By Brian Earp
This is a rough draft of a lecture delivered on October 1st, 2012, at the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights (Helsinki, Finland). It will appear in a substantially revised form—as a completed paper—at a later date. If you quote or use any part of this post, please include the following citation and notice:
Earp, B. D. (forthcoming, pre-publication draft). Assessing a religious practice from secular-ethical grounds: Competing metaphysics in the circumcision debate, and a note about respect. To appear in G. C. Denniston, F. M. Hodges, & M. F. Milos (Eds.), Proceedings of the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights, published by Springer. * Note, this is not the finished version of this document, and changes may be made before final publication.
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My name is Brian Earp; I am a Research Associate in the philosophy department at the University of Oxford, and I conduct research in practical ethics and medical ethics, among some other topics. As you saw from the program, my topic today is the ethics of infant male circumcision—specifically as it is performed for religious reasons.
The AAP report on circumcision: Bad science + bad ethics = bad medicine
For the first time in over a decade, the American Academy of Pediatrics (AAP) has revised its policy position on infant male circumcision. They now say that the probabilistic health benefits conferred by the procedure just slightly outweigh the known risks and harms. Not enough to come right out and positively recommend circumcision (as some media outlets are erroneously reporting), but just enough to suggest that whenever it is performed—for cultural or religious reasons, or sheer parental preference, as the case may be—it should be covered by government health insurance.
That turns out to be a very fine line to dance on. But fear not: the AAP policy committee comes equipped with tap shoes tightly-laced, and its self-appointed members have shown themselves to be hoofers of the nimblest kind. Their position statement is full of equivocations, hedging, and uncertainty; and the longer report upon which it is based is replete with non-sequiturs, self-contradiction, and blatant cherry-picking of essential evidence. Both documents shine as likely examples of a “lowest common denominator” mélange birthed by a divided committee, some of whose members must be well aware that the United States is embarrassingly out of tune with world opinion on this issue.
VIDEO DEBATE LINKED TO BELOW – ARI KOHEN AND I DISCUSS THE ETHICS OF RELIGIOUSLY-MOTIVATED CIRCUMCISION
Ari Kohen doesn’t like my recent post about circumcision—the one in which I argue that it is unethical to remove healthy tissue from another person’s body without first getting his permission. I then go on to say that religious justifications cannot override this basic principle. Here’s that post again.
Ari is a professor of political theory and human rights at the University of Nebraska at Lincoln. In this blog post, he takes me to task for failing to take seriously the religious commitments of Jews in framing my arguments. And while he gets some things wrong about, for example, the relevance of “sexually-sensitive tissue” to my overall reasoning; and while he misses the point of my bringing up female genital cutting entirely (I’ve since edited my post to clear up any lingering ambiguity) – he is probably right that my approach to debating this issue is unlikely to win me any converts from within the ranks of the religious.
See updated material below – reply to a critic.
Of faith and circumcision: Can the religious beliefs of parents justify the nonconsensual cutting of their child’s genitals?
Circumcising minors on religious grounds amounts to grievous bodily harm according to a German court ruling issued on Tuesday. AFP News reports:
The regional court in Cologne, western Germany, ruled that the “fundamental right of the child to bodily integrity outweighed the fundamental rights of the parents. The religious freedom of the parents and their right to educate their child would not be unacceptably compromised, if they were obliged to wait until the child could himself decide to be circumcised.”
Some Jewish groups are up in arms. They insist that God has “non-negotiably” required that circumcision take place on precisely the eighth day after birth; hence waiting to perform the operation until the child could consent would amount to breaking this keystone covenant with their deity. Using the force of law to delay circumcision, then, is no different from banning it outright, since a delayed circumcision is religiously meaningless.
I don’t find this argument very compelling.
By Brian Earp
A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa will increase transmission of HIV
Step 1. How not to design or conduct an experiment
A handful of circumcision advocates have recently begun haranguing the global health community to adopt widespread foreskin-removal as a way to fight AIDS. Their recommendations follow the publication of three  randomized controlled clinical trials (RCCTs) conducted in Africa between 2005 and 2007.
These studies have generated a lot of media attention. In part this is because they supposedly show that circumcision reduces HIV transmission by a whopping 60%, a figure that wins the prize for “most misleading possible statistic” as we’ll see in a minute. Yet as one editorial  concluded: “The proven efficacy of MC [male circumcision] and its high cost-effectiveness in the face of a persistent heterosexual HIV epidemic argues overwhelmingly for its immediate and rapid adoption.”
Well, hold your horses. The “randomized controlled clinical trials” upon which these recommendations are based (I use scare quotes deliberately) represent bad science at its most dangerous: we are talking about poorly conducted experiments with dubious results presented in an outrageously misleading fashion. These data are then harnessed to support public health recommendations on a massive scale whose implementation would almost certainly have the opposite of the claimed effect, with fatal consequences. As Gregory Boyle and George Hill explain in their exhaustive analysis of the RCCTs:
On the ethics of non-therapeutic circumcision of minors, with a post script on the law
By Brian D. Earp (Follow Brian on Twitter by clicking here.)
Seattle, 1985. I escaped the hospital with my penis intact. Lucky for me. Routine neonatal circumcision in boys is unethical, unnecessary, and should be made illegal in the United States. Or so I argue in this post.
Yet lawmakers in California, it is now being reported, have introduced a bill with the opposite end in mind. They wish to ban legislation that could forbid circumcision-without-consent. Read that sentence again. What could be going on?