A question for doctors who perform circumcisions.

[alphaboi867]

Doper doctors who perform circumcision; would you perfom an elective circumcision (ie there's no medical need for it) on a child old enough to remember it and possibly object? For instance if parents come into your office and want their 5/10/15 year old son circumcised and the son doesn't want it. Would the parents' reasons matter (religious conversion, asthetic reasons, etc)? How would you go about dealing a child who actively resisted?

[Qadgop the Mercotan]

I only ever did circs on newborns (with local anesthetic) and on consenting adults who had a valid medical reason such as phimosis or chronic infections. I would not do it for non-medical reasons on anyone otherwise, and actually gave up newborn circs back in 1989 anyway, as at the time I couldn't really justify it medically anymore (tho now it does seem useful for reducing the risk of HIV).

BTW, an elective circumcision can still be medically desirable, just not urgent or emergent.

[OliverTwistofLime]

I would NOT perform a circumcision on a child old enough to refuse a circumcision.

Not from fear of a malpractice suit which an individual can do up to or thru his 18th birthday butout of respect for the child's opinion if he is cognatively able to understand what is going on.

Unrelated to the OP, recent articles indicate that circumcisions are benifical for various reasons.......( I can not cite the articles but I did read them recently}.

[clayton_e]

Legally could parents force a kid to have it done if they could find a doctor who would do it? I mean, I know they could say no piercings or whatever, but could they say.. well.. you're gonna get the slice and dice?

[catsix]

I wonder why it is that it wouldn't be done without sound medical reason on a five year old, but it's perfectly acceptable on a five hour old?

Just because they can't object is no reason to assume they wouldn't object.

[Qadgop the Mercotan]

Originally Posted by catsix

I wonder why it is that it wouldn't be done without sound medical reason on a five year old, but it's perfectly acceptable on a five hour old?

Because it is a very simple procedure to do on a newborn, and a much more complex one to do as they get older.

Add to that the medical thought of the time that the medical benefits of neonatal circumcision outweighted its risks, & the parents' desire to have it done for cultural reasons, and there wasn't much reason to not do it.

I gave it up as more data came out indicating it was not of medical benefit. But parents didn't (and still don't) have much trouble finding someone to do the procedure.

And now since the data suggests that circumcision reduces the risk of acquiring AND transmitting HIV, it'll be interesting to see what the medical community will recommend in the future, and what parents will decide to have done.

[brownie55]

Doc Mercotan,

A few questions please? You said you would only perform a circumcision:

on consenting adults who had a valid medical reason such as phimosis or chronic infections

Does that mean you would not have done mine when I converted to Judaism? What would your rationale be for refusing? Please consider this an out of pocket, not insurance related expense.

I am not trying to put you on the spot, just trying to understand.

Thanks.

[Qadgop the Mercotan]

Originally Posted by brownie55

Doc Mercotan,

A few questions please? You said you would only perform a circumcision:



Does that mean you would not have done mine when I converted to Judaism? What would your rationale be for refusing? Please consider this an out of pocket, not insurance related expense.

I am not trying to put you on the spot, just trying to understand.

Thanks.

I generally don't do cosmetic procedures.

I also haven't done enough adult circumcisions to feel comfortable with doing one anymore.

I've no objections to any adequately trained doc doing it as a non-necessary procedure for a competent adult, IF the doc wants to do it.

I've also no objections to any adequately trained doc refusing to do it if they didn't want to.

No rationale needed. Docs are there to meet medical needs. It's up to them whether they want to meet medical wants or not.

[brownie55]

Originally Posted by Qadgop the Mercotan

I generally don't do cosmetic procedures.

I also haven't done enough adult circumcisions to feel comfortable with doing one anymore.

I've no objections to any adequately trained doc doing it as a non-necessary procedure for a competent adult, IF the doc wants to do it.

I've also no objections to any adequately trained doc refusing to do it if they didn't want to.

No rationale needed. Docs are there to meet medical needs. It's up to them whether they want to meet medical wants or not.

Understood and respected. Thanks. FWIW I would not want a doc that did not feel comfortable doing it either.

[alphaboi867]

[quote=brownie55]...Does that mean you would not have done mine when I converted to Judaism? What would your rationale be for refusing? Please consider this an out of pocket, not insurance related expense...QUOTE]

Wouldn't a mohel (not a doctor) need to do it for it to count as a bris?

[brownie55]

[quote=alphaboi867]

Originally Posted by brownie55

...Does that mean you would not have done mine when I converted to Judaism? What would your rationale be for refusing? Please consider this an out of pocket, not insurance related expense...QUOTE]

Wouldn't a mohel (not a doctor) need to do it for it to count as a bris?

It depends... like so much of Judaism.

[t-bonham@scc.net]

Originally Posted by Qadgop the Mercotan

And now since the data suggests that circumcision reduces the risk of acquiring AND transmitting HIV, it'll be interesting to see what the medical community will recommend in the future, and what parents will decide to have done.

I imagine the medical community will wait and see. Since there seem to be some problems with that data.

Mainly the fact that only one study has shown this result so far. And it contradicts most of the previous studies, which generally showed no impact either way. And the fact that nobody else has been able to replicate that one so far. Plus the fact that there are questions about other other variables besides circumcision (family income, level of cleanliness, etc.) that don't seem to have been controlled within the study group.

No doubt we'll hear eventually whether any other studies, with better data controls, are able to reach the same results.

[clayton_e]

Originally Posted by Qadgop the Mercotan

I also haven't done enough adult circumcisions to feel comfortable with doing one anymore.

You have done them, though? What was the patient's reason, if they told you?

[Ceejaytee]

Not a doc, but I have a story on point: My son had a circumcision for religious reasons, which was mostly well-done, but left an extra piece of skin which he rather likes tugging on (the pediatrician called it "redundant"). We left it alone for a while, but recently we had reason to bring his older brother to a urologist so we brought the little one along to see what the doc said. He thought we should give him another circumcision now, while he's young (he's 2 1/2) because his opinion was that the extra skin would continue to grow as he (and his penis) does. 2 pediatricians disagreed, but noted that it was possible. So we decided to leave it up to him, even though circumcisions are more difficult the longer you wait. If it continues to grow and one day he decides he hates it and wants it gone, we'll get him another circumcision to remove it. But the requirements of religion have been satisfied and this is purely cosmetic and a body image issue, so we can wait until he can decide for himself. We would never make him get it done if he objected.

[OliverTwistofLime]

I am a retired obstetrician/gynecologist......I have done hundreds and hundreds of circumcisions on newborns over 40 years....and a few on toddlers.

In my opinion, the parent can request or refuse to have the newborn circumcision performed and this is all legal. I am not an atty but I don't believe a Dr. would do a circumcision on a boy up to 18 years of age without parental written autorization.

If an extra piece of forskin is left, generally it can be removed easily.

[Weirddave]

Originally Posted by Qadgop the Mercotan

I gave it up as more data came out indicating it was not of medical benefit. But parents didn't (and still don't) have much trouble finding someone to do the procedure.

Hey Doc, I thought circumcision pretty much eliminated the chances for a male to get penile cancer, and we've know this for a while now. Am I wrong on that? Granted, the chances of getting penile cancer are vanishingly small in the first place, but still, I wouldn't call that "no medical benefit". Since complications from circumcision are even rarer, doesn't that sway the balance towards the procedure (barely) rather than against it?

[Qadgop the Mercotan]

Originally Posted by Weirddave

Hey Doc, I thought circumcision pretty much eliminated the chances for a male to get penile cancer, and we've know this for a while now. Am I wrong on that? Granted, the chances of getting penile cancer are vanishingly small in the first place, but still, I wouldn't call that "no medical benefit". Since complications from circumcision are even rarer, doesn't that sway the balance towards the procedure (barely) rather than against it?

Frankly I suspect penile cancer is rarer than circumcision complications.

[alphaboi867]

Originally Posted by OliverTwistofLime

...In my opinion, the parent can request or refuse to have the newborn circumcision performed and this is all legal. I am not an atty but I don't believe a Dr. would do a circumcision on a boy up to 18 years of age without parental written autorization.

But would you have circumcised a 17 year old boy who's parents did give writen authorization against his will? If not then how old would the boy have to be before you wouldn't do it against his will?

Originally Posted by OliverTwistofLime

...If an extra piece of forskin is left, generally it can be removed easily.

True, but it's alot easier to not remove the foreskin in the first place. And while a circumcision is more complicated and riskier to perform on an adult if an intact male decides he want's one it's still a simpler procedure than trying to restore a circumcised male who wants to be intact.

[groman]

Originally Posted by alphaboi867

But would you have circumcised a 17 year old boy who's parents did give writen authorization against his will? If not then how old would the boy have to be before you wouldn't do it against his will?

I am having trouble imagining any doctor trying to perform a circumcision on an unwilling 17 year old boy. I think you'd need a very brave anesthesiologist with a tranq gun and some means of obscuring faces and names of all of the staff. Something I learned very quickly as a child is that while your parents can force you to do a lot of things, and doctors will often disregard your wishes, doctors are also not nannies or correctional officers and will not go above and beyond of what would reasonably be expected of them to perform any elective or even non-elective routine procedure.

I mean, I think your hypothetical is flawed. It came up a few times in my family, I said no, and that's where it would end. If you feel strongly about not having a piece of your manhood cut off, there's very few things that somebody can threaten you with that would make you comply against your wishes. And if you want to threaten me with penile cancer or HIV, I am going to need a causative link, not a correlation, because without a causation your claim that foreskins cause penis cancer holds about as much water as my claim that dirty wang causes penis cancer and people with foreskins are more likely to have dirty wang because of socioeconomic issues.

[alphaboi867]

Originally Posted by groman

...It came up a few times in my family, I said no, and that's where it would end. If you feel strongly about not having a piece of your manhood cut off, there's very few things that somebody can threaten you with that would make you comply against your wishes...

You're lucky nobody in my family even bothered to ask me if I wanted a piece of my manhood cut off . Hell they didn't even wait until I was even capable of giving them a response.

Originally Posted by groman

...I think you'd need a very brave anesthesiologist with a tranq gun and some means of obscuring faces and names of all of the staff.

I assume you mean in case the patient decided to stalk, kill, or commit other crimes of violence against them, not in case the patient decided to sue them. Though f legally all that matters is the parents' consent then wouldn't the patient lack grounds to sue the medical staff .

[groman]

Originally Posted by alphaboi867

I assume you mean in case the patient decided to stalk, kill, or commit other crimes of violence against them, not in case the patient decided to sue them. Though f legally all that matters is the parents' consent then wouldn't the patient lack grounds to sue the medical staff .

I was implying exactly that. I would imagine somebody in the business of routinely performing circumcisions on people capable of protesting and remembering everything would have an incredibly short life expectancy. I can't comment on the legal matters.

[Weirddave]

Originally Posted by groman

I am having trouble imagining any doctor trying to perform a circumcision on an unwilling 17 year old boy. I think you'd need a very brave anesthesiologist with a tranq gun and some means of obscuring faces and names of all of the staff. Something I learned very quickly as a child is that while your parents can force you to do a lot of things, and doctors will often disregard your wishes, doctors are also not nannies or correctional officers and will not go above and beyond of what would reasonably be expected of them to perform any elective or even non-elective routine procedure.

I mean, I think your hypothetical is flawed. It came up a few times in my family, I said no, and that's where it would end. If you feel strongly about not having a piece of your manhood cut off, there's very few things that somebody can threaten you with that would make you comply against your wishes. And if you want to threaten me with penile cancer or HIV, I am going to need a causative link, not a correlation, because without a causation your claim that foreskins cause penis cancer holds about as much water as my claim that dirty wang causes penis cancer and people with foreskins are more likely to have dirty wang because of socioeconomic issues.

The fact of the matter is that circumcised men don't get penile cancer. Now it's an extraordinarily rare cancer, but being circ'd prevents it. That's a lot different from saying "foreskins cause penis cancer".

[groman]

Originally Posted by Weirddave

The fact of the matter is that circumcised men don't get penile cancer. Now it's an extraordinarily rare cancer, but being circ'd prevents it. That's a lot different from saying "foreskins cause penis cancer".

Foreskins cause penile cancer is about as strong (and unfounded) statement as circumcision prevents penile cancer. There might be a strong correlation between not getting penile cancer and being circumcised, but that doesn't mean there is a causal link. For example, virgin women are probably significantly less likely to get cervical cancer than non-virgins of same age, and had such a study been done prior to the established link between HPV and cervical cancer, using your logic one might hypothesize that intercourse causes cervical cancer.

I am not claiming voluntary circumcision is not a valid personal or religious choice, but my guess is that in a few generations you will find prophylactic circumcision considered in the ranks of trepanation, prefrontal lobotomy, ECT, prophylactic appendectomy, bloodletting, leeches, etc. While none of these things can be considered always unquestionably incorrect, and all have some sort of a valid medical application even today, performing these procedures indiscriminantly, non-consensually or prophylactically is considered barbaric.

[OliverTwistofLime]

Originally Posted by alphaboi867

But would you have circumcised a 17 year old boy who's parents did give writen authorization against his will? If not then how old would the boy have to be before you wouldn't do it against his will?

No.......In general an obgyn will do desired circumcision on newborns. Older babies or young adults would be better off having the circ done by a urologist.

In answer to the question, when the child is able cognitively to understand what is going on and does not wish to have a circ.......I doubt a gyn, family practice MD or a Urologist would do the circ.....I will stick to newborns to perform the surgery.