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Penile transplantation as an appropriate response to botched traditional circumcisions in South Africa: an argument against
  1. Keymanthri Moodley1,
  2. Stuart Rennie2
  1. 1Department of Medicine, Centre for Medical Ethics and Law, Stellenbosch University, Stellenbosch, Western Cape, South Africa
  2. 2Department of Social Medicine, UNC Center for Bioethics, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Professor Keymanthri Moodley, Department of Medicine, Centre for Medical Ethics and Law, Stellenbosch University, P.O. Box 2400, Cape Town, 8000, South Africa; km{at}sun.ac.za

Abstract

Traditional male circumcision is a deeply entrenched cultural practice in South Africa. In recent times, there have been increasing numbers of botched circumcisions by untrained and unscrupulous practitioners, leading to genital mutilation and often, the need for penile amputation. Hailed as a world's first, a team of surgeons conducted the first successful penile transplant in Cape Town, South Africa in 2015. Despite the euphoria of this surgical victory, concerns about the use of this costly intervention in a context of severe resource constraints have been raised. In this paper, we explore some of the ethical implications of penile transplants as a clinical and public health response to the adverse consequences of traditional male circumcision. Given the current fiscal deficits in healthcare and public health sectors, how can one justify costly, high-technology interventions for conditions affecting a small section of the population? Since botched traditional male circumcisions are preventable, is a focus on penile transplantation as a form of treatment reasonable? Finally, do such interventions create undue expectations and false hope among a highly vulnerable and stigmatised group of young men? In this paper, we argue that given limited healthcare resources in South Africa and competing healthcare needs, prevention is a more appropriate response to botched traditional circumcisions than penile transplants.

  • penile transplantation
  • botched circumcisions
  • South Africa
  • ethics

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Footnotes

  • Contributors KM conceived the idea for the article and drafted the first version. SR contributed to the article and edited all subsequent versions. Both authors conducted a literature search and contributed equally to the final version.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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