The Ethics of Neonatal Male Circumcision: A Catholic Perspective

Michael Benatar and David Benatar (2003) identify and insightfully refute two arguments that opponents of neonatal male circumcision use in an attempt to demonstrate the moral illicitness of the practice. The first argument they consider is that circumcision is tantamount to an unjustifiable form of mutilation. The second argument is that, because circumcision is not a strictly therapeutic procedure, parents are not justified in giving consent for it on behalf of their child. As ethicists for a large Catholic health system, we have encountered a third argument opposing the practice, particularly in Catholic hospitals. In short, this argument is that the practice of circumcising male neonates is a violation of the natural law as conceived within the Catholic moral tradition and Church teaching.¹

The argument is based on the two considered and refuted by Benatar and Benatar, but as applied within the context of Catholic Church teaching and the Ethical and Religious Directives for Catholic Health Care Services (ERDs; U.S. Conference of Bishops 2001). In particular, some have argued that circumcision of neonatal males is tantamount to "amputation;" in support of this conclusion they cite the Catechism of the Catholic Church (1997), where it addresses "Respect for bodily integrity." Here, the Catechism states, in part, that "except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law." Accordingly, these opponents of the practice argue that circumcision violates the moral law because it entails "amputating" the foreskin. Directive 29 of the ERDs has also been cited in support of this position insofar as it states, in part, that "all persons served by Catholic healthcare have the right and duty to protect and preserve their bodily and functional integrity" (United States Conference of Catholic Bishops 2001). These considerations have led proponents of this view (e.g., Petrina Fadel) to conclude that "Catholic hospitals follow the moral law by not allowing abortions, sterilizations and genital mutilations of females, but they violate the moral law by allowing nontherapeutic routine circumcisions of infant males at their facilities."

It is our opinion that a more appropriate interpretation of the Catholic moral tradition, the teachings of the Catholic Church and the ERDs as they pertain to this issue is consistent with the "middle ground" taken by Benatar and Benatar and adopted by the American Academy of Pediatrics' Task Force on Male Circumcision (Schoen et al. 1989). We consider this interpretation to be more appropriate for two reasons. First, we concur with the main premises upon which the middle way is founded. In particular, while the medical data regarding possible therapeutic benefits of male circumcision are inconclusive, there is significant scientific evidence that there might be benefits of a preventive nature. These can be reasonably weighed against the risks and possible harms of the procedure. Moreover, the goals of medicine are not limited to healing through therapeutic interventions, but also include the promotion of health and the prevention of disease, along with the relief of pain and suffering, and caring for those who cannot be cured. From the holistic perspective emphasized within Catholic healthcare, these latter goals are just as legitimate and noble as the former. Therefore, a decision to have a male infant circumcised may fall within the scope of appropriate medical decisions to be made by parents on behalf of their children if the decision is made in the best interests of the child.

The second reason we find the middle path to be more appropriate is that the proscriptive moral argument rests on a flawed application of both Church teaching and the natural law approach to ethics within which this teaching and the ERDs are situated. We are unaware of the Catholic Church explicitly addressing the practice of circumcising male infants in any of its official teachings. No. 2297 of the Catechism...