Legal threat to infant male circumcision.

Despite a recent shift in pediatric policy in the United States toward support for newborn circumcision of boys,1 the procedure continues to be challenged on legal and ethical grounds. In 2010, a ballot initiative in San Francisco, California, to ban the circumcision of male infants gained publicity, as did a decision by a minor court in Cologne, Germany, in 2012 that found the illegality of circumcision is among the “undecided questions of law,” concluding the defendant was not guilty of a criminal act. New legislation was then passed in each jurisdiction protecting the practice. Nevertheless, while no court of law or government in the United States or elsewhere in the world has successfully enacted a ban on the circumcision of male minors, lobbying efforts by opponents continue unabated. Such campaigns contributed to the withdrawal of Medicaid coverage for elective male circumcision in 18 states. On January 14, 2013, the Federal Prohibition of Genital Mutilation Act of 2013 was submitted to the US Congress.2 This seeks an amendment to section 116 of Title 18, Part I, Chapter 7 of the Female Genital Mutilation Act of 1996 to make removal of the foreskin of boys younger than 18 years a criminal offense. The draft amendment invokes the highly questionable term male genital mutilation (MGM) to falsely equate male circumcision with the female procedure. A so-called MGM bill has been submitted to Congress every year since 2004.2 Even foreskin retraction is proscribed in this document. Legislator responses each year have been published.2 In the present article, we evaluate the legislation upholding the right of parents to avail themselves of circumcision for their sons and protection of physicians who perform male circumcisions with parental consent. We also assess the legal challenges and the human rights arguments to this minor surgical procedure. Parents can legally authorize surgical procedures in the best interests of their children.1 The 2012 American Academy of Pediatrics policy statement asserts that: ...minors in the United States are not considered competent to provide legally binding consent regarding their health care, and parents or guardians are empowered to make health care decisions on their behalf. In most situations, parents are granted wide latitude in terms of the decisions they make on behalf of their children, and the law has respected those decisions except where they are clearly contrary to the best interests of the child or place the child’s health, well-being, or life at significant risk of serious harm.1(ppe578-e579)