School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW 2006, Australia.
BMC Pediatr. 2013 Sep 8;13:136. doi: 10.1186/1471-2431-13-136.
Recent attempts in the USA and Europe to ban the circumcision of male children have been unsuccessful. Of current concern is a report by the Tasmanian Law Reform Institute (TLRI) recommending that non-therapeutic circumcision be prohibited, with parents and doctors risking criminal sanctions except where the parents have strong religious and ethnic ties to circumcision. The acceptance of this recommendation would create a precedent for legislation elsewhere in the world, thereby posing a threat to pediatric practice, parental responsibilities and freedoms, and public health.
The TLRI report ignores the scientific consensus within medical literature about circumcision. It contains legal and ethical arguments that are seriously flawed. Dispassionate ethical arguments and the United Nations Convention on the Rights of the Child are consistent with parents being permitted to authorize circumcision for their male child. Uncritical acceptance of the TLRI report's recommendations would strengthen and legitimize efforts to ban childhood male circumcision not just in Australia, but in other countries as well. The medical profession should be concerned about any attempt to criminalize a well-accepted and evidence-based medical procedure. The recommendations are illogical, pose potential dangers and seem unworkable in practice. There is no explanation of how the State could impose criminal charges against doctors and parents, nor of how such a punitive apparatus could be structured, nor how strength of ethnic or religious ties could be determined. The proposal could easily be used inappropriately, and discriminates against parents not tied to the religions specified. With time, religious exemptions could subsequently be overturned. The law, governments and the medical profession should reject the TLRI recommendations, especially since the recent affirmative infant male circumcision policy statement by the American Academy of Pediatrics attests to the significant individual and public health benefits and low risk of infant male circumcision.
Doctors should be allowed to perform medical procedures based on sound evidence of effectiveness and safety with guaranteed protection. Parents should be free to act in the best interests of the health of their infant son by having him circumcised should they choose.
最近在美国和欧洲，有人试图禁止为男童施行割礼，但未能成功。目前，塔斯马尼亚法律改革协会（TLRI）的一份报告受到关注，该报告建议禁止非治疗性割礼，除非父母与割礼有强烈的宗教和民族联系，否则父母和医生将面临刑事制裁。如果接受这一建议，将为世界其他地方的立法开创先例，从而对儿科实践、父母的责任和自由以及公共卫生构成威胁。
TLRI 的报告忽略了医学文献中关于割礼的科学共识。它包含严重有缺陷的法律和伦理论点。冷静的伦理论点和《联合国儿童权利公约》与允许父母为其男婴授权割礼是一致的。不加批判地接受 TLRI 报告的建议，不仅会加强和使澳大利亚乃至其他国家禁止男童割礼的努力合法化，而且会使其合法化。医学界应该关注任何将一种被广泛接受和有证据支持的医疗程序定罪的企图。这些建议不合逻辑，存在潜在危险，在实践中似乎行不通。没有解释国家如何对医生和父母提出刑事指控，也没有解释如何构建这样的惩罚性机构，以及如何确定民族或宗教联系的强度。该提案很容易被不适当地使用，并歧视与指定宗教没有联系的父母。随着时间的推移，宗教豁免权可能随后被推翻。法律、政府和医疗行业应该拒绝 TLRI 的建议，尤其是因为最近美国儿科学会发布了关于肯定婴儿男性割礼的政策声明，证明了婴儿男性割礼在个人和公共卫生方面有显著的益处，且风险很低。
医生应该被允许根据有效性和安全性的可靠证据实施医疗程序，并保证他们得到保护。父母应该自由地为他们的男婴的健康利益行事，如果他们选择为他们的男婴进行割礼，他们应该这样做。
