Pros And Cons Of Circumcision

BAN OF NON-THERAPEUTIC MALE CHILD CIRCUMCISION IN DENMARK

Male infant circumcision is a health topic that generates large controversy and in some parts of Western Europe this topic has generated important debates in recent times. For instance, in 2012 the German court considered male circumcision equivalent to grievous bodily harm (1).

There is convincing evidence that male circumcision reduce the risk of HIV infection. In addition, carcinogenic subtypes of human papillomavirus (HPV) have been associated with lack of circumcision (2,3). Conversely, there have been some reports related to complications e.g. bleeding and infection. However, the complications are usually minor and easily managed. The decision regarding circumcise an infant can

First of all, the health system will be playing medical paternalistic role. The interference in this case may be justified on the basis of a higher good, in order to maintain child welfare and due to that the infant has impairments for consenting the circumcision (4).

Promoting or discouraging certain practices needs to be done with scientific evidence and a principle of proportionality. Consequently the Danish health system first step should be to involve all the stakeholders, this may be done by the creation of a board with the stakeholder groups. This will be important not only for the situation analysis but for a successful implementation as well. A board can provide the main focus for accountability and preparing advice to decision-makers, as well as wider communication with all interested parties (1,5).

Second, it is important to state clearly the health and quality goals beforehand, these goals have to be explicit and measurable (5). The health system needs to have a strong leadership and support for quality needs in order to achieve the best outcomes. If necessary some interventions may be conducted to build commitment and leadership capacity, and to strengthen accountability. An engagement with the population is crucial due to that this will prevent dangerous practices, especially in such sensitive topic.