Comments

HeyItsMe says: If the harm (medical, psychological and sexual) of male circumcision is ever proven to exceed the benefit, rest assured that the procedure will be swiftly banned. This is an interesting reversal of the usual standards applied to most other invasive medical procedures. Surely with circumcision, as with any other operation, it should be a case of "if the potential benefit is shown to exceed the potential harm then it should go ahead", not "do it by default for religious and/or societal reasons and then if some harm is shown to come of it, stop". The study by Krieger et al. suffers from two flaws. First, although they used randomized controlled trials, they did not use randomized double blinded controlled trials. Trials that are not subject to blinding are, of course, susceptible to observer bias. Second, the trials were stopped early by the authors. Such trials tend to overestimate the efficacy of the intervention [Mills E, Siegfried N. Cautious optimism for new HIV/AIDS prevention strategies. Lancet 2006;368(9543):1236.]. The paper by Krieger et al. also points out a 1.5% complication rate, including impotence, anesthetic morbidity and pubic abscess. The fact remains that this is a highly invasive and irreversible surgical procedure that in most cases is performed without the patient's consent (i.e. on newborns). The foreskin evolved for a good reason and, except in genuine cases of medical need, there is no equally good reason for removing it, especially for those living in first world countries where hygiene standards are high and prophylactic measures against HIV infection may be readily taken. If it is to be removed, this is a decision that should be made by an adult for themselves alone. Most people abhor female circumcision, and rightly so. Why is it, then, that male circumcision so often seems to get a free pass, especially in the US?