Circumcision in males is a matter of considerable debate in the United States. The procedure has ostensible medical benefits and is commonly utilized by a variety of cultures, which leads to significant support for the continued existence for the treatment. However, an opposition also exists, claiming that the procedure is unnecessary and that the risks are higher than the benefits. Furthermore, some cultures practice neonatal circumcision, which can be considered a violation of human rights.
Nature of the Issue
Male circumcision comes in two primary varieties that are separated by the age group of the patients. The first type of circumcision is performed on adult males who have given full, informed consent and chosen to undertake the procedure. The second variant is done on young children, who cannot decide for themselves, with the agreement of the parents. The first kind of the procedure usually does not meet with significant objections since adults have the right to decide what to do with their bodies, and the matter is similar to tattoos, piercings, or plastic surgery. However, some people choose circumcision because of its alleged medical benefits, which are currently being researched and debated.
Neonatal circumcision, however, is at the center of considerable controversy. The procedure is usually performed for the same reasons as in adults, namely medical concerns or religious and cultural practices. However, the treatment is uncomfortable for the child and ethically questionable, possibly constituting a violation of the infant’s rights. Furthermore, the benefits of the procedure are as yet unconfirmed while the complications and risks are well documented. The reasons mentioned above lead to demand for serious consideration of the topic by families that want their children to be circumcised at a young age, and some members of the opposition are asking for the procedure to be abolished altogether.
The Benefits and Risks of Circumcision
The primary reason for voluntary male circumcision is the presence or likelihood of specific diseases. According to Ahmad et al. (2015), the list includes HIV, multiple sexually transmitted infections, balanitis, posthitis, penile cancer, cervix cancer for partners, and phimosis. Current research is leading to the accumulation of a significant basis for the claim that the procedure can reduce the risk of the person contracting any of the above. Advocates for the availability of circumcision use these benefits to support their argument that circumcision should be permitted for males who can give informed consent. They also state that modern methods of performing the procedure are less likely to lead to adverse consequences than the traditional practices.
However, some specialists call the validity of the claims about the health improvements related to the treatment into question. Robin (2016) asserts that the evidence of benefits provided by circumcision is still lacking, particularly for infants.
Some studies may be displaying bias, while other fields of research yield conflicting results and require further investigation. He adds that there are less harmful and expensive methods that achieve the same ultimate goal or show superior results. Those approaches include medicine treatments, stretching the foreskin, retracting it, and using different, less damaging surgeries. In light of their existence, there would be no medical reason to permit the procedure or endorse it. Opponents of circumcision often call for it to be declared a cultural or religious ritual for this reason.
The procedure can also lead to a variety of issues and complications, most of which are related to its injurious nature. According to Ahmad et al. (2015), they include swelling, discomfort, external and internal bleeding, wound infection, and various penis injuries after the operation. However, they add that the issues occur in less than 1 in 50 trials. On the other hand, Robin (2016) notes that the procedure can often result in boy’s exhaustion and inability to sleep, or breastfeed. The treatment is already restricted to healthy and stable infants, but they still experience the adverse consequences. Ultimately, this part of the debate has no clear winners, and future research will determine the validity of each side’s claims.
Ethical Concerns
Voluntary male circumcision for a person that has reached the age of consent is an ethically sound procedure, as the person has the right to make the decision. Furthermore, it is supported in its social acceptability by long-term practice and religious or traditional reasons for its use. However, the performance of the procedure on infants and young children at the parents’ request is the primary topic of circumcision debates. According to Izgi (2015), neonatal circumcision is not medically ethical, as is prioritizes the needs of the society over those of the individual. The use of the procedure for religious reasons may lead to labeling later in the person’s life despite his freedom to choose whether to continue adhering to that religion later in life.
Infant circumcision may also be considered a violation of human rights. A child is unable to make meaningful choices, especially when it is newborn and does not have any decision-making capacity. Circumcision is usually an unnecessary procedure that does not immediately benefit the child, and opposition to the treatment sometimes declares it an act of mutilation, which would mean it violates the child’s right to security of person.
Furthermore, the procedure can be considered a cruel and degrading one, as the foreskin is a part of the child’s body, and removing it without a valid reason may violate that right as the child experiences pain and other adverse outcomes. Lastly, religious or other forms of circumcision conflict with the right to thought and religion and may violate the child’s best interests.
Nevertheless, numerous organizations consider neonatal circumcision to be an acceptable treatment, though they do not endorse it or recommend it as routine. According to Baskin (2015), the Canadian Paediatric Society considers the evidence evenly balanced while the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Urological Association claim the treatment is beneficial but not necessary.
Furthermore, the World Health Organization recommends circumcision for HIV prevention in less developed countries. According to Baskin (2015), “they stated that a human rightsbased approach to promotion of male circumcision requires measures that ensure that the procedure be carried out safely, with informed consent, and without coercion or discrimination” (p. 6). In this context, the procedure is considered to adhere to the best interests of the child and have medical advantages that make it necessary enough to make the harm to the child permissible.
Role of the Nurse
Ultimately, the nurse does not choose whether the patient receives the operation, as the decision belongs to the person or the parents of the child. If circumcision is in order, the nurse should do his or her job and ensure the best outcomes for the patient through competent practice. However, discussing the benefits and risks of the treatment as well as the ethical concerns surrounding it with the related parties before the decision is made is part of a nurse’s duty as a patient advocate. He or she should concentrate the narrative on facts and evidence-based practice and avoid disclosing his or her personal opinion or attempting to sway the person to his or her viewpoint.
However, nurses can still influence the legislative process by collecting evidence and applying to the relevant parties, such as the organizations mentioned above, with well-structured proposals supported by the gathered data. If they manage to gather sufficient data to reach a decisive conclusion, the principles of evidence-based practice demand that the findings be taken into consideration and used to support the viewpoint of the nurses in question. Nurses are in a position where they can collect detailed information with the consent of the involved parties, potentially allowing them to exhibit a significant influence on the topic.
Conclusion
The primary topic of the male circumcision debate is the performance of the procedure on infants without their informed consent. There is evidence for the medical benefits of the treatment, but it is debatable and not yet conclusive. Furthermore, most neonatal circumcisions are carried out for non-therapeutic reasons, which raises a variety of ethical concerns and may violate the human rights of the infants. Nevertheless, most U.S. medical organizations view the procedure as acceptable under the condition that the parents are informed about the issue. Nurses can contribute to the discussion through the medium of evidence-based practice by collecting data and using it to make and support claims.
References
Ahmad, S., Shrama, S., Tripathi, M. K., Pundhir, A., Kumar, G., & Ali, S. A. (2015). Socio-cultural factors of male circumcision: Its benefit and risk effects. Journal of Contemporary Medicine, 3(1), 7-10.
Baskin, L. S., (2015). Neonatal circumcision: Risks and benefits.
Izgi, M. C. (2015). Ethical evaluation of non-therapeutic male circumcision. Turkish Journal of Psychiatry, 26(3), 204-212.
Robin, E. (2016). Alleged medical benefits of circumcision.