There is a very strong suggestion these days, emanating particularly from the NOCIRC camp in America, that parents do not have the right to have their sons circumcised. We even hear of sons threatening to sue their parents for assault in having had the operation performed, although I have yet to hear of such a case being successful. I think therefore that the situation in which the parents of a newborn child find themselves vis-a-vis circumcision bears some analysis.
The first point which should be made about the circumcision decision is that it is a decision for life, whether it is for or against the cut. We often hear that leaving the child intact effectively places choice in the boy's own hands. When he is an adult, he can himself determine whether or not he wishes to be circumcised. I believe that the so-called choice which is being preserved is illusionary. Picture the 18-year-old, newly arrived in adulthood. Are the arguments for or against circumcision put to him? Is there literature available which explains clearly to him the advantages and disadvantages, what the operation would involve, and how to obtain it? Of course not. And if the 18-year-old, in his wisdom or foolishness, decides he wishes to be circumcised, how should he proceed? He will get little help from his GP unless there are definite medical indications, with no chance of a referral to a consultant or an operation on the NHS. If he is streetwise, persistent and can accumulate a fair sized pot of money, he can go to a private clinic. But how many 18-year-olds have the knowledge and experience, let alone the funds, required to pursue this course? We must face the fact that, although adult circumcision remains a theoretical option, for most it is never a realistic choice. In practice, if a father leaves his son uncircumcised at birth, the son is highly likely to die with foreskin still intact. To circumcise or not to circumcise, either way it is in effect a choice for life.
But suppose that the father is convinced by the arguments in favour of circumcision. Suppose he takes seriously the evidence that urinary tract infection, with consequent kidney damage, is more prevalent in uncircumcised than circumcised boys, evidence which persuaded the American Academy of Pediatrics to revert to advising in favour of circumcision. Suppose the father is persuaded by the prophylactic arguments: that circumcision will prevent phimosis, paraphimosis, balanitis and other diseases of the foreskin which can require surgical intervention in up to 10% of boys and men: that circumcision gives added (but by no means complete) protection against venereal disease and AIDS. Suppose the father thinks that circumcision is an aid to genital hygiene, knowing that the fact that a foreskin is retractable is no guarantee that it will be retracted and cleaned on any regular basis.
If a father is convinced by all these arguments, what is he to do? Wait until his son reaches adulthood and deprive him of the benefits of circumcision for 18 years? Surely, if he believes that he is acting in the best interest of the child, he has a duty to have him circumcised.
In our society, people are often placed in positions of authority which give them the right to influence or direct how others act. In the place of work, the employer determines how the employee shall act during work hours. Police officers have the power to arrest; judges and magistrates the power to imprison; and prison officers the power to confine. In all walks of life, people are daily taking decisions which will affect the lives of many others for better or worse.
This is particularly true of the parent. A parent's responsibility is awesome. For an extended period of time, the child is totally within the parent's sphere of power and influence. Decisions have to be taken daily, hourly, on behalf of that child, when there is no certainty that those decisions will be right. Children are indoctrinated into the religious, cultural, social mores of the parents. If a child is born into the Christian, Jewish or Moslem faith, he may drift into indifference, or atheism; very few will cross the boundary between one religion and another. The education chosen for the child will significantly affect his ways of thinking and his opportunities in later life. The diet chosen, the environment in which he lives, whether or not his parents smoke, all are likely to have a significant influence on his future and well-being. There are even routine medical decisions to take - to immunise or not, for instance; whether to risk the possibility of damage through inoculation in return for the protection offered against serious disease.
Nevertheless, these responsibilities are borne lightly. People weigh up the pros and cons, take a measured decision and act for what they hope will be the best. There can never be any certainty that a decision will be right; if such certainty existed, no decision would be required. Nor is inaction necessarily a valid option; always to do nothing as a matter of policy is a decision in itself, and will many times bring results infinitely worse than if a positive decision for change had been made. Life is uncertain and full of risk. Most of the time we accept that risk - we still drive cars even though we know the relatively high chance of an accident. We trade that chance against the advantages of speedier and more convenient travel. In medicine, all drugs have side effects for some people. After rigorous trials, a drug is accepted for clinical use, even though it is known that its effect on some patients will be deleterious. And when we are that individual who is affected, we rail against the system, feel ourselves ill-used and demand compensation. Such personal anger is justified, but it is against the fates that we should fulminate, not against those who took decisions in good faith and with the best possible evidence. As humans we crave certainty when there is no such thing.
There is little doubt that the actions of parents have a profound influence on the child, for better or worse. The parents must take these actions and decisions. The child cannot be left uneducated until adulthood to decide for himself the education he wishes to receive. The child cannot be raised in a religious or cultural vacuum. If immunisation is delayed, the protective shield is lost. Mankind depends upon each generation being raised to succeed its parents and to take its responsibilities in turn. The responsibility for raising the next generation has, from time immemorial, been given to the current generation. We, as individuals, may not like what our parents did: but who can doubt that most parents act as responsibly as possible towards their children; caring for, and nurturing them to the best of their ability, accepting as part of that role the necessity to take decisions on behalf of their children, and to act positively for their children whenever such action is required.
In this context, circumcision is just one of many decisions which a father must take on behalf of his son. Society has given him the right to act. It is his duty to take that action in what he deems to be the best interests of his son. If he is convinced of the merits of circumcision, he has the duty to confer those benefits on his son. To do otherwise is to surrender his role, to abnegate his responsibility, to fail to act as a true father.
GP = General Practitioner. A doctor providing general medical services to patients in his locality. Also known as a Family Doctor.
NHS = National Health Service. The network of doctors and hospitals, and the services they provide, funded from Social Security taxation.
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