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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

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.

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. Jeff Cowsert says:

    The original Jewish Genital Mutil – I mean Circumcision was a small ritual nick of the foreskin – not a complete amputation of an organ from the reproductive system as is performed today. This is due to 1,000 year old Jewish opinion regarding sexual pleasure. See for yourself in The Guide for the Perplexed by Maimonides, the great Jewish philosopher:

    “As regards circumcision, I think that one of its objects is to limit sexual intercourse, and to weaken the organ of generation as far as possible, and thus cause man to be moderate. Some people believe that circumcision is to remove a defect in man's formation; but every one can easily reply: How can products of nature be deficient so as to require external completion, especially as the use of the foreskin to that organ is evident. The bodily injury caused to that organ is exactly that which is desired; This is, as I believe, the best reason for the commandment concerning circumcision.”.

    This is a Jewish woman’s research into Jewish infant circumcision and her opinion of what is truly going on with regard to religious control:

    http://www.huffingtonpost.com/miriam-pollack/circumcision-identity-gen_b_1132896.html – It practically tells us that Jews have and do circumcise to break the bond of security and trust between mother and son. And later weaken the bond between husband and wife by making sex less pleasurable.

    "Circumcision subverts the community's relationship to the life-giving principle of the feminine, not only by obliterating the woman's rightful identity in structuring the historical social network of her tribe, but also by trivializing and implicitly forbidding her to acknowledge, much less act upon, her deepest mammalian instincts to protect her newly birthed child".

    "Typically, a mother's feelings are dismissed or ridiculed. Her voice is silenced, even to herself".

    "The wounding of circumcision irreversibly alters both mother and child: the mother is fractured at the base of her deepest womb-wisdom, which knows that she must protect her child no matter what; and the baby, shocked and traumatized, is fractured in his ability to absolutely trust the protective arms of the mother he has biologically and innately turned to as his primordial source of safety".

    “Additionally, the removal of the foreskin creates a secondary loss of sensitivity: not only has the most erogenous tissue of the male sexual organ been removed, but, as the man ages, the glans loses its mucosal covering, becomes dried out, and keratinizes over time. Typically by middle age the glans of the circumcised penis has lost much of its receptive potential and the man requires more abrasive stimulation to achieve orgasm.”.

    “In subtle but profound ways, circumcision functions to diminish a man's pleasure potential, allowing his bond to his partner to be subordinated to his bond to his tribal male peers.”.

  2. Jamie Smith says:

    Dan the medical benefits you speak of are much like the medical benefits the drs here tout as medical benefits to female circumcision.

    If you told me of the medical benefits as a intact female, I would tell you, very impolitely where to go. Just as you telling me my healthy normal intact son needs to be circumcised for medical benefit will get me to unleash a fury like you have never seen before. You circumcised your son out of your bias to your own genitalia and your refusal to see yourself as a victim of genital mutilation and nothing more.

  3. Jeff Cowsert says:

    Mark Lyndon What about the Muslims Religious rights. Don't you think the US Ban of Female Genital Mutilation makes the Muslims feel unwelcome or violated. The truly believe they need to amputate parts of their girls and boys reproductive system in order for them to be accepted by their god and community. Seems strange to me that Jewish are allowed to mutilate their boys for their god but Muslims aren't allowed to mutilate their girls to offer a little blood and flesh to their god. Do you think we should talk to local law about getting the FGM Ban reversed? I'm personally not in favor of ANY Genital Mutilation of ANY Child, but fair is fair – right?

  4. Jeff Cowsert says:

    Arie's Pragmatic Politics Because the SF attempt didn't need to include Female Genital Mutilation. FGM was outlawed in the US in 1997.

  5. Jeff Cowsert says:

    Are you suggesting that those fighting for genital autonomy are also pro-abortion?

  6. Jeff Cowsert says:

    Does anyone else notice those in favor of child rights have a photo of themselves, while the pro-cut comments all come from Guns, Paintings, No Face….. If the pro-cut folks feel so right about this argument, why do they hide?

  7. Jeanice Barcelo says:

    Two points I'd like to make — (i) Your notion that "the amount of pain endured by a grownup far exceeds the suffering of an 8-day old infant" is absolutely wrong. Infants are at the height of sensitivity and vulnerability. Sensory learning is at its peak while children are in the womb and for the first few hours and days after birth. Slicing off the most sensitive part of their penis while an infant is strapped to a board or while adult men forcefully hold him down and dribble wine in his mouths does not make for positive sensory stimulation. On the contrary. Cortisol levels in the brain rise to new heights during circumcision and do not return to baseline even six months after the trauma. We are talking about irreversible harm and brain damage because of this sadistic procedure. (ii) If you god demands that you cut off a piece of your infant son's penis in order to create a covenant with him, then it is time you questioned the god you are worshiping. The real Creator — i.e., the one who created the magnificent human body, with every inch receptive to human love, gave us everything we need to lead spiritually fulfilling, deeply meaningful lives. It only those who would benefit from destroying human love and the natural connection we have to each other and to all of life that would create a god who tells people to cut off the most sensitive part of their baby's penis. And it is only those who are under a spell and severe forms of mind-control that would mutilate and harm their children through circumcision.

  8. 1. http://en.wikipedia.org/wiki/Pain_in_babies
    1a. adults can be given general anesthesia and narcotic painkillers; babies can not.
    1d. http://www.drmomma.org/2011/03/he-didnt-cry-babies-in-shock.html

  9. Arie's Pragmatic Politics says:

    You mean like the pedophile promoting pic you have. A legend in your own narcissistic mind

  10. Arie's Pragmatic Politics says:

    If you don't want your son circumcised, don't. That is your right. Thankfully, the US Constitution protects me from bigots like you.

  11. Arie's Pragmatic Politics says:

    Care to post a link to the RAMBAM quote? And I don't mean the stormfront site you frequent

  12. Arie's Pragmatic Politics says:

    Jeff, We are saying that given your bogus quotes – for which you refuse to provide a legitimate link, your angst is not about circumcision but about Jews. Thank you for outing yourself

  13. Arie's Pragmatic Politics says:

    As I read some of the postings, something quickly stands out: There are two types objecting circumcision. People like Mark, objecting for personal reasons, but accepting Freedom Religion and Beliefs and understanding his beliefs are different then those accepting of circumcision yet is not imposing of those beliefs.

    Then we have the likes of Jeff, who posts bogus quotes from nazi blogs to promote he DEMANDS whose attacks are not on circumcisions, but on Jews.But then, Jewish sites tend to attract Jew haters. I would dare Jeff to go to a Muslim site to condemn anything.

    As for Jamie, somewhere in between. I am "a victim of my own circumcision?" Thank you very much I like my circumcision! There are more doctors that agree with circumcisions being a health benefit then there are the euro doctors who oppose. And let's remember: THOSE are the same euro doctors that were visibly upset when the nazi medical experiments were stopped after the Shoah removing a (to them) great source of learning. The tradition of Jew hatred in the euro 'scientific' community is as old as science itself. Unlike female circumcision, circumcision of boys does not negate or diminish sexual pleasure. Keep your prejudices to yourself.

  14. Jeff Cowsert says:

    Arie's Pragmatic Politics I have yet to see anyone request a link for any of my comments – but I will look again. What information would you like to see? Your opinion that I have an issue with Jews instead of circumcision is incorrect.

  15. Jeff Cowsert says:

    I gave citation for the book and the author. Go to the library and look it up. I also gave a link to the article, written by a Jewish woman, in revolt to circumcision.

  16. Jeff Cowsert says:

    Arie's Pragmatic Politics Wow! Have you ever heard the term "slander"? You go pretty far out with your name calling, while hiding behind your gun pic and alias. Nice touch with the Politically Inorrect Comment bud!

  17. Jeff Cowsert says:

    I am not a Nazi or have I ever visited or quoted from a Nazi site. You don't have to dare me to speak in revolt to child mutilation on Muslim sites because I have already done this. I also speak out against the actions of many hospitals, for MGM who happen to be Christian, Community, Federal. You really don't know me well enough to be making the attacks and accusations you are making.

  18. Jeff Cowsert says:

    I am not a Nazi or have I ever visited or quoted from a Nazi site. You don't have to dare me to speak in revolt to child mutilation on Muslim sites because I have already done this. I also speak out against the actions of many hospitals, for MGM who happen to be Christian, Community, Federal. You really don't know me well enough to be making the attacks and accusations you are making.

    You seem to have conventiently left Rob out of your "sizing up" of those in this conversation whom you disagree with. What about Robs cries that he has been robbed of a body part he never wanted to lose because the Jewish community felt the need to take it from him to mark him for their chosen religion. What about the fact that his religious freedom has been violated? What words to you have to make it right for him? How does the Jewish faith make it right for all the other men and children who feel the same as Rob? Are they mere caualties of the faith?

  19. Tamara Murphy says:

    Your religious freedoms do not extend to the genitals of children- male or female.

  20. James Loewen says:

    Arie's Pragmatic Politics to suggest that anyone who questions or criticizes forced genital cutting is a "Jew hater" is simplistic and willfully ignorant. A blatant diversionary tactic that is not working anymore.

    Circumcision is child sexual abuse and I respect all Jews who recognize this an speak out against this atrocity.

  21. I have renounced my Judaism, because I don't want to be part of a group that ritualistically mutilates babies.

  22. Megan Lioness says:

    No one is assaulting Jewish culture! We are aiming to stop the assaults on baby boys. There is absolutely no science to back the fact that infants feel less pain than adults. The only difference in circumcising a baby versus an adult is that the adult can say, NO! There is no harm in letting babies grow into adults and letting them decide for themselves what God has in plan for the look and function of their genitals.

  23. Arie's Pragmatic Politics says:

    And YOU define MY religious FREEDOMS? Not in the US it doesn't! It is because of people like you that we will continue to defend the Constitution

  24. Arie's Pragmatic Politics says:

    Jeff Cowsert Where's the source of your FABRICATED quote jeff?

  25. Arie's Pragmatic Politics says:

    Stu Silverman Isn't Freedom of Religion GREAT! That if you have a personal profound disagreement, you are not obligated to remain part of that faith. Truly great to live in a FREE State. Thanks Stu

  26. Arie's Pragmatic Politics says:

    @James: ONE doctor's opinion. And we can provide quotes from numerous pediatricians that disagree. And in reading Glick's articles, two things come to mind: ONE: He is an anthropologist, NOT a physician. And SECOND, he repeatedly comments that he "thinks," NOT "knows." BIG difference. Read his works.

  27. Arie's Pragmatic Politics says:

    And the majority of US DOCTORS say there is. FACT: This is a DIRECT attack on Judaism! FALLACY: It's meant to protect the child. Come out of the closet and admit it

  28. Arie's Pragmatic Politics says:

    "Your religious community?" Speaks for itself. "No respect?" Personal attacks. Not unusual for Jew haters to stage personal attacks when their convoluted "logic" fails. Disdain for Western Democratic Values? Yet, I aam the one that will fight to protect the Constitution (The hallmark of Democratic values) whilst you would shred the parts you don't like! Admit what you are rob and stop pretending.

  29. Tamara Murphy says:

    The 14 amendment grants males the same constitutional right to genital integrity females have regardless of what religion their parents follow.

  30. James Loewen says:

    Leonard Glick is both a medical doctor and an anthropologist.

    Increasing numbers of ethical doctors are voicing publicly their opposition to genital mutilation of children. 38 of them just protested publicly.

    See: Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision. Pediatrics 2013 131 (4)

  31. Sorry, but you've got some mid 19th century views on infants and pain. Just because you don't remember something, doesn't mean you weren't in pain. Pain has a lasting effect when experienced by a newborn. It alters the brain and causes a lessened tolerance in the child and adult. Unlike adults who can prepare, rationalize, (and quite importantly) receive relief, newborns interpret severe pain in the only way they can (that they are dying and their loved ones have abandoned them) which interferes with trust development and bonding. They receive no – or pathetic excuses for- pain relief like sugar or alcohol. Physically, the infant has to endure the tearing of synechia (the membrane that bonds the foreskin to the glans) which in a grown man has naturally separated painlessly. Also, the spinal function of dampening pain signals is not yet fully functional in an infant. You have come quite close to a rational perspective here with the exception that you use these outdated notions to continue support of denial of choice. If a man wants to pledge a sacrifice to god, more power to him, and if it hurts, well, that's part of it, but it WILL be less pain than he would have endured as a baby.

  32. Arie's Pragmatic Politics – You're incorrect. Rules in place against violence do not change in favor of the violent party when their act is religiously motivated. You can't kill, hit, stab or poison someone just because you hear god tell you to, or because you read it in a religious book,or choose to interpret a leaders words in that way. That's NOT what religious freedom is. People are protected physically from harm REGARDLESS of motivation for harm coming from someone's religion. We are still working the social biases and normalized habits out of practice to attain integrity for that ESTABLISHED principle. Forced genital alteration is simply the next step. You can still do it, just make sure the person you do it to is WILLING. /,,

  33. Katie Allen says:

    It sounds like the only portion of the constitution you are interested in upholding would be the portions you see fit to validate you argument, while completely ignoring the portions that protect the individual actually being circumcised. So long as the YOU can use the first amendment to protect your right to circumcise your child, why can't that same amendment be used to ensure the CHILD has the religious freedom to refuse a religious circumcision. Or the 14th amendment be used to guarantee equal protection under the law for male minors to be protected from underage circumcision as females are protected?

  34. Jeff Cowsert says:

    Which quote?

  35. Jeff Cowsert says:

    Arie's Pragmatic Politics, is it possible that "you" actually hate anyone who isn't Jewish or who doesn't agree with your views. I happen to have Jewish friends whom I love dearly. I also happen to know Megan and I am certain she is not Anti-Semitic. You cannot possibly know the people in this thread well enough to be making these accusations of hatred and hidden agendas.

  36. Vincent Coletta says:

    I was forced to have a circumcision at only days old. Religious freedom ends where someone else's body begins. All I want is someone to be able to CHOOSE what they want for their body.

  37. Arie's Pragmatic Politics says:

    Sounds more like a genetic problem. Most men I know are circumcised and NONE have any issues. Stop blaming the circumcision for what is obviously another cause. And as the CONSTITUTION allows, I will choose for my sons – not you

  38. Vincent Coletta says:

    What could the other cause be, please enlighten me? Because I was born with the equipment to keep this from happening. The Constitution doesn't allow you to choose, the 14th amendment extends the same protections girl's get to boys. The problem we have is one of enforcement.

  39. There is no medical reason that can insist to remove a men's sensitive part.
    Almost all medical reasons have good alternatives thatn circumcision.
    This procedure should be banned world wide.

  40. A man should make up his own mind when he is 18. A child should never get cut.

  41. A man should make up his own mind when he is 18. A child should never get cut.

  42. Arie's Pragmatic Politics says:

    According to YOU! There IS significant data that refutes your comments and second my Freedom of Religion of faith trumps your demands. But nice to know that your ilk – that is pushing for an end to Judaism all together – considers doctors whose research disproves your prejudices as either "non-qualified" or "biased." If you don't approve, make sure none of your children have a circumcision. That is your CHOICE!

  43. Arie's Pragmatic Politics says:

    Vincent Coletta Make sure your children are not circumcised vinnie. If you're pissed, take it out on your parents. My First Amendment trumps your attempts to ban my religion! And by the way, you may want to read the 14th Amendment. You obviously are ignorant of what it provides for.Your ignorance of the Constitution (More probably your hatred of it) is only surpassed by your hatred of Jews and Muslims

    http://www.law.cornell.edu/constitution/amendmentxiv

  44. Anonymous says:

    Dan Silagi if circumcision was this miracle procedure that reduced the risks of HIV/ aids then why are the rates of hiv/aids in Europe 3 times lower in north america we we practice circumcision

  45. Nigel Oswyn says:

    I remind people that if Abraham had done to himself what they do to boys today, he would have never lived to tell anyone about it. Moreover, after he allegedly did this, and told everyone, did he show everyone what he did? People have built their lives around fables, started a cycle of abuse, and now have to continue the abuse to justify it. Genital mutilation is a shonda.

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