Jackson Doughart
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Challenging P.E.I.'s circumcision culture

The Charlottetown Guardian, 02 August 2012

This summer has produced a new episode in the longstanding ethical debate about circumcision, the medical procedure which removes the prepuce, or foreskin, of a male patient. First, a district court in Cologne, Germany ruled on June 26 that the circumcision of infants was illegal, since it violates one’s constitutional right to bodily integrity and causes irreversible bodily harm. Shortly thereafter, two children’s hospitals in Switzerland announced that they would temporarily stop performing circumcisions in light of the German ruling. Finally, the Governor of Vorarlberg Province in Austria ordered a ban on all such procedures until a consistent policy could be implemented throughout the country. The controversy over these decisions has stretched beyond the countries involved, and has been especially fervent in North America, where infant circumcision is much more widely practiced than in Europe. Incidentally, Prince Edward Island has one of the highest circumcision rates in Canada at 39 per cent, according to a 2009 report by the Public Health Agency of Canada. Moreover, the presence of faith groups that practice circumcision as a religious rite is negligible, meaning that P.E.I.’s high incidence is attributable to secular justifications, most likely in the form of cultural tradition.

I advocate legal restrictions against infant circumcision for many of the reasons cited in the Cologne ruling. While religious faith, aesthetic preference, perceived (though dubious) medical and hygienic benefits, and conformity are all legitimate reasons for an adult male to consider the procedure, none of these justifies circumcision on infants, whose autonomy in medical matters ought to be respected as much as possible. The role for the state, in a society that values liberty and individual rights, is to permit adult circumcision while protecting the freedom of a child to make such a decision for himself. Though P.E.I.’s government cannot impose legislative restraints on circumcision, as criminal law falls under federal jurisdiction, citizens should nonetheless be critical of how passively this tradition is accepted in our community, and cognizant of how easily our attitudes about circumcision could be changed.

The commonest response to the broaching of this subject is that medical decisions involving children are the responsibility of parents alone, and that the rest of society should not involve itself in such private matters. This is a bunk argument because it falsely presumes that parental decisions are taken in a vacuum and without any consideration of public partiality or expectation. A review of circumcision rates in the United States (where, as in Canada, circumcisions are overwhelmingly performed without religious motivation), suggests that cultural attitudes toward the practice are of immense influence upon the parents of newborn males. For example, Hispanic communities in America do not practice routine circumcision, as is the case in Latin American countries, such as Mexico, Cuba, and Puerto Rico. This has significantly affected the overall incidence in Southern states, where Hispanics represent a sizeable ethnic minority. Meanwhile, circumcision remains prevalent among non-Hispanics in those areas, and even more so in regions of the country without these communities, such as New England and the Midwest, whose overall frequency remains high.

The impact of cultural bias is also relevant in Canada, as demonstrated by Quebec, which has never adopted circumcision as a cultural marker, rendering its practice minute. This is also true in several English-speaking provinces, such as Nova Scotia and Newfoundland and Labrador, which have consciously abandoned routine circumcision. So while parents are indeed the ones who sign off on the surgery, there is every reason to believe that their decision is ultimately colored by the preference of the greater population, which is rarely discussed or disputed. In fact, P.E.I. constitutes an interesting case study of the secular circumcision tradition, as there is no apparent reason for which Islanders should be more favorable to the practice than residents of the other Atlantic provinces. Circumcision was once prevalent throughout all of English Canada, yet the rates of most provinces have declined due to a general shift in medical opinion, which views the operation as unnecessary. So why has circumcision remained prevalent on P.E.I.?

The answer, I posit, is a kind of kindling phenomenon, whereby the desire to have one’s child conform to his peers has transformed circumcision from medical misconception into rite of passage. Though few parents would likely admit it, this desire to conform can be so strong that the stated justification for circumcision — hygiene, medical benefit, or appearance — is often subordinate to a preconceived and underlying determination to carry out the ritual, which signifies one’s inclusion in the community. Such a state of affairs, where the stated reason for surgery is divorced from the actual motivation, has turned circumcision into a wag-the-dog medical practice. Of course, one can easily sympathize with parents who want to help their children to fit in and avoid alienation, especially when their doctors are more willing to collect a surgical fee than to challenge the status quo. Yet this merely underscores the duty of the community to get the social question of circumcision right. All that is required is a measure of leadership and deliberation to overturn this unjustified and unnecessary tradition.

Jackson Doughart jdoughart (at) gmail (dot) com