In a statement issued by its Ministry of Foreign Affairs, Israel calls on the Parliamentary Assembly of the Council of Europe to rescind a resolution against circumcision adopted earlier this week. Circumcision is the surgical removal of some or all of the foreskin covering the tip of penis, and in the U.S., this is commonly performed on newborn boys before they leave the hospital.

The resolution was passed by the Council of Europe, a human rights organization that includes 47 member states, based on a report authored by Marlene Rupprecht on behalf of the Committee on Social Affairs, Health and Sustainable Development. Issued last month, the report noted objections to “a category of violation of the physical integrity of children,” which included circumcision along with female genital mutilation, early medical interventions for intersexual children, and piercings, tattoos, or plastic surgery for children.

“Any comparison of this tradition to the reprehensible and barbaric practice of female genital mutilation is either appalling ignorance, at best, or defamation and anti-religious hatred, at worst,” Israel’s Ministry of Foreign Affairs stated before citing a 2012 paper presented by the American Academy of Pediatrics (AAP), which offered evidence of the health benefits of newborn male circumcision.

Health Benefit or Harm?

Beginning in the 19th century, the ancient ritual of circumcision gained ground as a routine medical operation to prevent conditions and behaviors like syphilis, masturbation, headache, rectal prolapse, gout, and even asthma. But rates of circumcision began to drop during the 20th century when nationalized health care systems performed cost-benefit analyses and did not find the procedure to be cost-effective. Prevalence in Europe today is less than 20 percent in most countries. In a 2007 report, the World Health Organization (WHO) estimated that about 30 percent of males, or about 665 million men, are circumcised worldwide; populations of circumcised men are concentrated in the U.S., Canada, countries in the Middle East and Asia, and large proportions of Africa.

Circumcision remains more or less routine practice in the U.S. and is endorsed, as Israel’s ministry noted, by the likes of the AAP. Although it provides strong evidence in favor of circumcision, AAP’s recommendation of the practice is rather tepid. After a ‘comprehensive review of the scientific evidence,’ the medical organization found that circumcision lowers the risk of acquiring human immunodeficiency virus (HIV), genital herpes, human papilloma virus (HPV), and syphilis. AAP also noted that the neonatal practice lowers the risk of urinary tract infections in the first year of life, the risk of penile cancer over a lifetime, and the risk of cervical cancer in sexual partners. Yet in its recommendation, AAP stated that such benefits “are not great enough to recommend universal newborn circumcision.”

Conversely, WHO is more vocal in its recommendation of the practice, which it hopes to embed within comprehensive HIV prevention programs. “There is conclusive evidence from observational data and three randomized controlled trials that circumcised men have a significantly lower risk of becoming infected with the human immuno-deficiency virus," WHO states. Despite this scientific evidence backed by authoritative support, circumcision appears to be waning in the United States.

Declining numbers in the US

Or that is what one organization would like to suggest. Intact America, founded in 2008, seeks to protect children “from permanent bodily alteration inflicted on them without their consent, in the name of culture, religion, profit, or parental preference.” On its website, the organization suggests that it is currently the norm in the U.S. to not circumcise baby boys, with rates well below 40 percent. This figure is not quite as high as those quoted by the Centers for Disease Control and Prevention, which found the national rate of newborn circumcision declining by 10 percent overall, from 64.5 percent in 1979 to 58.3 percent in 2010. Is this a true 'movement' against the practice in the U.S. or a temporary waning of support?

Meanwhile, in a statement to the press, the Council of Europe, which lacks authority to make or enforce laws, requested its member states to ensure that certain operations, including the ‘non-medically justified circumcision of young boys,’ not be carried out before a child is old enough to consent. The Council further recommended that “children’s right to physical integrity” be included among its standards. In its own statement, Israel countered, “This resolution casts a moral stain on the Council of Europe, and fosters hate and racist trends in Europe.”

Source: Weiss H, Polonsky J, Bailey R, et al. Male circumcision: global trends and determinants of prevalence, safety and acceptability. World Health Organization. 2007.

Published by Medicaldaily.com