Letter to the Canadian Paediatric Society Male Infant Circumcision Policy Committee May 19, 2014

19 May 2014

To the members of the Canadian Paediatric Society Male Infant Circumcision Policy Committee

cc. Dr. Andrew Lynk, MD, Canadian Paediatric Society President

The Children’s Health & Human Rights Partnership (CHHRP) is Canada’s first dedicated not-for-profit partnership of medical, legal, and ethics professionals working alongside concerned citizens towards ending forced non-therapeutic genital cutting of children in Canada. Our work is in accordance with the Canadian Charter of Rights and Freedoms and international human rights law.

We write today to inform you of important developments surrounding the practice of infant male circumcision which should be seriously considered when formulating any future policy statements on the practice in Canada. We offer this with the hope that the Canadian Paediatric Society will take a strong stand in favour of allowing males—when there is otherwise no immediate medical need—to decide upon and consent to circumcision at an age when they can fully understand the consequences.

Such a stand would be consistent with the international movement of child protection advocates, especially paediatric and medical societies and children’s ombudspersons in Europe, who recognize this issue as an important human rights concern.

We enclose for your benefit a copy of the 2012 report from the International NGO Council on Violence against Children. This groundbreaking report identifies numerous harmful practices based on tradition, culture, religion or superstition that violate the rights of children.

While we encourage you to read the entire report for contextual reasons, we wish to draw your attention to those sections we believe are relevant to the present discussion of neonatal circumcision.

Page 7 lists general categories of rights violations based on tradition, culture, religion and superstition. It is difficult to argue that circumcision of otherwise healthy newborns is not a medical, cultural or religious tradition and that many parental motivations for requesting newborn circumcision can be considered superstitious or based on fear of the unknown, e.g., “My uncle had to be circumcised as an adult so we might as well do it to our son now” or “My son will be psychologically harmed if he doesn’t look like his circumcised father or the other boys”.

The report goes on to state (bolding is ours): “The list includes a number of practices perpetrated through false beliefs about child development and the cause and treatment of ill-health. These may stem from religious edict or belief, or from tradition or superstition or in some cases be promoted by health practitioners.”

This is the case especially in North America, where paediatric societies take ambiguous stands and fail to firmly reject any medical justification for newborn circumcision and who issue statements that ignore the functions, benefits, and natural development of the foreskin, while failing to identify the newborn’s inherent right to bodily integrity. You will take note that the practice of male circumcision is specifically identified on pages 21 and 22 as a traditional practice that violates the rights of male children (to bodily integrity). The report states that “non- consensual, non-therapeutic circumcision of boys, whatever the circumstances, constitutes a gross violation of their rights, including the right to physical integrity, to freedom of thought and religion and to protection from physical and mental violence.”

The report also recognizes that “There are now substantial established campaigns against non-therapeutic, non-consensual circumcision of boys and growing support to end it, particularly within the medical community.” The rest of the paragraph from which this excerpt was taken, we believe, is mandatory reading for any paediatric association that claims to have its child patients’ best interests at heart.

Page 47 of the report asserts that health practitioners should be encouraged to work actively to eliminate these harmful practices as parts of their codes of ethical conduct. We at CHHRP assert that this duty to child patients extends to the issuance of a neonatal circumcision policy that explicitly identifies the right of the child to physical integrity and eventual self-determination.

It has become increasingly clear that Europeans are taking seriously their pledge to protect children as well as their international treaty commitments regarding this group of vulnerable citizens. Their medical associations, child welfare agencies, and some legislative bodies reject the promotion of circumcision of otherwise healthy children, especially when such promotion is done by medical professionals and associations.

The American Academy of Pediatrics (AAP) has been publicly condemned by international paediatric authorities for its shoddy 2012 statement that failed to recognize the functions of the foreskin, the medical ethics involved in non-therapeutic circumcision, and the important human rights that are violated by those who circumcise otherwise healthy children. We direct you to one such rebuke signed by 38 physicians from 16 European nations, and Canada’s own Dr. Noni MacDonald.
Source: http://intaction.org/circumcision-policy-denounced/
Full Document: http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896.full.pdf+html

As further evidence of the cultural bias and personal and professional ignorance of AAP Task Force members on this matter, in October 2013 at the 20th Pitts Lectureship in Medical Ethics at the Medical University of South Carolina in Charleston, South Carolina two members of the AAP Task Force on Circumcision were asked by a member of the audience to identify the functions of the foreskin. Task Force member Dr. Michael Brady stated “I don’t think anyone knows the functions of the foreskin” and later reiterated “Nobody knows the functions of the foreskin.”

Source: http://arclaw.org/our-work/presentations/charleston-debate-marks-turning-point-movement-recognize-circumcision-human-r

It deeply concerns us to report that the bias does not end there. Dr. Andrew Freedman, one of the AAP circumcision policy task force members, when asked if he had a son and whether he had him circumcised, was quoted as saying: “Yes, I do. I circumcised him myself on my parents’ kitchen table.” We at CHHRP certainly hope the CPS has taken the necessary steps to guard against such blatant conflicts of interest amongst the members of its Male Infant Circumcision Policy Committee.
Source: http://www.thejewishweek.com/features/new-york-minute/fleshing-out-change-circumcision

We also note that much media attention has been paid recently to a recent review that attempts to equate neonatal circumcision with vaccination. Any clear-thinking individual can see the many ways in which this is a false equivalency; however, if left unchecked, this logically unsupportable notion may gain traction among the public. We hope that any future CPS statement on circumcision will refute such attempts to conflate these two practices.
Source: http://www.ctvnews.ca/health/circumcision-should-be-seen-in-the-same-light-as-childhood-vaccination- study-1.1757650#ixzz2xkx6ATBP



Canada has always been a leader in the international arena when it comes to recognizing human rights — in many cases long before our immediate neighbours to the South. We look forward to a forthcoming update from the CPS on this topic and sincerely hope that the update will not embarrass Canadians by merely parroting the AAP statement, but will be a document that all Canadians can be proud of by progressively incorporating the important issues described in the enclosed report.


In unity for the children,


Dr. Christopher L. Guest, MD, FRCPC Medical Director

Kira Antinuk, RN, BScN Nursing Director

Tim Hammond Outreach Director

David Saving Technical Director

Dr. Arif Bhimji, MD Advisory Board Member

Dr. Cameron Bowman, MD, FRCSC Advisory Board Member

Dr. Kaleb Montgomery, HBSc, DTCM Advisory Board Member

Jessica Forbes, RM Advisory Board Member

Kerstin Helén, RN, RM, BScN Advisory Board Member

Tony Chacon, RN, BSN, MN(c) Advisory Board Member

Geoffrey T. Falk, BSc, MA Advisory Board Member

Tracy Cassels, BA, MA, PhD(c) Advisory Board Member



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