Dr. Amy Tuteur's cloudy view of newborn circumcision

In her blog post The case for neonatal circumcision Dr. Amy Tuteur lashes out at those calling for freedom from non-therapeutic circumcision and displays a culturally biased view while advising the AAP to recommend the surgery for all newborn males.

Joining with Tobian, Gray, and Quinn she discards the careful consideration of physicians around the world who have consisently and recently rejected the arguments they are promoting.

Statement by the College of Physicians and Surgeons of British Columbia

Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended.

Statement by the Royal Australian College of Physicians (RACP)

“the RACP does not recommend that routine circumcision in infancy be performed.”

These statements were published in August and September of 2009.

In addition to recognizing the clinical data is insufficient to indicate newborn circumcision, and unlike Dr. Tuteur, these medical organizations give significant weight to the ethical issues involved in a surgery which is irreversible, unnecessary, and occurs without consent of the patient.

Dr. Tuteur uses sloppy language to make her case, for example by claiming "the benefits of circumcision are real and clinically important." In fact, they are only potential benefits which will not materialize, and will not be important for the vast majority of circumcised males. The risks of circumcision are also real and clinically important, but she omits them.

Is data from adult Africans any more applicable to American newborns than to Canadain, Australian, or British newborns? Probably not. The low rate of acceptance and support of newborn circumcision by physicians outside the United States, and relatively high rate of support among American physicians like Dr. Tuteur suggests that the existing culture of male circumcision here is clouding her view of the data, and completely obscuring her view of ethical considerations.

The early days of 2010 have seen a concerted effort by some to upset the trend of falling circumcision rates in the United States. The AAP appears likely to issue a revised recommendation on newborn circumcision in the near future. Hopefully they will avoid the cultural bias which affects Dr. Tuteur and some of her colleagues, but leaves physicians outside the United State largely unaffected.