Yes, it is not a mandatory procedure. However that misses the point. As an elective procedure made without an immediate and compelling reason, it should be left to the individual to make the decision and no one else. It should not be done routinely and the decision is not to be made casually. Most American parents simply elect to have the procedure done because they consider it “normal” and don’t investigate much further, if it all.
As for UTI reduction, I should have framed this differently. There is a reduction, but is that reduction worth it? Tonsillectomies used to be routine, but now they aren’t and are only suggested if there is a chronic problem. Surveys have been conducted and found that an overwhelming number of intact men would not have the procedure done just to have fewer UTI’s. I for one, would rather treat such infections as they arise rather than amputate some tissue just so that I could deal with those uncommon infections less often.
>”We accept the practice for newborns under the logic that it will be less traumatic and less risky than doing it when they come of age later in life.”
It is said that it is less traumatic to do this at birth, but I question this. I suspect people only believe this because babies cannot articulate what is happening to them and none of us are able to remember anything from our infancy. I have no idea what babies “think” but if we agree that this surgery is traumatic and risky, I simply don’t believe one can argue that it is less traumatic and less risky for a human who is only a few days old. A newborn cannot possibly understand and contextualize the intense pain that it is being subjected to, both during the procedure and during the recovery. Whereas an adolescent or an adult opting for this procedure would be informed beforehand, give explicit consent, and be given sufficient anesthesia.
> A newborn cannot possibly understand and contextualize the intense pain that it is being subjected to, both during the procedure and during the recovery.
While I wouldn't defend infant circumcision in any way, I think the paragraph from you is exactly the point. Babies don't conceptualize pain in the same way children or adults do, it just isn't the same sort of thing. It doesn't necessarily scare them in the same way, and there is no evidence whatsoever that painful experiences are traumatic for infants. And biology seems to align with this, as all infants also naturally suffer quite intense pain for months as their teeth grow.
So I don't think the case that inflicting necessary pain on infants rather than doing it later as children or adults is a bad one. Of course, the pain of circumcision is entirely unnecessary (for the vast majority of people, since of course phimosis is a thing that affects some people). But, in principle, for a necessary operation, having it done as an infant is sound medical practice.
That used to be true but the rate has declined significantly recently.
> Tonsillectomies used to be routine
Well you can literally observe the inflammation of those. Which is significant if your patient is not verbal yet. The risk of UTI drops off significantly after age 5 which highlights some of this reasoning more clearly.
> Surveys have been conducted and found that an overwhelming number of intact men
In cases where state Medicaid stopped covering the procedure for newborns they found it did reduce the rate of newborn circumcisions; but, it increased the rate of adolescent and adult circumcisions.
Also the use of "intact" and "amputate" are fairly judgemental terms particularly when "uncircumcised" and "circumcised" are more correct and more commonly used. To be technical it's actually a partial amputation as it's not typical to remove all of the foreskin. It's also true that the procedure can be a treatment for Phimosis or other chronic infection issues. So these terms are needlessly loaded and possibly inappropriate for the stigma they create.
> don’t believe one can argue that it is less traumatic and less risky for a human who is only a few days old
I'm sorry but the medical data is perfectly clear on the risk. It is absolutely less risky. "Circumcision risks tend to be lower when performed on infants compared to older children and adults. The complication rate is generally much lower in neonates (around 0.4%) than in boys aged 1-9 (around 20-fold higher) or those 10 and older (10-fold higher). "
> understand and contextualize the intense pain that it is being subjected to
Do you believe that the act of birth itself is painful for the baby? Was it more or less painful than this procedure that is performed with local anesthetic? I also think this is why parents are somewhat inclined to opt into the procedure. You've already gone through so much you might as well get it all done early.
We could also observe that parents that are circumcised are likely to opt into the procedure for their own children. So to the extent that this pain made any impression on them it doesn't seem to be evidenced in practice.
These are pretty thin points either way. We need better data otherwise this will always be rooted in subjectivity.
> Whereas an adolescent or an adult opting for this procedure would be informed beforehand, give explicit consent, and be given sufficient anesthesia.
Parents are expected to make health care decisions for their children until the age of majority. In most treatment related cases they would still be under their parents care. In both cases as long as the parent is informed and consents there is no actual difference.
Unless you're suggesting that unless required by medical condition that all circumcisions must be performed after 18 and only when a patient solely consents for it; well, there are clearly just as many problems with that proscriptive and tortuous approach. And without strong data to suggest that it would be a net benefit to do this we're better off with the current status quo.
Vaccines can be administered to adults for clinical trials.
If there was a way to do whole body CRISPR most of the ethical considerations would disappear, because there are a lot of ill people awaiting treatment.
As for UTI reduction, I should have framed this differently. There is a reduction, but is that reduction worth it? Tonsillectomies used to be routine, but now they aren’t and are only suggested if there is a chronic problem. Surveys have been conducted and found that an overwhelming number of intact men would not have the procedure done just to have fewer UTI’s. I for one, would rather treat such infections as they arise rather than amputate some tissue just so that I could deal with those uncommon infections less often.
>”We accept the practice for newborns under the logic that it will be less traumatic and less risky than doing it when they come of age later in life.”
It is said that it is less traumatic to do this at birth, but I question this. I suspect people only believe this because babies cannot articulate what is happening to them and none of us are able to remember anything from our infancy. I have no idea what babies “think” but if we agree that this surgery is traumatic and risky, I simply don’t believe one can argue that it is less traumatic and less risky for a human who is only a few days old. A newborn cannot possibly understand and contextualize the intense pain that it is being subjected to, both during the procedure and during the recovery. Whereas an adolescent or an adult opting for this procedure would be informed beforehand, give explicit consent, and be given sufficient anesthesia.