Male Circumcision: A Social And Medical Misconception

Male Circumcision: A Social and Medical Misconception

University of Johns Hopkins

Introduction

Male circumcision is defined as a surgical procedure in which the prepuce of the penis is separated from the glands and excised. (Mosby, 1986) Dating as far back as 2800 BC, circumcision has been performed as a part of religious ceremony, as a puberty or premarital rite, as a disciplinary measure, as a reprieve against the toxic effects of vaginal blood, and as a mark of slavery.

(Milos & Macris, 1992) In the United States, advocacy of circumcision was perpetuated amid the Victorian belief that circumcision served as a remedy against the ills of masturbation and systemic disease. (Lund, 1990) The scientific community further reinforced these beliefs by reporting the incidence of hygiene-related urogenital disorders to be higher in uncircumcised men.

Circumcision is now a societal norm in the United States. Routine circumcision is the most widely practiced pediatric surgery and an estimated one to one-and-a-half million newborns, or 80 to 90 percent of the population, are circumcised. (Lund, 1990) Despite these statistics, circumcision still remains a topic of great debate. The medical community is examining the need for a surgical procedure that is historically based on religious and cultural doctrine and not of medical necessity. Possible complications of circumcision include hemorrhage, infection, surgical trauma, and pain. (Gelbaum, 1992) Unless absolute medical indications exist, why should male infants be exposed to these risks? In essence, our society has perpetuated an unnecessary surgical procedure that permanently alters a normal, healthy body part.

This paper examines the literature surrounding the debate over circumcision, delineates the flaws that exist in the research, and discusses the nurse's role in the circumcision debate.

Review of Literature

Many studies performed worldwide suggest a relationship between lack of circumcision and urinary tract infection (UTI). In 1982, Ginsberg and McCracken described a case series of infants five days to eight months of age hospitalized with UTI. (Thompson, 1990) Of the total infant population hospitalized with UTI, sixty-two were males and only three were circumcised. (Thompson, 1990) Based on this information, the researchers speculated that, "the uncircumcised male has an increased susceptibili...

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...a cultural and religious ritual and has been maintained over the decades despite the risks associated with this nonessential, surgical procedure. The current literature does not reveal a need for circumcision in the neonate. However, circumcision in the male neonate will continue to be a topic of wide debate until the risks can be shown, without a doubt, to outweigh the benefits. Circumcision has truly become a social norm in our country that the medical community attempts to justify with weak and inaccurate research.

According to the ANA, it is not the role of the nurse to decide for the parent on the need for circumcision in the infant. Rather, it is the nurse's role to present all of the information in an unbiased manner and remain an advocate of the rights of the patient. Nurse's need to realistically analyze the data available and decide if they truly are an advocate, or are merely following in the steps of their colleagues.

References

American Nurses Association (1991). Standards of clinical nursing practice. Washington, D.C.: American Nurses Association.

Gelbaum, I. (1992). Circumcision to educate not indoctrinate-a mandate for certified nurse-midwives. Journal of Nurse-