The American Journal of Bioethics 3.2 Web Only (2003)
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Respect for Bodily Integrity:
A Catholic Perspective on Circumcision in Catholic Hospitals
New York State Right to Life Committee, Inc.
Slosar and O'Brien (2003) seek guidance on the ethics of elective infant circumcisions at Catholic hospitals from Michael Benatar and David Benatar, two non-Catholics, instead of from the Catholic Catechism teaching on "Respect for bodily integrity" and the New Testament. They would do well to read the writings of two Jesuit priests, Fr. Paquin, S.J. (1957), and Fr. Healey, S.J. (1956), who independently found that because routine circumcisions are not medically defensible, they are morally objectionable.
Slosar and O'Brien claim that No. 2297 of the Catechism of the Catholic Church (1994) applies only "within the context of kidnapping, hostage-taking, and torture," even though the concluding sentence speaks of respect for bodily integrity within a medical context. They mistakenly equate the terms therapeutic and prophylactic (preventative). Finally, they rely on an outmoded position statement of the American Academy of Pediatrics Task Force on Circumcision (1989), one that has been replaced by a newer statement (American Academy of Pediatrics Task Force on Circumcision 1999).
No. 2297 of the Catechism, "Respect for bodily integrity," states in part: "Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law." The American Heritage Dictionary defines amputate as "To cut off (a part of the body), esp. by surgery," and it defines therapeutic as "Having healing or curative powers." In 1999 the American Academy of Pediatrics described circumcision as "amputation of the foreskin," and the American Medical Association called elective circumcision "non-therapeutic" (Council on Scientific Affairs 1999). Elective circumcisions are directly intended, nontherapeutic amputations of healthy foreskins. As such, they do violate the moral law.
There are no medical indications for circumcision in the newborn period (Committee on Fetus and Newborn 1971; 1977; Fetus and Newborn Committee 1975). In 1999 the American Academy of Pediatrics, after studying nearly 40 years of research, concluded "these data are not sufficient to recommend routine neonatal circumcision." No national medical group in the world today recommends infant circumcision. Although Slosar and O'Brien claim a health benefit, Medicaid programs in 11 states (five within the past year, including Missouri, home of Ascension Health) have dropped funding of nontherapeutic circumcisions. The Birthing and Care Program of the Catholic Archdiocese of Washington, D.C., likewise does not cover circumcisions.
Slosar and O'Brien defend circumcision by citing Directive 33 of the Ethical and Religious Directives for Catholic Health Care Services (ERD; Conference of Catholic Bishops 2001), which discusses only "therapeutic procedures," not "non-therapeutic procedures" such as elective infant circumcision. Directive 29 supports respect for bodily integrity, stating that "All persons served by Catholic health care have the right and duty to protect and preserve their bodily and functional integrity." The 1977 ERD, Directive 33, states that "unnecessary procedures, whether diagnostic or therapeutic, are morally objectionable. A procedure is unnecessary when no proportionate reason justifies it." The chair of Applied Health Care Ethics in Oregon, who is also a Catholic priest, wrote that he doubted any proportionate reason justified the circumcision of male infants, but he was sure he had heard many attempts. Slosar and O'Brien's commentary is one such attempt. Male neonatal circumcision has no proven medical utility and cannot support the use of "proportionate reason" to override the child's right to bodily integrity and the hospital's duty to protect that right.
The primary reason American parents choose circumcision is to make the baby "look like" the circumcised father (Brown 1987). This egocentric reason clearly does not take into account "the best interests of the child" or the numerous risks of the surgery. Catholic hospitals don't accept the parental-choice line for abortions. Neither should they promote this line for nontherapeutic circumcisions.
Hospitals and physicians profit from circumcisions (Mansfield 1995). The June 22, 1987 Boston Globe quoted Thomas Wiswell...