J Med Ethics doi:10.1136/medethics-2013-101614
  • Public health ethics
  • Paper

Veracity and rhetoric in paediatric medicine: a critique of Svoboda and Van Howe's response to the AAP policy on infant male circumcision

  1. Thomas E Wiswell9
  1. 1School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, New South Wales, Australia
  2. 2Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3Department of Global Health, Academic Medical Centre and Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands
  4. 4Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  5. 5Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, California, USA
  6. 6GBC Health and Global Youth Coalition on HIV/AIDS, New York, New York, USA
  7. 7People Incorporated, St. Paul, Minnesota, USA
  8. 8Departments of Medical Microbiology, Community Health Sciences and Medicine, University of Manitoba, Winnipeg, Canada
  9. 9Center for Neonatal Care, Orlando, Florida, USA
  1. Correspondence to Professor Brian J Morris, School of Medical Sciences and Bosch Institute, The University of Sydney, Bldg F13, Sydney, NSW 2006, Australia; brian.morris{at}
  • Received 31 May 2013
  • Revised 18 July 2013
  • Accepted 25 July 2013
  • Published Online First 16 August 2013


In a recent issue of the Journal of Medical Ethics, Svoboda and Van Howe commented on the 2012 change in the American Academy of Pediatrics (AAP) policy on newborn male circumcision, in which the AAP stated that benefits of the procedure outweigh the risks. Svoboda and Van Howe disagree with the AAP conclusions. We show here that their arguments against male circumcision are based on a poor understanding of epidemiology, erroneous interpretation of the evidence, selective citation of the literature, statistical manipulation of data, and circular reasoning. In reality, the scientific evidence indicates that male circumcision, especially when performed in the newborn period, is an ethically and medically sound low-risk preventive health procedure conferring a lifetime of benefits to health and well-being. Policies in support of parent-approved elective newborn circumcision should be embraced by the medical, scientific and wider communities.

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