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Evaluations of circumcision should be circumscribed by the evidence
  1. David Benatar
  1. Correspondence to Professor David Benatar, Dept of Philosophy, University of Cape Town, Rondebosch 7701, South Africa; Philosophy{at}uct.ac.za

https://doi.org/10.1136/medethics-2013-101519

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    One common mistake in discussions about the ethics of infant male circumcisioni is to attempt to answer the question of the practice's permissibility by appealing to general principles and bypassing the empirical evidence about purported benefits and harms of the practice.

    Joseph Mazor1 avoids the mistake of appealing only to general principles. He correctly argues that it is not sufficient to invoke a child's right to bodily integrity or to self-determinationii. Moreover, he does not appeal to parents’ rights to religious or cultural freedom in order to make his case for the permissibility of parents having their sons circumcised for religious or cultural reasons.

    However, in invoking empirical considerations, he is insufficiently careful. For example, he includes, on the negative side of the circumcision ledger, a reduction in sexual pleasure, yet it is not clear that even his own reasoning warrants this. The problem is that he seems to want both, to acknowledge the absence of clear evidence for this claim, and to accept it as one of the costs of circumcision.

    He says that Michael Benatar and I2 ‘carefully reviewed the medical evidence’1 about circumcision. In the paper that he cites, we noted that competing claims were made about the effect of circumcision on sexual pleasureiii and we established that no conclusion could be drawn from the limited and conflicting evidence available on this question. Dr Mazor notes that critics could point (selectively) to those studies that lend support to the conclusion that circumcision reduces sexual pleasure, but he concedes that this would be controversial,1 …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.

    • ↵i Henceforth, for the sake of simplicity, I shall refer to this as ‘circumcision’.

    • ↵ii However, he seems to misunderstand the relationship between a child's interests and its rights, even though his argument does not rest on this misunderstanding. He says of the court that ruled against circumcision: ‘Since the German court does not consider any of the various interests of the child with respect to circumcision, I take it that the court holds something like this right-as-trump view’. See ref. 1. But the rights-as-trump view is not the view that a child's rights trump his own interests (or that a competent adult's rights trump his assessment of his own interests). It is that one's rights trump those interests of others that are not protected by rights of the same or greater strength. It is easy to understand how one could have a duty that trumped one's own interests, but it would be a very strange right that trumped a child's own interests. Any such right would prevent parents doing what is best for the child.

    • ↵iii Some claim, for example, that sexual dysfunction is less common among circumcised men. See ref 3.

    • ↵iv Of course, this does not stop those who dogmatically believe that circumcision has no health benefits from disputing the evidence. One common technique is to question the studies’ methodologies. This typically involves grasping at straws. However, if the methodological concerns had substance, one would think that those critical of the evidence would be interested in somebody running a trial that was methodologically sound. If the subjects of such a trial were consenting adults, the usual objections about violating a child's right to bodily integrity would not apply, and yet, we do not see opponents of circumcision recommending such trials.

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