Morris Brian J, Krieger John N, Klausner Jeffrey D
Brian J Morris, School of Medical Sciences, University of Sydney, Sydney, New South Wales 2006, Australia.
World J Clin Pediatr. 2016 Aug 8;5(3):251-61. doi: 10.5409/wjcp.v5.i3.251.
We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur. In contrast, early infant circumcision is convenient, safer, quicker, lower risk, healing is faster, cosmetic outcome is routinely good and the lifetime benefits accrue immediately. Benefits include reduction in urinary tract infections, inflammatory skin conditions, foreskin problems, and, when older, substantial protection against sexually transmitted infections and genital cancers in the male and his female sexual partners. Some authorities regard the failure to offer parents early infant circumcision as unethical, just as it would be unethical to fail to encourage the vaccination of children. In conclusion, the criticisms of evidence-based infant male circumcision policy are seriously flawed and should be dismissed as unhelpful to evidence-based development and implementation of pediatric policy intended to improve public health and individual wellbeing.
我们评估了近期反对男性婴儿包皮环切术的观点,该手术目前得到了美国儿科学会循证政策的支持。我们发现,这些批评依赖于对包皮的推测性说法,以及对支持儿科政策制定的有力科学证据的混淆。一种认为包皮环切术应推迟到男孩成年后自己做决定的观点,没有认识到后期包皮环切术带来的心理、时间安排和经济负担,从而降低了其实施的可能性。相比之下,早期婴儿包皮环切术方便、更安全、更快、风险更低、愈合更快、通常美观效果良好,且终身益处立竿见影。益处包括减少尿路感染、炎症性皮肤病、包皮问题,长大后还能大幅预防男性及其女性性伴侣的性传播感染和生殖器癌症。一些权威人士认为,不向父母提供早期婴儿包皮环切术是不道德的,就像不鼓励儿童接种疫苗一样不道德。总之,对循证男性婴儿包皮环切术政策的批评存在严重缺陷,应予以摒弃,因为它们无助于循证制定和实施旨在改善公众健康和个人福祉 的儿科政策。