Recently, a German court ruled that the right of the child to physical integrity trumps the right of the parents to religious freedom. The court further stated that circumcision of a minor for non-medical reasons is a criminal offense. Circumcision should therefore be postponed until the boy can decide for himself.
This ruling caused a worldwide uproar, mainly from religious leaders who claimed their right to religious freedom was being violated. This ruling is no isolated incident, however, but part of a growing global resistance to the practice of circumcision. This increasing criticism has led to a significant decline in the incidence of circumcision over the last several decades in many Western countries.
As part of this worldwide trend, and following other professional organizations, the KNMG published a position paper in 2010 on the ‘non-therapeutic circumcision of minors’ (NTC). In it, the KNMG concluded that circumcision violates the child’s right to autonomy and physical integrity. One of the main guideposts for the KNMG in this issue is the Convention on the Rights of the Child (CRC). This declaration states that children should be protected ‘against all forms of physical or mental violence, injury or abuse.’ It also calls upon governments to ‘take measures to abolish traditional practices prejudicial to the health of children.’ There is ample scientific proof that NTC is indeed prejudicial to the health of children. Around 25-50% of healthy skin is removed from the penis in circumcision. Bleeding and infection occurs as a direct result in 2-5% of children. These complications are usually minor, but sometimes hospitalization is necessary. Later on in life a stricture of the urethra develops in up to 20% of boys, causing bladder and urination problems. Upon reaching the age of sexual activity, circumcised men develop sexual problems three times as often as do non-circumcised men, due to decreased sensitivity of the penis. Many men complain they have been circumcised without their consent. Some of them even try to restore their foreskin by mechanical or surgical means. Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, circumcision can be postponed until an age at which such a risk is relevant and the man himself can decide about the intervention or opt for alternatives.
More important than these negative medical consequences, however, is the fact that circumcision is an infringement of the child’s right to physical integrity. This right, as laid down in Dutch Constitution, is an inalienable human right like the right to life and the right to personal freedom. ‘Inalienable’ in this sense means that parents’ request or permission does not offer sufficient justification to perform the surgery. Besides a request, there must always be an additional reason, such as a medical interest, as in the case of disease. Circumcision is therefore contrary to the cardinal rule for doctors of ‘first, do no harm’ and to the rule that non-consenting children should only receive medical treatment when medically necessary.
It is often suggested that the current worldwide debate on circumcision is an expression of growing anti-Semitism, anti-Islamic sentiment, or xenophobia. For several reasons I believe this is not the case. During the last century, since the atrocities of World War II, there has been an increasing emphasis on human rights, combined with a growing sensitivity towards suffering and infringements of animal, human, women’s, and children’s rights. This had led to a plethora of international declarations safeguarding human rights in all sorts of different situations.
In the Netherlands, this development of human rights has led to strict laws on animal abuse, child abuse, polygamy, and female genital mutilation, amongst others. The KNMG, together with other professional organizations, has been working for several years now to develop strict guidelines for doctors to signal and prevent all forms of child abuse. As in other countries, the Netherlands has appointed a Children’s Ombudsman and hotlines for reporting child abuse have been set up throughout the country.
The growing resistance to circumcision stems not only from medical and secular organizations, but comes also from within religious communities themselves. In the US and Israel, more and more Jewish parents are abandoning circumcision in lieu of rituals that do not lead to an infringement of physical integrity.
This growing aversion to NTC is therefore not caused by anti-religious or anti-Semitic feelings, but by an increased emphasis on human rights, combined with a growing awareness that children have the same fundamental human rights as adults. If it is not permissible to forcefully circumcise a grown man, why would it be permissible to do so to a child? The law protects the physical integrity of young girls, should it not do the same for boys? As it is his body, shouldn’t it be his choice?