By REBECCA WALD
|Noni MacDonald, M.D.|
The article’s author, Noni MacDonald, M.D., is a professor of pediatrics at Dalehousie University in Nova Scotia, Canada. Her point is a fairly simple one, which is that any potential benefit circumcision has for preventing sexually transmitted disease only kicks in when males become sexually active. If the medical specialty associations in Canada and America are going to consider changing their position statements about the benefits of circumcision, shouldn't they also consider when best to circumcise?
Dr. MacDonald points out that circumcision causes pain and discomfort at any age and that delaying the decision until a boy is an adolescent has benefits. The boy would have the opportunity to participate in the decision. Moreover, it would be a good time to discuss other ways a young man can decrease his risk of contracting sexually transmitted disease, regardless of whether he decides to be circumcised.
For those of us who value the foreskin, the question of when to routinely amputate it seems absurd. It’s like asking: When should we cut off a person’s perfectly functioning finger, or when should we poke-out a sighted eye? For us, the answer is simple: never! However, Dr. MacDonald is functioning within the public health machine, where mechanical approaches based upon “evidence based” medicine are the standard. I applaud her for working within this system in an attempt to reduce infant circumcision and bring individual choice and informed consent to the process.
As for Rabbi Werde’s opinion that circumcision is much less traumatic for the youngest among I us, I seriously question this. Yes, adults cannot consciously remember being circumcised as neonates, but what does memory have to do with the experience of trauma? If memory were a requirement for emotional and/or physical trauma, those who have been abused or neglected as small children, but can't remember it, would suffer no adverse consequences. We know this isn’t true.
Any sensitive person who has had children of their own, or has spent time caring for infants, knows they are exquisitely sensitive beings. Something as trivial as gas pain brings bouts of pitiful crying. Infants probably feel things far more acutely than older children and adults because they have not had the opportunity to develop defensive mechanisms. An older child or an adult would go into the experience of circumcision with an understanding of why the procedure is to be done and knowing the alleged benefits. During and after the surgery, he would be able to discuss his pain level with his caregivers, so his pain can be adequately controlled. Conversely, a newborn knows nothing of what is being done to him, or why. During the event he cannot process in an intellectual way what is being done to him. He can only scream in anguish. He cannot understand that he will feel better soon. Nor can he discuss has happened to him with others, thereby gaining their sympathy and understanding, which is an important part in overcoming any trauma.
When to circumcise--if one is going to get circumcised--is indeed an important question that should be well considered by any medical society making recommendations on the subject. I am thankful that Dr. MacDonald has sparked thinking and conversation on this subject, both within the Jewish community and beyond.
© 2011 Rebecca Wald
© 2011 Rebecca Wald