, and possibly some reduction in risk of urinary tract infection, there is no doubt that the risk of harm greatly exceeds the health benefits in the developed world. Infants cannot give consent to surgical procedures, and there is no ethical argument for performing an irreversible procedure which might impair later sexual function (or at least sexual pleasure) before a child is old enough to give consent. Prioritising parents' religious beliefs over the health needs of their child disregards fundamental ethical principles of non-malificence and respect for patient autonomy.

The only argument for the involvement of the NHS in religious circumcision is harm reduction, and it is for that reason that I refer patients to paediatric surgeons when parents request it. There is a strong argument for the practice of male infant circumcision being treated by the law in the same way as female genital mutilation.

• © British Journal of General Practice, 2010.