Hot on the heels of a resolution of the Finnish Greens that non-therapeutic circumcision of children should be prohibited, a district court in Cologne, Germany, has ruled that non-therapeutic circumcision of children, even when performed for religious reasons at the request of a boy’s parents, is unlawful, and that those responsible are guilty of inflicting bodily harm. The case arose from a 4-year old boy circumcised by an Islamic doctor who later suffered severe bleeding requiring emergency medical care. The case has far-reaching implications for the future of medically unnecessary circumcision of minors and the human rights of children. The following article is translated from the German newspaper, Financial Times.
German court: Religiously motivated circumcision is unlawful
A judgment of the District Court of Cologne [refers to] a widespread medical intervention carried out for religious reasons. According to this judgement, (non-therapeutic) circumcision of boys will in future be regarded as personal injury. Those who circumcise boys for religious reasons make themselves liable to prosecution for assault causing bodily injury. This is the decision of the Cologne regional court, in a landmark ruling that has come to the attention of the Financial Times Germany. In its judgment, the Court made it clear that neither the rights of the parents nor the freedom of religion guaranteed in the basic law can justify this intervention. Thus, for the first time a German court places circumcision as a religious custom under the threat of penalty. Each year, several thousand boys in their first years of life are circumcised in Germany at the request of the parents. In the United States, even the majority of all boys are circumcised largely independently of religion directly after birth. Massive resistance to this practice has now developed. Worldwide around a quarter of all men are circumcised.
For decades doctors in Germany operated in a legal grey area when they circumcised boys for purely religious reasons, without medical necessity. Up till now, however, they could rely on the claim that they did not know that religiously-motivated circumcision was unlawful. Even if a court accepted that there had been personal injury, the doctor would be acquitted because of legal technicalities. The Cologne decision has now eliminated this possibility. Holm Putzke from the University of Passau said “The decision is extremely important especially for doctors because they have legal certainty now for the first time.” The legal expert has called for an explicit prohibition of non-therapeutic circumcision for years. “In the past courts – like politicians – have been afraid to act out of fear of being accused of anti-semitism and hostility to religion”, said Putzke. “This decision could influence not only future case law, but lead to a change of consciousness and greater respect for the fundamental rights of children.” Muslim and Jewish organizations have so far rejected suggestions that circumcision of children is unlawful. They regard a ban as “serious interference with the right to the free exercise of religion”. They did not respond immediately to requests for comment on the Cologne court’s decision, but wanted time to consider the judgment.
The judgment is likely to provoke discussions. For years struggle politicians and welfare associations have struggled to improve the integration of the Muslim population. In 2006 Wolfgang Schäuble, as Minister for the Interior, convened an Islamic Conference on his own initiative. The former German President Christian Wulff said: “Islam belongs to Germany.” His successor Joachim Gauck also commented: “Muslims who live here are part of Germany." Some Muslims are now likely to regard the Cologne decision as a step backwards. Experts assume that more cases like this will come before the courts. Eventually the question could be settled by specific regulations governing religiously motivated circumcision issued by the Federal Constitutional Court.
In the Cologne case, a Muslim physician circumcised a four-year old boy at the request of the parents. Two days later he suffered severe haemorrhage, and the mother brought the boy in for emergency medical care. The public prosecutor’s office was informed of this and pressed charges against the circumciser. After the medical legal tribunal ruled the procedure to be legal the prosecutor lodged an appeal. As a result of this, the Court assessed the circumcision as “serious and irreversible impairment of physical integrity”.
Source: Matthias Ruch, Court: religious circumcision is punishable, Financial Times (Germany), 25 June 2012
The following report of the decision was published in the Melbourne Age.
A GERMAN court has ruled that circumcising young boys represents grievous bodily harm, a decision that could have significant repercussions for religious groups. The president of the Central Council of Jews in Germany condemned the decision by the regional court in Cologne as '”an unprecedented and dramatic intrusion on the self-determination of religious communities” and called on the German parliament to pass legislation protecting circumcision as a religious practice.
The case centred on a four-year-old boy whose Muslim parents had him circumcised by a doctor, which led to medical complications.
Advertisement: Story continues below. The doctor was charged with grievous bodily harm but acquitted by a lower court, which judged he had acted within the law as the parents had given their consent. On appeal, the regional court also acquitted the doctor, but for different reasons. It upheld the original charge of grievous bodily harm, but ruled that the doctor was innocent as there was too much confusion on the legal situation.
Although Muslims and Jews circumcise infant boys as a religious practice and many other people do so for health reasons, the court found that the child's “fundamental right to bodily integrity” was more important than the parents’ rights. “The body of the child is irreparably and permanently changed by a circumcision,” it said. ''This change contravenes the interests of the child to decide later on his religious beliefs.” According to the court, the religious freedom “would not be unduly impaired”, because the child could later decide whether to have the circumcision.
Germany has no law against male circumcision, as there is against female genital cutting. Experts said the decision would not be enforceable in other jurisdictions. But the legal uncertainty and threat of prosecution could lead doctors to decline to perform the procedure. Holm Putzke, a criminal law expert at the University of Passau, said the ruling was not binding for other courts, but could send a welcome signal. “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate,” he told the German news agency DPA.
Source: Circumcision on boys assault, court rules, The Age (Melbourne) 28 June 2012
The following analysis of the Cologne court ruling by the German legal expert Dr Holm Putzke, professor of law at University of Passau, was published as an interview in German Turkish News, 26 June 2012. An edited English translation follows
Opinion: Doctors should refuse to perform religious circumcision
The District Court of Cologne has recently ruled that the circumcision of boys, even for religious reasons, shall henceforth be considered a crime. ... Criminal law professor Dr. Holm Putzke of the University of Passau evaluates the judgment in an interview for the German Turkish News. For him, the ruling is an appeal to parents to deliberate whether such interventions are really necessary.
German Turkish News: How do you interpret the ruling of the Cologne Court? Is this a landmark decision?
Holm Putzke: Although the Cologne District Court generally follows prevailing opinion in the legal and medical literature, this ruling does represent an important turning point. For the first time, a court has declared – no ifs and/or buts about it – that medically unnecessary circumcision on non-consenting boys is illegal, and in fact is punishable by law. Prior to this decision, the legal situation was unclear for lack of a clear judicial decision. ...
German Turkish News: Could you say it's a specific feature of Western democratic societies that the legal right to physical integrity is trumps the right to religious freedom?
Holm Putzke: There’s no blanket answer to that. Protecting religious freedom is important and necessary, just as it’s essential to protect the physical safety of persons, especially children. It would be a queer understanding of religious freedom if religions were simply allowed to physically injure people in the name of their faith and thereby circumvent the prevailing statutory laws of German society. ...
German Turkish News: What does this ruling now mean for doctors? Should doctors basically refuse to perform circumcisions for religious reasons?
Holm Putzke: Two Munich doctors, Maximilian Stehr and HansGeorg Dietz, collaborated with me on an article in 2008 that was published in the German Medical Journal regarding the criminalization of religious circumcisions on boys. Since then, more and more doctors have refused to participate in medically unnecessary circumcisions of non-consenting boys. This is primarily because the surgery carries risks, and confers absolutely no health benefits in childhood. After the Cologne ruling, doctors can now be threatened with criminal prosecution, and without going into too much detail, the inherent illegality – of the act of circumcising boys who don’t need it – will likely impact doctors’ liability insurance. If doctors are presented with a request to perform a religiously-motivated circumcision, they would do well to advise the parents of the legal situation in this country, as well as the risks of surgery itself, and refuse to perform the surgery. At the same time, doctors should clearly point out that circumcision should be postponed until the individual in question can decide about the procedure himself.
German Turkish News: What message does this ruling send to the religious communities?
Holm Putzke: The message is: Think about, really reflect, whether it is really necessary to put a small, often utterly frightened boy through surgery that has no medical necessity and that carries risks, or whether you can hold off on this or opt for some other ritual that symbolically fulfils the religious intent. ...
German Turkish News: Do you expect there to be an appeal?
Holm Putzke: This was already an appellate decision. Since the state bar apparently has decided not to consider any further appeals, the judgment is final. There is no way to challenge this ruling. This message is especially true for individuals or organizations that might viscerally attack this decision just to declare their outrage and disgust.
German Turkish News: Do you expect more lawsuits because of similar incidents?
Holm Putzke: I won't hazard an answer. Conceivably a storm of indignation from religious groups might initially discourage other prosecutors from bringing such cases. But in the long run the solid arguments will prevail. And those arguments pretty clearly now say that children should not have their genitals forcibly violated. Rather, they can make a decision at an appropriate age about whether they want it or not.
Prof. Dr. Holm Putzke, LL.M. teaches Criminal Law at the University of Passau. Since the 2008 publication of his essay "The Criminal Relevance of Circumcision of Boys," he has made many other contributions to the subject and has participated in the public debate on the criminalization of circumcision of minors that is not medically indicated.
Source: DeutschTurkischeNachrichten, 26 June 2012
Dr John Warren’s letter to The Times
Doctors throughout Europe, where there is no tradition of infant male circumcision in medical practice, have been faced in recent years by an increasing demand for this service, due to the immigration of families from other parts of the world where male circumcision has been a cultural norm. There is confusion over how to respond to this demand, both among the medical and also the legal professions. The ruling in Germany, reported in The Times on 28 June, illustrates this problem. In this case a state court ruled that circumcision on non-medical grounds of a child amounted to grievous bodily harm. In The Netherlands, the Royal Dutch Medical Association has issued a report stating that non-therapeutic circumcision of underage boys amounts to a violation of a child’s physical integrity, and so contravenes Article 8 of the European Convention of Human Rights and Article 11 of the Dutch constitution. In Norway, the Centre Party has proposed an outright ban on non-therapeutic male circumcision of under-age boys, provoking a heated debate.
Here in the UK , there has so far been little debate, despite the fact that large numbers of boys are being circumcised for non-therapeutic reasons, some within the NHS, some in private clinics, and some by non-medically qualified operators. It is impossible to determine accurately how many. However, the medical literature shows a complication rate of anywhere between 2 and 20%. These do not include late problems discovered by adult men who were circumcised as infants, and our records at NORM-UK include many examples of both physical and psychological problems that appear to result from this operation. Earlier this month (June) the Westminster coroner gave a verdict of accidental death in the case of a one month old baby boy who died of haemorrhage from his wound two days after circumcision.
The General Medical Council does not have a position on the issue of non-therapeutic male circumcision of children. It states: We do not have general authority to determine public policy on issues that arise within medical practice – these are matters for society as a whole to determine, through the parliamentary process. There are four principles of medical ethics: autonomy, beneficence, non-maleficence and justice. Clearly a child’s autonomy is breached by a non-therapeutic procedure permanently altering his anatomy. Regarding beneficence, no medical organisation in the world recommends routine infant circumcision for health reasons. Non-maleficence refers to not doing harm; the possibility of complications mentioned above shows that there is considerable potential for harm from this procedure. Justice asks the question ‘is it fair?’ Would you do the same to a girl? Would you do the same to an adult male without his consent, that is tie him down and forcibly remove his foreskin, possibly without anaesthesia?
In my view the UK needs a debate involving doctors, lawyers, ethicists, politicians, representatives of religions and the wider public on the subject of non-therapeutic circumcision of underage boys. And the General Medical Council should consider coming off the fence and consider carefully whether its lack of position on this topic is consistent with its role: to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.
Dr John Warren
Chairman NORM-UK
This letter was sent to The Times (London), but not published.
“Protection from violence is more important than religious rites”
Because of an article four years ago, he finds himself now seriously threatened: Professor Holm Putzke of the University of Passau speaks out against the circumcision of boys. The recent judgment of the District Court in Cologne rests on his findings. “It’s really a question of postponing a religious act,” he explains in an interview with Bavarian Radio.
BR.de: How do you view the judgment of the District Court in Cologne?
Holm Putzke: The judgment of the District Court in Cologne is correct. The court came to its conclusion, after an intensive analysis of the jurisprudential debate, that religious freedom ends where physical safety of children is irreparably impacted, in this case due to unnecessary and risky surgical procedures. It should be self-evident that we simply don't allow this in a society that emphasizes the protection of children from forceful or violent acts.
The verdict
The District Court in Cologne determined that the circumcision of a minor boy for religious reasons in June 2012 was an injury. The judges argued that religious circumcision is a permanent and irreversible intrusion on the child. Jewish and Muslim groups criticized the decision as impermissible encroachment on the freedom of religion.
BR.de: What significance does it have?
Holm Putzke: It’s a brave decision, because the wave of indignation was predictable and the climate of discussion almost always suffers when it comes to any criticism of religion. Despite the this ruling being non-binding on other courts or prosecutors, the ruling could send a signal and - more importantly - finally lead to a long-overdue public discussion.
BR.de: Isn’t this a very western, and therefore one-sided, view of things?
Holm Putzke: It's not actually a one-sided view of things, because the court doesn’t simply make an assertion. Rather, it reaches a judgment after a careful weighing of the constitutionally protected rights to self-determination and bodily integrity against the parents’ right to free exercise of religion. You also can't really say this is a “typically western” view, since in other parts of the world enlightened people are thinking the same way.
BR.de: What does the ruling now mean for doctors? Should they decline to do circumcisions for religious reasons?
Holm Putzke: The risk of doctors being held criminally liable in case of complications, or losing their insurance coverage, is now elevated. However, as a doctor I wouldn't simply decline to do these circumcisions because they’re religiously-motivated, but rather because performing medically unnecessary surgery on children who can not defend themselves is ethically incompatible with the medical profession.
BR.de: What message do the court judgment and your legal commentaries send to the religious communities?
Holm Putzke: The point of my early 2008 article, dealing with legal culpability in the religious circumcision of boys, was not to criminalize doctors and parents, or really even religious groups. Rather, I was hoping that a broad public debate might get underway about how much religiously motivated violence against children is tolerable. Neither the judgment nor the overall viewpoint it favors prevents anyone from exercising their religion. It’s not about discrimination against religious groups or the total prevention of religious practice; it's really just about postponing a religious act.
BR.de: Is this whole thing a typical German debate? How do you think this topic will be handled in Europe and globally?
Holm Putzke: In other countries, especially in the United States, there has been a strong movement for decades that criticizes medically unnecessary circumcision on non-consenting children as unethical. Even Israel has seen intense debate over whether religious circumcision of children is ethically justifiable. I have received numerous letters from Israel, where parents have told me that despite their ongoing religious affiliation to Judaism they've abstained from infant circumcision, and prefer to wait until their child is able to make his own independent decision about it. So it seems that if it’s supposed to always be the case, as the Central Council of Jews here in Germany claims, that infant religious circumcision remains essential and indisputable in Judaism... then they're really only telling half the story.
BR.de: There’s a good chance you’re going to be reviled and threatened over this ruling. How do you plan to handle it? [Threats to Professor Putzke have included drowning and forcible circumcision.]
Holm Putzke: It would be naive to think that my critiques, and the skeptical views of what is by now the majority in the medical and law professions, will only be discussed in a rational, calm and composed manner. Any criticism of religion has always triggered emotional reactions. Insults and threats don’t bother me really, if for no other reason than some people are simply hiding behind them when they can't express their displeasure any differently. Good arguments, however, are much more likely to impress me.
Source: Bayrische Rundfunk, 29 June 2012
Publications
Zirkumzision bei nicht einwilligungsfähigen Jungen: strafrechtliche Konsequenzen auch bei religiöser Begründung; in: Deutsches Ärzteblatt 2008, A 1778–1780 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) Full text here (in German)
Strafbarkeit der Zirkumzision von Jungen. Medizinrechtliche Aspekte eines umstrittenen ärztlichen Eingriffs (Liability to penalty for circumcision in boys. Medico-legal aspects of a controversial medical intervention); in: Monatsschrift Kinderheilkunde 8/2008, S. 783–788 (gemeinsam mit Maximilian Stehr und Hans-Georg Dietz) Full text (PDF) here (in German)
ABSTRACT in ENGLISH
Often (pediatric) surgeons or (pediatric) urologists have to face the request for circumcision of a minor male by persons having the care and custody in absence of a medical indication. This review points out the imperative of refraining from such a procedure to avoid being a possible addressee of a claim according to civil law or even being accused in a lawsuit later. The attending physician who performs the circumcision without medical indication on a minor male, incurs a penalty according to § 223 para. 1 German Criminal Code, even though the person having the custody of the child signed the informed consent to that procedure. Lacking the cognizance of disposition about the legally protected interest of the child (physical inviolability), the consent is namely not effective. In this article not only the german current legal status is demonstrated, but arguments for the legitimacy of a male circumcision (treatment of phimosis, prevention of different diseases, religious aspects) are discussed.
The following interview with Munich paediatric surgeon Maximilian Stehr appeared in Deutsche Welle, 17 July 2012
Children have to be old enough to give their consent to a religious circumcision, says leading pediatrician Maximilian Stehr. But the law does not need to be changed. Maximilian Stehr is a pediatric surgeon at the University Hospital in Munich and chair of the working group on pediatric urology at the Germany Association for Pediatric Surgery.
DW: What has been the effect as far as pediatricians are concerned of the ruling by the court in Cologne regarding the religious circumcision of boys who are not yet able to give informed consent?
Maximilian Stehr: To start with, one should note that this ruling has not changed the law, it has merely interpreted existing law and applied it. There has of course been an effect on colleagues working in the field of pediatric surgery and urology in that the ruling has led to a public discussion, and, should similar charges be brought against a doctor in future, it will not be possible to argue [as in this case] that the doctor could not be expected to know that his actions were illegal. I know of many doctors who are currently not carrying out any circumcisions of boys who are not able to give informed consent.
What is your advice to doctors who ask whether they should carry out this operation?
I've always given the same advice, even before this ruling. I've always held the view that this medical intervention cannot be regarded as conforming to current law or current medical ethics. And so I continue to advise doctors not to carry out this operation; instead, if religiously-motivated circumcision is to be carried out, it should only be carried out at an age when the child or the young person is able to permit it himself or at least consent to it.
Would you see the issue of the inability of the child to give its consent as a bigger issue than that of the child's physical integrity?
I don't think you can separate the two. Physical integrity is certainly the highest value. That goes without question. There are certainly medical conditions and situations in which people want to decide for themselves that they would like to change something about their body. That is standard procedure in cosmetic surgery - it's the same in pediatric surgery, for example, when we correct protruding ears. For that, the child has to be able to judge for itself the seriousness of the operation, as well as its risks and side-effects, and that is only possible when the child is 14 or 16 years old.
How far is this an issue of medical ethics?
Medical ethics is very closely related to the Hippocratic Oath. All our actions as doctors must work towards healing and towards the benefit of the patient to the best of our knowledge and conscience. A further principle is never to cause any harm. Both these principles are imperiled when one carries out the circumcision of a boy who is unable to give consent.
That means it's an unnecessary operation?
It is an unnecessary operation. All the benefits which are said to come from circumcision, some of which are certainly valid - for example, concerning sexual infections or penile cancer or the development of tumors - are all reasons which argue for circumcision as a possible preventative measure - but not at this age.
The German government wants to find a speedy solution to the problem, and it has hinted that it plans to introduce a law which will continue to permit religious circumcision. Would you consider that any solution must include restrictions as to age?
I don't see any reason to pass a new law - one just has to apply existing law and existing medical ethics. There's no need for anything else. Then you come to the situation we have at the moment, that, if one wants to carry out such an operation which has no medical justification, it requires the consent of the patient. I would find extremely dangerous if there were to be a special law to permit such an operation to be carried out on, for example, Jewish children. That would go entirely against the principle of equal treatment. One could then certainly argue that this in itself would be discrimination.
Currently, though, it's the case that the parents can decide, since they have legal custody.
The legal custody of the parents only allows decisions which are clearly for the benefit of the child. That's why I consider this medical intervention to be illegal. It can only be dealt with if the religious communities can agree that the operation can be delayed until the child is old enough to decide for itself or to give its consent. There has to be a compromise, but I don't see any compromise possible which involves special laws for specific religious communities or other groups. That would go against the principle of equal treatment and would backfire in the end.
Source: Wait until later, say paediatricians, by Dagmar Breitenbach and Joanna Impey, Deutsche Welle, 17 July 2012
Brian Earp, Religion is no excuse for mutilating your baby’s penis, Practical Ethics Blog, 28 June 2012
Andrew Sullivan, Cologne decision a victory for religious freedom, Daily Beast, 27 June 2012
Kerre Woodham, Spare the children, New Zealand Herald, 1 July 2012
Humanistic Judaism increasingly critical of child circumcision, IntactNews, 30 June 2012
Jewish Journalist Larry Derfner, Stand up for your son: Say ‘no’ to ritual circumcision, 972Mag, 29 June 2012
Robert Darby, Non-therapeutic circumcision of minors: A legal and ethical minefield, On-Line Opinion, 9 July 2012
Open slather, illegal or regulated: The new debate on male circumcision, Open Forum, 16 July 2012
Dr Maximilian Stehr, Circumcision without medical necessity is wrong, Spiegel International, 26 July 2012
Turkish-German politician supports circumcision restriction (“Boys should decide at age 14”), TagesZeitung magazine, Berlin, 26 July 2012
Kenneth Houston, Male genital mutilation a gross breach of baby's bodily integrity, Irish Times, 31 July 2012.
Against male circumcision on religious or cultural grounds, Udo Schuklenk's Ethx Blog, 31 July 2012
Anthony Levin, We must bring religion in on the push to ban circumcision, The Punch, 8 August 2012
Pro-Kinderrechte - In favour of the rights of children (in German; FAQ in English)
Toby Lichtig, Circumcision: Time to cut it out? New Humanist, Sept/Oct 2012
Brian D. Earp and Robert Darby, Tradition vs individual rights: The current debate on circumcision, The Conversation, 2 November 2012
The Cologne decision has generated immense debate, especially in Europe, and new developments and commentary appear too fast to record. To keep up to date, check out the news pages of Circumstitions.com and Circumcision News Blogspot
In the wake of the Cologne court’s decision that non-therapeutic circumcision of minors constituted bodily harm and a violation of the child’s physical integrity and religious freedom and was thus unlawful, the German parliament passed a law clarifying the legality of circumcision. In an article published in the international journal Bioethics, Diana Aurenque and Urban Wiesing argue that the law was a response to political lobbying and ignored accepted principles of human rights and bioethics. Assessing the balance of benefits and harms from circumcision, the authors conclude that circumcision provides no benefits to the child as a child, but only risks and harms.
ABSTRACT: The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the ‘child as a child’ and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany’s unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues – as in the case of religious circumcision.
Diana Aurenque and Urban Wiesing, German law on circumcision and its debate: How an ethical And legal issue turned political. Bioethics, early view, 23 December 2013.
See also the article by Reinhard Merkel and Holm Putzke in the July 2013 edition of the Journal of Medical Ethics.
Meanwhile in Finland there is a growing gulf between legal regulators, who want to tolerate minority cultural practices, and doctors and bioethical experts who consider circumcision of boys to be genital mutilation, no different in ethical and moral terms from female genital mutilation. Recently the Finland Greens passed a resolution that all non-therapeutic circumcision of minors should be stopped.
The following commentary is from a Helsinki newspaper.
The issue of circumcisions performed on boys for religious and cultural reasons has reached a stage in Finland in which it is difficult to find a solution that is acceptable to all. The Green League voted in favour of a resolution at its party congress a week ago that such procedures should be phased out in Finland either through advice or, if necessary, through legislation. Finns Party MP Vesa-Matti Sarakkala submitted a legislative initiative in Parliament calling for an outright ban on circumcisions. Earlier in the spring the issue was also taken up by Minister of Justice Anna-Maja Henriksson (Swed. People’s Party). In her view, the procedures should be permitted, but legislation, or at least guidelines from the ministerial level are needed on who may perform the circumcisions and under what circumstances.
There are problems involved in both permitting and prohibiting the operations, but there are also problems involved in the Finnish status quo, which has no specific legislation to back it up. It is estimated that hundreds of non-medical circumcisions are performed on boys each year, but the circumstances under which they might be permitted, and when they would be classified as criminal assault are unclear. A basic guideline has been the decision handed down by the Supreme Court in 2008, in which the religiously motivated circumcision performed on a Muslim boy was not considered a crime, as it was performed in a medically sound manner. The decision has been interpreted in such a way that non-medical circumcisions have been seen as permissible as long as they are performed by a doctor.
However, last year Helsinki District Court took a tougher line. The court ruled, among other things, that the person undergoing the procedure should understand what is happening. This means that circumcision of small children would not be allowed. The court based its decision on the Convention on Human Rights and Biomedicine of the Council of Europe, which was adopted by Finland only after the Supreme Court’s decision. The case is still in the Court of Appeals, and it is too early to say if the Supreme Court will rule on it someday. As long as no legislation is passed, or case law established, cases will end up in court. The situation causes uncertainty among parents who do not know if they could face charges.
If the surgeries are banned, there is a danger that they will be performed abroad, or that quacks might be enlisted for the purpose, and that if complications occur, the parents might be afraid to take their children in for treatment. In addition, both the Jewish and Muslim communities oppose any ban. However, if the procedures are permitted, Finland will be giving its approval to medically unnecessary surgery that interferes with the integrity of the body. The Finnish Medical Association takes the stand that child circumcisions are in conflict with medical ethics. The Ministry of Social Affairs and Health favours a compromise. It does not take a stand in either direction on the issue of legislation, but it is preparing a set of guidelines for health care professionals. Ministry official Marie Kolimaa is not disclosing the content or schedule of the guidelines. “There are many things that remain open”, she says. This is certainly easy to believe. A number of thorny questions need to be considered:
There is also the question of basic principles, which the Greens also referred to. Should Finland seek to act in such a way that non-medical circumcisions of boys would become less common, or be eliminated completely? If so, what would be the means to that end?
Source: Irina Vähäsarja, Finland lacks policy on religiously-mandated male circumcision, Helsingin Sanomat International edition, 28 May 2012
Defence of their right to commit an act of violence against their children seems to be the only issue that distracts Jewish and Muslim adults from their need to commit violence against each other. Yet there is a major difference between Jewish and Muslim circumcision practices: for a devout Jewish parent who follows all the rules laid down in the Torah, there is a passage in Genesis that appears to require them to circumcise their male children on the eighth day (and also their servants and employees, though this is not insisted upon these days). Circumcision is (or should be) performed by a Mohel as a religious ceremony, analogous to baptism, with a service, liturgy, ritual and celebration following a set pattern. There are no such requirements in the Muslim scriptures: the Koran makes no mention of circumcision, and the only words from the prophet Mohammed recorded on the subject state that is desirable or meritorious for both men and women as a sign of piety and commitment to the faith. Unlike in Judaism, there is no liturgy or religious ceremony associated with the operation, which (these days) is normally carried out by a doctor in a sterile clinical setting, and no ritual elements at all. In other words, there is no obligation placed on parents to circumcise their children; circumcision is merely an act of faith that a devout Muslim might be expected to elect for himself. It follows that there is no valid reason why children of Muslim parents should not be protected from circumcision until they are old enough to decide the matter for themselves. Those who talk about the right to religious freedom forget that the treaties and declarations that guarantee such freedom extend it to everybody, irrespective of age: children have their own entitlement to religious freedom.
As to the question of assault, there can be little doubt that forcible circumcision of an adult would be a criminal assault occasioning actual bodily harm; if that is the case, at what age does the same action become a legal and acceptable practice? Would it be legal to forcibly circumcise a 15-year old boy? What about a 10-year old? A 5-year old? From a logical point of view, if to circumcise an adult without his informed consent is a criminal assault, it must be equally wrong to perform the same action on a minor. To argue otherwise would be to imply that while it is wrong to commit sexual assault or rape on an adult, it would be perfectly OK to rape a child. Society has decided the contrary: that assaults on defenceless children are far more wicked than the same assaults on adults. Why should cutting of a boy’s genitals be regarded any differently? The words of Holm Putzke, a criminal law expert at the University of Passau, get to the heart of the matter: “After the knee-jerk outrage has faded away, hopefully a discussion will begin about how much religiously motivated violence against children a society is ready to tolerate.”
Further information on the ethics page
The British Medical Association will be urged to debate the banning of Unnecessary Male Circumcision at its annual meeting next week after a baby bled to death in Queens Park, London. The tragic case of 28 day old Angelo Ofori-Mintah is the latest in string of deaths and injuries that have prompted some doctors to call for laws that protect girls from unnecessary genital cutting to be extended to protect boys. The news of Angelo’s death came in the same week that The British Association for Community Child Health reported in it’s quarterly newsletter that a baby boy’s skull was fractured during a ritual circumcision performed on a kitchen table in Bristol.
Now Dr Antony Lempert GP, Director of the Secular Medical Forum, will be calling on the BMA to debate the banning of non-therapeutic circumcision in the UK at the start of its annual meeting. Other cases that have helped push the issue up the agenda include the case of a Salford midwife who will be tried for manslaughter later this year after a boy she circumcised bled to death, and a report in The Journal of Public Health that found that nearly 1 in 2 Muslim boys circumcised in an Islamic school in Oxford ended up with medical complications.
There is currently a growing demand across Northern Europe to outlaw medically unnecessary circumcision of boys, with the junior party in Norway’s coalition government calling for a ban earlier this month, and medical associations in Finland, Sweden and The Netherlands also opposing the practice. Britain’s leading anti-circumcision charity, NORM UK, is heading for Rotterdam next week for an international conference on the Doctor and the Foreskin (subtitled Circumcision: Forbid, deter or encourage?) The Campaign to End Unnecessary Male Circumcision estimates that more than half a million boys living in the UK will be subjected to medically unnecessary circumcision before their 16th birthday.
And the anti-circumcision movement is growing in the UK with campaigners from the group Men Do Complain planning to protest outside the British Medical Association’s Annual Representatives Meeting in Bournemouth next week. The campaign founder, Richard Duncker, says they will be protesting because “cutting the genitals of healthy boys who cannot consent is profoundly unethical”. Another group, Genital Autonomy, is planning a mini-conference in at Keele University in July to bring together leading experts and practitioners to debate “How Can We Prevent unnecessary Male Circumcision”.
Source: Medics urged to ban circumcision as baby boy bleeds to death, Health Matters (UK), June 2012