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April 17, 2014 / 17 Nisan, 5774
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Human Rights Lawyer Challenging AAP Pro-Circumcision Stance

"The AAP’s circumcision recommendations contradict its own bioethics policy statement, which requires pediatric care to be based only on the needs of the patient."

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Photo Credit: Serge Attal/FLASH90

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Religious Jews don’t circumcise their male children because of the alleged medical benefits of this Biblical rite, but because it is a Biblical rite. Over the generations, popular and medical views on circumcision have shifted from hearty endorsements to strong rejections and all the positions in between, and Jews just continued to circumcise their sons.

Still, it is fascinating to see how this area of human behavior is evolving in keeping with the shifting social mores. Today, in the midst of all out political attacks on circumcision in Europe and the U.S., yet another assault on Brit Milah is making headlines.

“Attorneys for the Rights of the Child” J. Steven Svoboda and pediatrician Robert S. Van Howe, M.D. have published a new article in the Journal of Medical Ethics (JME), arguing that the American Academy of Pediatrics (AAP) position regarding male circumcision lacks credible support.

The article, “Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision,” is being published online today (subscription required).

Svoboda and Van Howe criticize the AAP’s apparent cultural bias in favor of circumcision, which they note puts the AAP firmly out of step with world medical opinion on this issue. They argue that the AAP documents suffer from troubling deficiencies, ultimately undermining their credibility. According to the authors, these deficiencies include the omission of critical issues, biased use of the medical literature, and conclusions that are not supported by the evidence given.

Svoboda commented, “The AAP ignores so many important topics that it is hard to know where to begin. For example, the anatomy and function of the foreskin are not mentioned in their documents, even though they propose to cut it off without first considering the harm and pain that result from its removal. The AAP’s circumcision recommendations contradict its own bioethics policy statement, which requires pediatric care to be based only on the needs of the patient. Non-therapeutic circumcision is incompatible with widely accepted ground rules for surgical intervention in minors.”

Dr. Van Howe, a Clinical Professor at Michigan State University College of Human Medicine, said, “When physicians decide whether to do a procedure, they must, and normally do, exclude from their medical decisions non-medical factors regarding the parents’ culture. Contrary to what the AAP suggests, doctors are not cultural brokers. Their duty is promoting and protecting the health of their patients, not following practices lacking a solid ethical and medical foundation.”

Svoboda asks, “Why is the AAP promoting public funding for an unnecessary and harmful surgery when we find ourselves struggling even to provide basic care for all our children? In these days of rising medical costs and scarce resources, we simply cannot afford to continue to carry out such a harmful and outmoded practice.”

The AAP‘s official position on this matter states:

The American Academy of Pediatrics finds that circumcision has potential medical benefits and advantages, as well as risks. A recent analysis by the AAP concluded that the medical benefits of circumcision outweigh the risks. We recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions and personal beliefs.

Your pediatrician (or your obstetrician if he or she would be performing the circumcision) should discuss the benefits and risks of circumcision with you and the forms of analgesia that are available.

A few months ago, the Royal Dutch Medical Association favorably cited an earlier version of Svoboda’s and Van Howe’s article, noting that even if benefits do exist the procedure can safely be delayed until the boy himself can make the decision.

Svoboda and Van Howe’s article appears at a similar publication date with a commentary to appear in the AAP’s own Pediatrics by thirty-eight leading European medical authorities, who have independently reached a conclusion consistent with Svoboda and Van Howe’s in criticizing the “cultural bias” in the AAP’s policy.

Much of what the two authors are arguing makes perfect sense, although the notion of delaying the decision of circumcision until the child grows up is disturbing, because the amount of pain endured by a grownup far exceeds the suffering of an 8-day old infant. But their argument regarding the inherent conflict in a doctor’s recommendation of a procedure that doesn’t have scientifically proven benefits appears cogent.

And as in so many other divine commandments Jews are embracing, our position is that we’re not doing it because of the benefits—should they exist—but to fulfill a commandment. As in “I would have loved to eat pork, there’s nothing wrong with it, but God has commanded me not to.”

Works for me.

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About the Author: Yori Yanover has been a working journalist since age 17, before he enlisted and worked for Ba'Machane Nachal. Since then he has worked for Israel Shelanu, the US supplement of Yedioth, JCN18.com, USAJewish.com, Lubavitch News Service, Arutz 7 (as DJ on the high seas), and the Grand Street News. He has published Dancing and Crying, a colorful and intimate portrait of the last two years in the life of the late Lubavitch Rebbe, (in Hebrew), and two fun books in English: The Cabalist's Daughter: A Novel of Practical Messianic Redemption, and How Would God REALLY Vote.


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106 Responses to “Human Rights Lawyer Challenging AAP Pro-Circumcision Stance”

  1. What happened to the good old days when Jews believed in God?

  2. Dan Silagi says:

    God didn't command you not to eat pork. A bunch of rabbinical priests did. God has better things to do than worry about what you eat, Yori.

    As for circumcision, there are medical benefits to the procedure and that's why I'm in favor of it. If the only justification for it is tradition, or because the Bible tells you to do it, I'd tell the mohel to get lost, not terribly politely.

    On the other hand, if Mr.Svoboda and his ilk tried to keep me from having my son circumcised, I'd tell them where to go, even less politely.

  3. Ethan Perks says:

    Dan; Following the Commandments is why there are still Jews in the world after 3,000 years despite all of the despots who sought to destroy us. Without Jewish Law we would be like anybody else.

  4. Hey religious fanatics—mutilating, blood rituals aren't for children! Shame on those who seek to perpetuate this physical and sexual child abuse.

  5. Dan Silagi says:

    Got news for you, Ethan. We ARE just like anybody else; we're all God's creatures. And the 3,000 years of despots arguments doesn't wash anymore; at least as far as Americans (and virtually all western Jews) are concerned. The days of circling the wagons, of seeing anti-Semites under the bed, and behind the bushes, are over.

    But at least you concede that the 619 laws of halaicha are meant to render Jews apart from others. Back in Poland, 1910, this might have made sense; the Poles WERE out to get us, as were the Russians, the Ukranians, etc. But we're in a new era, a new age, and as far as I'm concerned, I'm first and foremost an American, of Jewish descent on both sides. The United States is my homeland; America is my nation.

  6. Dan Silagi says:

    I don't miss my foreskin, and neither does my wife. To me, most of this stuff is pure unadulterated BS.

  7. How can you miss what you never had – ask intact men and they wouldn't give up this highly innervated skin and neither would their partners. Who doesn't want more penis instead of less?

  8. I wonder if there is a way to welcome baby boys and baby girls into the covenant equally.

    When I reflect on halacha, I have faith that the intention is more important than the rule. I sense the intention of circumcision is to devote ourselves and our families to God. I am hopeful that we can fulfill this intention by doing as Moses instructed by circumcising the foreskins of our hearts. It seems possible to me that Moses had whole sexual anatomy and never made the choice to have part of it cut off, and yet he chose to circumcise his heart and open it fully to God. I am inspired that the instructions given by Moses can be followed in choice by both men and women equally.

    I want to be very clear that I am not against the mitzvot of circumcision. We can מוּל by cutting the foreskins of our hearts in spirit, so I wonder if we can מוּל by cutting the foreskin of a penis in spirit as well. The covenant does not specify how to circumcise.

    I would like the circumcision of children to be performed in a way that keeps their sexual anatomy whole. I wonder if the covenant could be fulfilled by sliding a metal ring onto a child's penis to imprint a mark in the flesh of the foreskin for the ceremony. I also wonder if the covenant could be fulfilled by the mother touching blood to the child's genitals as Zipporah did to Moses's genitals on the way to Egypt. After that, the Lord let him alone. This circumcision would celebrate a mother's role as protector.

    If an adult wants to have his or her own foreskin cut off, I support that freedom of choice. I ask that we please protect the freedom of children to make their own choice about their sexual anatomy when they are old enough to make such a complicated and personal decision.

    Shalom.

  9. I know many men who are heartbroken that they are circumcised and that they didn't have a choice. Quite a few of these men are Jewish. I am hopeful there is a way to fufill the religious imperative and protect genital autonomy at the same time.

  10. Dan there are 613 mitzvot and if you believe in Judaism's you would know that what you are referring to is the oral law. You also obviously do not follow history or the news too much or you would know that in the '30s Jews in Germany felt as you do, wouldn't even refer to themselves as Jews but "Germans of Mosaic persuasion " (what do you think happened to them although quite a few of them voted for hitler) and now under the guise of "free speech" some of the most vile anti semitism is being spread on many (if not most) collage campuses. Some pretend its "anti Zionism" but all you have to do is read that garbage to know the truth.

  11. Jew Haters in the without the Nazi face.

  12. The headline today "Indonesian Muslims Reject Ban on Female Cirumcision".
    The anti semitic pediatriacians are silent.. Why only Jews?

  13. Dan Silagi says:

    Let's start with your premises: First, I follow the news plenty, probably a lot closer than you. Second, I've never heard the term "Germans of Mosaic Persuasion" before, and I'm quite familiar with the history of German Jewry and the history of the Third Reich. Third, I don't believe "quite a few of these Germans of Mosiac Persuasion" voted for Hitler. Maybe future Field Marshall Erhard Milch, a Nazi war criminal who was also a full-blooded Jew did (he received his Deutschesbluteserklarung from the Fuhrer himself).

    Yes, there is a lot of anti-Israel sentiment at some universities, and most of the most vile are Jewish lefties. But that hardly means that if I eat a cheeseburger or a pork chop, the Fourth Reich will kill all the remaining Jews, which some knuckleheaded hasids and haredim would tell us.

    Finally, it's "college" not "collage." One doesn't get an education at a kaleidoscope.

  14. Gil Gilman says:

    Wow! So much negativity and angst written here. People are jumping up and down and waving their arms like the flames of hell are searing through their shoe leather. Speaking of shoe leather, why don't you go out and feed the hungry, clothe the naked, and house the homeless, because circumcision must have caused that also. What Ithink is that you are a bunch of kooks who don't mind slicing and dicing a fetus, but are in horror of a little snip of the foreskin on a living baby. Funny, I don't remember all that trauma and separation you talk about, have no psychological problems, have a high IQ, a good sense of humor…somehow I survived it. Oh. I get it, that little tantrum, that cause is what you live for, it replaces Hashem in you lives. That little foreskin is your life! Okay, just don't bring it into my bed ;-)

  15. Dan Silagi says:

    Where's Foreskinman when we really need him?

  16. Dan the misspelling is due my iPhone's spellcheck and if you don't see the rise in anti semitism in the US particularly in the Democratic Party you're blind and deaf.

  17. Ron Low says:

    Adult self-elected genital surgery is not the trauma the author suggests. Adults can tolerate much higher dosage for pain management. Plus, they have the satisfaction of knowing they chose it, they could wiegh in in the style or degree of cutting, and if they don't like the outcome, there is someone NOT long dead to be sued.

  18. Elwyn Moir says:

    How about the fact that if an adult man asks for it his doctor WILL give him as much endone as he likes for the recovery period, no questions asked.

  19. Dan Silagi says:

    You obviously didn't get a very good education at Mercy College. And yes, I'm a Democrat. Got a problem with that, schmuck?

  20. Rebecca Fine says:

    When it comes to the medical policy on circumcision for boys, it has recently been reported that the Canadian Pediatric Society is dropping its previous opposition to male circumcision. The new Canadian policy will recommend that parents be informed of both the benefits and risks of circumcision for boys and leave the decision up to the parents.

  21. Mark Lyndon says:

    All western medical organizations already have policies condemning female circumcision, and it's illegal in most of them.

  22. Dan, Considering what almost happened at the last national Democratic Party conference last summer I understand your hostility because after all they could only change the party platform back by ignoring the vote. Obama's associations would (if they were as anti black as they are anti Semitic and anti white) have precluded him from even being a serious candidate the first time. If it were not for both the collusion of the "main stream" media and voter fraud he would not have won the second. His fanatically anti Semitic anti white anti capitalism associates are numerous enough that I only list a few here (some you may have heard of others not) of course J Wright (who he refers to in his book as his "mentor and spiritual father", W Ayres (in whose living room he announced his candidacy), Derrick Bell (father of that racist "critical race theory")(he was so highly regarded by Bell's followers he delivered the eulogy) the list can go on but here are a few very influential bigots in Obama's past

  23. Dan Silagi says:

    Obama is truly a great socialist. Just ask equity traders, who'll tell you that the stock market has more than doubled in the 4+ years since he has taken office. Manufacturing jobs have been steadily increasing, for the first time in at least 12 years. By 2020, the US will almost certainly no longer need to import oil from any country other than Canada, and by 2030, will be completely energy-independent. By contrast, in 2006, the US imported 2/3 of its oil. Now that's down to just over 1/3, and is dropping fast. We no longer have to kiss Saudi ass, and were able to impose an embargo on Iranian exports without even a blip in crude oil prices.

    The US auto industry, which was moribund in 2008, is now vibrant. American cars are as good or better than anyone's, including Germany's. And we have two Beemers, which are both great automobiles.

    Obama has done something no other president in the past 100 years has been able to do. He averted a second Great Depression, despite Republicans dogging him every step of the way. It took FDR nine years to get us out of the first (and only) Great Depression, and FDR needed lots of help from Adolf and Tojo to do it.

    I drank the same Kool-Aid you're now drinking back in 2008. I believe the Jeremiah Wright and Bill Ayres BS, and voted for McCain, whom I highly respect. I thought Obama was the Second Coming of Karl Marx.

    I am happy to admit I was dead wrong.

  24. Arie's Pragmatic Politics says:

    No one is telling you you are FORCED to have a circumcision. You call the Mohel, he does not arrive automatically. Get over yourself Dan. Just as much as the supposed "human rights" activists (and I would dare say Antisemitic) are demanding it be stopped your comments are no better

  25. Arie's Pragmatic Politics says:

    San Francisco, where your ilk attempted to become the first city in the US to make Judaism illegal by banning both circumcisions and Kosher food. While you Jew haters demand Constitutional freedoms so long as they allow you to spew your hate, you demand it be shredded when someone dares disagree with you. You may want to re-read, or have someone read for you, the First Amendment.

  26. Arie's Pragmatic Politics says:

    "some circumcised men." Meaning very few!! Sexual anxieties, low self-esteem? Sounds like any man – circumcised or not – that has personal issues. And your presumption that ONLY the reports from doctors YOU support are supposedly "authoritative" is disingenuous at best and propaganda on its face. Bottom Line: You have an agenda. And demonizing those that disagree with you, like the doctors of the AAP that don't agree, is your only method of attack since you have no objective evidence.

    So let's complete your stats and conduct a REAL evaluation: How about we do a study how many serial killers are circumcised so we can establish a correlation! How many arsonists are circumcised so we can establish a correlation! How many politicians are circumcised so we can establish a correlation! How many pedophiles and rapists are circumcised so we can establish a correlation!

    And by the way, I checked your blog (and a blog is what it is). A large number of the articles you have posted are bogus or been overturned – the Germany ban for example. Obfuscation, Lies and Propaganda appears to be all you have.

  27. Arie's Pragmatic Politics says:

    And I know a significant number of men, and their wives, that are very happy/. You mind your religion and we will mind ours. And yes, we are grateful for the First Amendment that makes sure we are left alone.

  28. Arie's Pragmatic Politics says:

    Mark Lyndon And yet, the attention of the liberals is to ban Judaism. San Francisco's attempt ban is the perfect example. When SF pushed to ban circumcision, it was directed against ONLY males, (JEWS!!) no mention of women. I wonder why that si

  29. If by making Judaism illegal you mean protecting the human rights of all children including Jewish boys from sadistic, abusive, sexually repressive adults then yes, it's about damn time! One's freedom of religion ends where someone else's body begins. No child should be forced to participate in some superstitious, disfiguring, dick-carving ceremony. Children aren't property no matter how much some parents would like to believe that to be the case. After all, slavery was abolished in the United States.

  30. Arie's Pragmatic Politics says:

    SF tried to ban kosher slaughter and tried to ban circumcisions. See the pattern? The rest of us do! And the FACT that your ilk always attacks Jews but never when its under banner of islam further illustrates the point. And "superstition?" So what you are saying is that YOU know what is right and everyone that disagrees with you is "superstitious." TYPICAL "LIBERAL" (or quite simply at your core a Jew hater!) Notice how the bigots always migrate to Jewish web sites to spew forth? I guess they know tat unlike Muslims, Jews won't blow them up

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