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13th January, 2020. The ethics of ritual circumcision.

Norwegian doctors get their foreskins in a knot

In 2015, alarmed at the risks of backyard circumcisions among the immigrant community, Norway pssed a law mandating public hospitals to perform circumcisions on request (for €400 - not free). There was much protest and so a conscience clause was included allowing doctors to opt out. A very recent (10th Jan) paper by Liv Astrid Litleskare and colleagues, set out to investigate doctors' reasons for opting out, particularly looking to see if a line could be drawn separating conscience and medical ethics. The paper, "Refusals to perform ritual circumcision: a qualitative study of doctors' professional and ethical reasoning" is available open access on BMC Medical Ethics.

The authors were only able to find 10 doctors from 3 hospitals willing to participate, which may suggest the 'protest' is somewhat overrated. One stated reason was to deny the medical benefits of circumcision, apparently on the basis that HIV prevalence in Norway is low. Infection rates in Norway are indeed low, 1 in 1,000 - the same as in Australia but better than the UK (1.7 in 1,000) and the US (1 in 300). But ... long before the HIV epidemic we knew that circumcision prevented urinary tract infections, phimosis, balanitis and penile and cervical cancer. Another was the circumcision was 'causing harm'. How do you get there from the list of medical benefits and the fact that it makes sex better? Perhaps the most bizarre reason cited was that circumcision in unethical and so it should only be performed in private hospitals. Er .. can we think that one through? One fact that was consistently ignored is that in Islam circumcision is not required as an abstract God-given covenant, as in Judaism, but for its health and cleanliness benefits (along with rules about washing your hands and cleaning your backside).

Thanks to regular correspondent JH for alerting us to the link.

12th January, 2020. Southern Africa circumcision season gets underway.

For once, a good news story

As ever, we get horror stories from that part of the world at this time of the year, but not in Kisii Town, Kenya. Here the operation part of the traditional ceremony is carried out by medical professionals. A local businessman, Steve Arika, is providing sponsorship so that the local street kids aged 10-12 can also be included. This includes food supplies for their period of seclusion (for which a former street boy, Duke Ombati, is loaning a rural house). Read the story at KBC (Kenya Broadcasting Corp).

One ten-year-old boy was not so lucky. He wasn't a street kid but his parents couldn't afford the Ksh1,000 ($10 US) cost. Not wanting to be left out, he circumcised himself with a kitchen knife. He went to hospital but his parents couldn't afford the bill and took him away. He still has problems, but a local activist is seeking sponsorship for his treatment. Read about it at The Citizen.

Thanks to Tom for the stories.

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