Electronic letters to:

Journal Article:
E. Warner and E. Strashin
Benefits and risks of circumcision
CMAJ 1981; 125: 967-976 [Abstract]
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[Read eLetter] Benefits and Risks of Circumcision: A Retrospective
George Hill   (10 November 2004)

Benefits and Risks of Circumcision: A Retrospective 10 November 2004
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George Hill
Doctors Opposing Circumcision

Send letter to journal:
Re: Benefits and Risks of Circumcision: A Retrospective

iconbuster{at}earthlink.net George Hill

Dear Editor:

The 1981 paper by Warner and Strashin has a curious history.1 Some comment would be helpful to place this article in historical context.

Previous studies from the United Kingdom, Australia, and the United States had reported that non-circumcision is the medically preferred option for the newborn.2-4 and American, Australian, British, and Canadian medical societies had announced positions that favored non-circumcision as the medically preferred option.5-8

Warner and Strashin’s position was not accepted by the Canadian Paediatric Society (CPS), which published a special statement to reject their conclusions.9

Cadman et al. reported that neonatal circumcision is not a cost-effective prophylactive procedure,10 and most Canadian health insurance plans no longer cover the cost of non-therapeutic circumcision.

The CPS later issued a new statement on circumcision, which concluded, “Circumcision of the newborn should not be routinely performed.”11 More recently, the non-therapeutic circumcision of male children has drawn critical ethical comment.12-13 British Columbia practitioners must advise parents “that the current medical consensus is that routine infant male circumcision is not a recommended procedure; it is non-therapeutic and has no medical prophylactic basis; it is a cosmetic surgical procedure; current evidence indicates that previously-thought prophylactic public health benefits do not out-weigh the potential risks.”13

George Hill, Bioethicist
Executive Secretary
Doctors Opposing Circumcision
Suite 42
2442 NW Market Street
Seattle, Washington 98107
Web: http://www.doctorsopposingcircumcision.org/

References:

  1. Warner E, Strashin E. Benefits and risks of circumcision. Can Med Assoc J 1981;125(9):967-76.
  2. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7.
  3. Leitch IOW. Circumcision - a continuing enigma. Aust Paediatr J 1970;6:59-65.
  4. Preston EN. Whither the foreskin. JAMA 1970; 213(11):1853-8.
  5. Thompson HC, King LR, Knox E, et al. Report of the ad hoc task force on circumcision. Pediatrics 1975;56(4):610-611.
  6. Belmaine SP. Circumcision. Med J Aust 1971;2:223.
  7. Anonymous. The case against circumcision, BMJ 1979; 6172: 1163-4.
  8. Foetus and Newborn Committee. FN 75-01 Circumcision in the Newborn Period. CPS News Bull Suppl 1975; 8(2):1-2.
  9. Fetus and Newborn Committee. Benefits and risks of circumcision: another view. Can Med Assoc J 1982;126:1399.
  10. Cadman D, Gafni A, McNamee J. Newborn circumcision: an economic perspective. Can Med Assoc J 1984;131:1353-5.
  11. Fetus and Newborn Committee, Canadian Paediatric Society. Neonatal circumcision revisited. Can Med Assoc J 1996; 154(6): 769-80.
    12. 1
  12. Committee on Medical Ethics. The law & ethics of male circumcision - guidance for doctors. London: British Medical Association, 2003.
  13. Policy Manual: Infant Male Circumcision. Vancouver, BC: College of Physicians and Surgeons of British Columbia, 2004.


Conflict of Interest:

None declared