One of the AAP committee's chief Medical Ethics consultants suggested that something must be done about the AAP's "neutral stance" of 1999. The public has apparently acted irresponsibly based on its interpretation of the last statement, in part because of "the internet". This must be supplanted with doctors carrying the true message.
From the interview referenced above: "[The] decrease in the number of circumcisions [is] probably a result of a number of factors," Diekema says. "About 10 years ago, the American Academy of Pediatrics came out with a policy statement that was fairly neutral on whether circumcisions should be recommended for newborns or not. And that probably changed the way physicians were talking to their families."
In other words, it is imperative that this next statement not be neutral. The CDC and AAP must act now to reverse this disturbing trend because, according to Diekema, [circumcision confers] a fairly substantial, important reduction in the risk of contracting many sexually transmitted infections. In newborns, there is a decreased likelihood of getting a urinary tract infection and the risks of circumcision are considerably lower in the newborn population.
Doug Diekema doesn't want the AAP to be the bad guy here, but someone has to tell parents how important circumcision is. The AAP's hands are tied; if they "recommend" circumcision and something goes wrong, they have exposed their entire professional association to legal liability. Therefore, he says, "A doctor's role is to make sure the family is aware of the risks and benefits of the procedure." In plain English, sell it harder. Much harder.
Diekema is urgent. He implies throughout the interview that intactivists do not care about the health of the child and ultimately that is all that matters. Circumcision is low risk, high benefit, and it's utterly incomprehensible for parents not to choose it, even if that's their right.
Effectively countering these arguments means understanding where these sentiments come from. My best guess is that each and every person on the Task Force is personally affected by and invested in circumcision. For many years now they have talked about the terrible stigma of being among the few, unfortunate boys with foreskin in the neighborhood/locker room, and how unfair it is to relegate those innocent children whose parents may be on public assistance to an uncircumcised life of ridicule and increased health risks. But now the tide is turning and they fear the stigma of being the new minority... yes, karma can be difficult, it seems.
But what does this mean for a response? Is their attempt this time already "too little, too late"? I'll bet most people will yawn, at least until the associations and agencies take affirmative steps to reinstate funding for unnecessary circumcisions. And I feel awful for the parents here whose spouses next year can wave a document saying, "See? They now say it's beneficial!" Of course, we'll be the lone developed country saying so...
