NORM-UK is a registered charity dealing with the issues surrounding circumcision. This page looks at the main lobbying we have made.
In 2005 we asked the All-Party Group on Men’s Health to investigate the issue of male circumcision. They failed to do so and the issues we raised then have still not been addressed. The issues we would like investigating are as follows:
In 1997, The House of Commons Health Committee expressed concern that two thirds of circumcisions were unnecessary because doctors didn’t understand the natural history of the foreskin. Since then there has been little reduction in the number of operations performed. The House of Commons Health Committee also said that ‘It is a matter of concern that it appears that a considerable number of surgical interventions are being performed on children and young people unnecessarily. This is not only costly but is bound to be the cause of unjustified distress to some of those who are the most vulnerable’. And finally, in the November 1997 the Government Response to the Reports of the Health Committee on Health Services for Children and Young People Session 1996-1997 quotes ‘Surgical interventions should only be performed when clinically indicated, especially in children’.
The British Medical Association (BMA) has made its position clear. The Law & Ethics of male circumcision – Guidance for Doctors issued by the BMA in March 2003, states that ‘The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA that this surgical procedure has medical and psychological risks’. This document also states. ‘It is important that doctors keep up to date and ensure that any decisions to undertake an invasive procedure are based on the best available evidence. Therefore, to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate’.
On Wednesday 7 December 2011 we had a meeting with the BMA Ethics Committee. They Listened to us for an hour and have ignored us ever since.
In September 2000, we raised a number of concerns with the Chief Medical Officer, Sir Liam Donaldson. In an exchange of letters, he admitted that the diagnostic code for phimosis is frequently being used for recording a non-therapeutic circumcision, as there is no separate code for the latter procedure and that guidelines for this procedure have not been issued. Use of incorrect diagnostic codes is an issue not only because it is fraudulent, but also because it frustrates collection of meaningful data. As long as non-therapeutic circumcision continues in NHS hospitals, there should be a separate code for “non-therapeutic circumcision” to distinguish it from “phimosis”. We subsequently attended a meeting with the Deputy Chief Medical Officer to discuss these points further and at this meeting we were promised regular reports on progress on the issues we raised. The promised reports were not forthcoming and our attempts to organise a follow-up meeting were ignored. Unfortunately we have found that our approaches to the CMO over an extended period have proved
In October 2012 four trustees of NORM-UK we given an appointment with the
General Medical Council (GMC) to discuss problems. We explained our concern that Urologists seemed unaware that nonsurgical procedures were available for cases of phimosis. We suggested that these needed to be introduced into their training programme. The GMC team agreed to look into this. We also asked that accurate records be kept of all circumcisions which would note the reason for the procedure, by whom and when it was done and the pathology of the foreskin if it was examined. The operation should have a follow –up at a later date.
As nothing seemed to come from this meeting we wrote some letters to find out what was happening. Eventually it transpired that they had lost all correspondence relating to the meeting. After a FOI request they found our correspondence but still took no action to address our points. They then closed the dialogue and declined to meet us further.
We are also concerned at the lack of medical education on the conservation of the foreskin. Medical education and practice are out of step with the current research evidence. This will not change unless action is taken to change the curriculum. We would like to highlight what we consider to be the poor quality of the evidence in relation to the effectiveness of therapeutic circumcision as compared with the conservative alternatives.
We are concerned about the lack of statistics on male circumcision and would like to raise the possibility of compulsory registration of this procedure. There are currently no statistics for the number of circumcisions performed in GP surgeries, private clinics, mosques, synagogues or kitchen tables; let alone data on the complication rates. While we consider non-therapeutic circumcision to be unethical, registration of circumcisers, and registration of circumcisions with regard to who was circumcised, when, where, why, how and by whom would allow follow up, accountability and collection of meaningful data for input into public policy.
- Informed consent must be the key to the legality of the procedure. We should like to break this down into therapeutic and non-therapeutic
- Consent for therapeutic circumcision should require disclosure of
the potential alternatives and the potential complications as well as the
prospects of effectiveness.
- We would like it to be recognized that proxy consent for non-therapeutic procedures on a normal unconsenting child raises moral, legal and ethical concerns.
Finally, it needs to be recognised that a law which protects female citizens from circumcision but which fails to protect unconsenting male children is discriminatory