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Doctors' Circumcision Recommendations Influenced By Personal Factors, Study Finds

A Canadian study finds that personal factors, rather than medical reasons, influence primary care physicians' recommendations for routine infant circumcision.

A study published in the Journal of Men's Health has found that primary care physicians are most significantly influenced by their own circumcision status in their recommendations for routine infant circumcision. The circumcision status of their sons was also found to be significant.

The study was conducted by Andries J. Muller, who sent out a questionnaire to a cohort of medical practitioners in Saskatchewan, Canada. All respondents were included in the analysis.

The study found three main factors stated by participants as influencing their personal opinions: medical evidence (for or against), self/partner's circumcision status, and religious beliefs. Muller notes that participants might have felt expected to base their recommendations on medical evidence.

The study also identified nine circumcised men who wished they were intact, versus five intact men who wished they were circumcised.

Medical associations in Canada do not recommend routine infant circumcision. The Ministry of Health in Saskatchewan de-insured routine infant circumcisions in 1996, and since 2002, the College of Physicians and Surgeons of Saskatchewan has held a strong position against routine infant circumcision. The Canadian Paediatric Society does not recommend circumcision. These factors can help to explain why Canada has a lower circumcision rate (about 30%) than the United States (about 50%).

The fact that doctors continue to recommend circumcision raises serious ethical concerns.

Medical organizations worldwide stand strongly against routine infant circumcision. Last month, The Royal Dutch Medical Association (KNMG) launched a campaign to end circumcision in the Netherlands. The KNMG recognizes circumcision to be physically, sexually and psychologically harmful and a violation of bodily integrity. Also, this past June, the South African Medical Association denounced infant circumcision for HIV prevention as "unethical" and "illegal."

Critical analyses of personal bias are lacking in the circumcision literature. As most of the high-profile circumcision studies are performed by circumcised American researchers and their partners, these studies likely suffer from personal bias and are known to carry serious flaws. More work needs to be done to analyze these studies that are passed off as hard science.