The Circumcision Decision by Dave Gross Having a baby boy today means having to face an im

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The Circumcision Decision by Dave Gross Having a baby boy today means having to face an important decision: Should your son be circumcised. Only 25 years ago, in the United States anyway, it was an easy decision to make -- 95% of baby boys born in this country were circumcised, and the operation was considered a necessity. But then the American Academy of Pediatrics (AAP) declared circumcision unnecessary, and today only about 60% of American boys are circumcised at birth. That still makes circumcision the most common surgical procedure in the United States. Over one million baby boys were circumcised this year. Worldwide, the practice is much less common. Only about 20% of the world's male population is currently circumcised, and the United States is the only nation to continue routine circumcision for other than religious reasons. For some parents, the choice to circumcise is a religious one. In Jewish and Moslem custom, circumcision is evidence of a covenant with "God." Other parents have more vague reasons for deciding on circumcision for their boys. Some believe that there are health benefits. Others want their sons to look the same as the circumcised father. Others see the circumcised penis as a cultural norm, and more aesthetically appealing. Still others see circumcision as a cure for masturbation in youths or for premature ejaculation later on in life. In the last few years, there has been a great deal of controversy about circumcision. About two years ago, the AAP declared that there were some medical benefits as well as risks to circumcision. Most of this change of policy came from studies showing lower rates of penile cancer and urinary tract infection in circumcised men and boys. Although the AAP stopped well short of endorsing circumcision, many people interpreted this change in policy as an absolute reversal of the previous AAP stand. Not so, says Donald W. Schiff, M.D., president of the AAP, "We have not reversed our position. We've changed it a bit, but it's really just a bit." Circumcision foes compare removing the foreskin to prevent penile cancer or urinary tract infections in infants to pulling teeth at birth to prevent cavities. One doctor, in a presentation to the California Medical Association, wondered why, if circumcision was justified to prevent penile cancer, nobody was suggesting infant breast removal in girls to prevent the more-common breast cancer in women. Groups opposed to circumcision warn that not only are the benefits dubious, but the risks are very real. Edward Wallerstein, author of the award-winning "Circumcision: An American Health Fallacy," found that one in 500 circumcisions result in significant complications and that possibly 225 deaths per year can be attributed to the circumcision operation. In one of many such horror stories, an Arizona boy has had to undergo surgery eight times since a botched circumcision. He was awarded $1.5 million dollars in damages last August, but it is unknown whether he will ever have normal sexual functioning. For another boy, whose penis was completely burned off in a 1985 circumcision accident, there is little hope of a normal sex life. And new studies on infant pain have breathed new life into the debate over whether even a successful operation can harm a child physically or psycho- logically. In October, Los Angeles Times writer Ann C. Roark reported that for many operations, including circumcision, infants are not given any pain- killers or anesthetics. Doctors feel that the risks of giving these drugs to infants outweigh the benefits. In addition, many doctors are skeptical that infants do in fact feel pain, or if they do, that they remember it. New studies challenge this view. Ann Roark quotes Dr. Myron Yaster, an expert on pediatric pain at Johns Hopkins Medical Institutions in Baltimore, as saying that "most adults would be shocked if they saw what was done to children in hospitals without anesthetics. It's like roping and holding down a steer to brand it." Studies now show that infants do feel pain and that their bodies go through the same sorts of changes that adults' bodies go through when they experience pain. Circumcised boys are more irritable, eat less, have disrupted sleeping patterns and crying patterns, and show changes in infant- mother interaction. In addition, infants who have been anesthetized during surgery seem to recover more quickly and have fewer post-operative complications than those who have not. But circumcision appears to be a dying custom in the United States. Since the 60's, the rate of circumcision has been dropping, and insurance companies are increasingly refusing to cover the operation. Since care of the uncircumcised penis is simple, the only remaining reasons seem to be custom and conformity -- this last reason diminishing in value as fewer boys become circumcised. And ultimately, as Dr. James L. Snyder said in a presentation to the California Medical Association, a boy's penis is his own. "The part of the baby we have been throwing out with the bathwater is the birthright of the child and should not be destroyed by the collusion of physicians and parents."

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