The article on circumcision made interesting reading.1 However, in defining clinical indications for surgical procedures we must tread carefully. We as physicians have a duty of care to the patients (vulnerable children) and we must firmly adhere to the principle ‘first do no harm’. Infection, scarring, and anaesthetic reactions are all potential complications for a procedure with no clinical indication other than cultural/religious. The medicolegal issue is raised if and when a problem occurs. Medicolegally, liability arises when complications occur for the GP (in referring) and for the surgeon in carrying out the circumcision. It is an issue in the Republic of Ireland for parents of children that they have to wait on an ‘elective surgical list’ for a procedure they (the parents) feel is necessary in early infancy. We had a tragic death in 2003 of a 4-week-old infant of Nigerian parents who died from bleeding complications following a home circumcision. The man who carried out the procedure was ultimately found ‘not guilty of reckless endangerment’ by a jury of his peers. Interestingly, the judge directed the jury that ‘they could not bring their white Western values when they decide this case’. One would hope that such leniency would be shown to the medical profession should complications occur!
- © British Journal of General Practice, 2010.