Things I’ve learned (so far) about how to do practical ethics
I had the opportunity, a few months back, to look through some old poems I’d written in high school. Some, I thought, were pretty good. Others I remembered thinking were good when I wrote them, but now they seem embarrassingly bad: pseudo-profound, full of clichés, marked by empty rhetoric instead of meaningful content. I’ve had a similar experience today with my collection of articles here at the Practical Ethics blog. And Oh, the things I have learned!
Here are just a few of the lessons that have altered my thinking, or otherwise informed my views about “doing” practical ethics — particularly in a public-engagement context — since my very first blog post appeared in 2011:
Cultural bias and the evaluation of medical evidence: An update on the AAP
Since my article on the American Academy of Pediatrics’ recent change in policy regarding infant male circumcision was posted back in August of 2012, some interesting developments have come about. Two major critiques of the AAP documents were published in leading international journals, one in the Journal of Medical Ethics, and a second in the AAP’s very own Pediatrics. In the second of these, 38 distinguished pediatricians, pediatric surgeons, urologists, medical ethicists, and heads of hospital boards and children’s health societies throughout Europe and Canada argued that there is: “Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision.”
The AAP took the time to respond to this possibility in a formal reply, also published in Pediatrics earlier this year. Rather than thoughtfully addressing the specific charge of cultural bias, however, the AAP elected to boomerang the criticism, implying that their critics were themselves biased, only against circumcision. To address this interesting allegation, I have updated my original blog post. Interested readers can click here to see my analysis.
Finally, please note that articles from the Journal of Medical Ethics special issue on circumcision are (at long last) beginning to appear online. The print issue will follow shortly. Also be sure to see this recent critique of the AAP in a thoughtful book by JME contributor and medical historian Dr. Robert Darby, entitled: “The Sorcerer’s Apprentice: Why Can’t the US Stop Circumcising Boys?”
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 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 meta-ethics in the circumcision debate, and a note about respect. To appear in: 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.
* * * * * *
Hello. My name is Brian Earp; I am a Research Associate [Editor’s note: now Research Fellow] 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.
I should begin by saying that in debates on this topic, I’ve noticed that there is sometimes a very serious reluctance to address the issue of religious motivation directly. And this is true even among those who are otherwise outspoken in their opposition to circumcision on other grounds. For example, in 2007, Harry Meislahn of the Illinois chapter of NOCIRC—a prominent anti-circumcision organization—was asked if he would argue that Jews should discontinue circumcising their babies, along with secular or non-religiously-motivated parents who might be doing it out of a sense of cultural habit, or because they thought it could be good for the baby’s health. He replied: “No. I don’t prescribe for Jews, at all. This is an absolute loser. I’m not Jewish. … I withdraw from this field because it generates lots of heat [and] very little light” (quoted in Ungar-Sargon, 2007).
(He went on to say, however: “I would maintain that a Jewish baby feels pain just as a non-Jewish baby feels pain, and there are Jewish men, just like non-Jewish men, who are real angry that this was done to them.”)
The philosopher Iain Brassington has recently expressed a similar concern. On the Journal of Medical Ethics blog, he wrote: “Though I [have] mentioned the [recent] decision of the German court that ritual circumcision constituted assault, I’ve wanted to stay clear of saying more about it [because] it seemed too potentially toxic” (Brassington, 2012, para. 2). To give another example, the bioethicist Dan O’Connor from Johns Hopkins University—in an article entitled “A Piece I Really Didn’t Want to Write on Circumcision”—has recently said that: “when [a reporter] calls my work and ask[s] if there is a bioethicist in the house who will give the anti-circumcision viewpoint, I beg off. … I would be a terrible interviewee anyway, [since I would have to preface] my every argument against circumcision with rambling spiels about what loving and caring parents my [Jewish] friends are” (O’Connor, 2012, para. 10).
Finally, as a philosopher colleague of mine wrote to me in a recent email: “To be honest with you, I am strongly anti-circumcision. The reason I don’t [write papers on the topic] is that I have a large number of circumcised Jewish … friends who I think would be offended if they found out [about my views]” (personal communication, May 17, 2012).
Like all of the individuals I have just mentioned, I find myself in the position of being largely skeptical about the moral permissibility of ritual circumcision—for reasons I will give in just a moment—and yet I am well aware that since I myself am neither Jewish nor Muslim, I have an especially good chance of offending someone who is when I subject the practice to critical scrutiny. This chance is, of course, magnified by the fact that circumcision is seen by some as being a central, or even obligatory, ritual in each of these religions. And just like the bioethicist Dan O’Connor and the philosopher-colleague whose email I quoted above, this potential for causing offense extends to many of my closest friends, to colleagues of mine, and to a pretty wide range of people I have no particular interest in irritating.
So perhaps there is a reason to hesitate. Because religious convictions are a deep, and certainly emotionally-charged, aspect of the lives of so many, attempts to question a religiously-motivated practice—especially by one who is not religious, or differently religious—can lead to outcomes that are very far from productive. To illustrate, here is a quote from a comment I received on my Facebook page in response to a post I published on this topic in 2011:
Sorry Brian, you’re entitled to your non-Jewish opinion, but we’ve been doing very nicely for 5,771 years with this ancient tradition of our people. And I don’t even know who the hell you are, but this kind of nonsense just pisses me off. (quoted in Earp, 2011).
So, as I say, sometimes the conversation doesn’t turn out to be as productive as I’d hoped. Part of what I think is going on here, is that we have an unwritten rule in polite society that says that certain ideas or practices are out of bounds for critical discussion. The English humorist Douglas Adams made a similar point in a speech he gave in Cambridge in 1998. Talking about religious customs specifically, he said:
Here is an idea or a notion that you’re not allowed to say anything bad about; you’re just not. Why not? — because you’re not!’ If somebody votes for a party that you don’t agree with, you’re free to argue about it as much as you like; everybody will have an argument but nobody feels aggrieved by it. If somebody thinks taxes should go up or down you are free to have an argument about [that], but on the other hand if somebody says ‘I mustn’t move a light switch on a Saturday’, you say, ‘Fine, I respect that’. (Adams, 1998)
Now, obviously I don’t have any arguments about whether—or when—it’s OK to use a light switch. I do want to focus, however, on this idea about respect. I don’t think it actually is showing respect to anyone to give an automatic pass to anything she says or does just because it might have to do with her religious practice. I think that sort of avoidance has much more to do with fear than with respect—fear that you might upset the person, or fear that you might sound stupid for not knowing more about the custom, or fear that the conversation might turn out to be awkward, or whatever the fear might be.
Respect, it seems to me, is very different from this. Respect has to do with taking certain positive things for granted. In my own experience, for example, I sometimes talk with my Jewish and Muslim friends about my views on the ethics of circumcision. Some of these friends are in agreement with me that ritual circumcision may be, at the very least, morally suspicious; but others hold a different view. Whatever their perspective, however, I respect these friends enough to know that they’ll listen to my arguments with an open mind, really consider what I’m saying, and engage in debate productively. And most of the time, to be sure, they respect me enough to know that I’ll extend them the same courtesy, which I will. Respect is not about avoidance, then, at least in my opinion. It is about the opposite of avoidance—it is about engagement, conversation, communication—so long as these are done in a fair-minded and well-intended way.
I also think that there is something potentially very condescending about the idea that someone’s feelings—religious or otherwise—might be so fragile and irrational that instead of just saying what you really believe, and having an honest conversation about it, you should tiptoe around, and blush, and make excuses, and pretend that you don’t mean what you mean or think what you think. That doesn’t seem like real respect either—and I think my religious friends would be quite rightly insulted if they thought that I was operating out of this kind of mindset when I talked with them about their beliefs and practices.
So, having said all that, in what follows, I am simply going to trust that I can engage directly with the ethical arguments for and against religiously-motivated circumcision, without having to hedge or qualify, or worry about whether I might offend someone for whom this practice is seen as being too sacred to talk about. People are free to disagree with me, of course, and I will be happy to take on board any constructive criticism they may have to offer. I am open to changing my views. But I do want to spend the rest of my time dealing directly with the arguments.
I will start with an argument against religiously-motivated circumcision, and then I will consider some common objections.
The premise of my argument is this. As a rule, it should be considered morally impermissible to sever healthy, functional tissue from another person’s body—perhaps especially if the tissue cannot “grow back,” and even moreso if it comes from the person’s genitals—without first asking for, and then actually receiving, that person’s informed permission.
Now, ordinarily, and with respect to almost every case we could imagine, this would count as a foundational ethical principle. It does presume that the individual is an appropriate unit for moral analysis; it does presume that individuals have certain rights, among which is the right to bodily integrity; and it does presume that the infringement of that right can only be permitted under conditions of informed consent (or in circumstances like a medical emergency).
Of course, someone could question or even deny any one of those presumptions, but then they would have to come up with a better way to ground their own moral theories that didn’t inadvertently create a justification for having parts of their body cut off without their permission. I’m not saying this is impossible, but it’s something to look out for. And actually, I think there is a competing meta-ethic hidden within religious defenses of circumcision—and it’s one that downplays the relevance of the individual, and specifically the individual as a child, to independent moral consideration—but I will come onto that point a little bit later on.
For now, let us assume that the ethical premise I’ve given is a reasonable one, and let’s take it for granted to see what follows. Well, since ritual circumcision involves the removal of healthy, functional, erogenous tissue from the genitals of a newborn or young child, and since babies and young children are incapable of giving meaningful consent to such a procedure, our principle is obviously violated, and therefore circumcision is unethical on this theory.
Now, this is not just abstract philosophy. As most of us know, a recent decision by a German court in Cologne—which said that ritual circumcision is a form of assault—relied on ethical reasoning very similar to what I have just laid out. And as we also know, this conclusion was not very readily accepted by a large number of religious leaders within Judaism and Islam, and even within some corners of Christianity. This last part should be a little surprising, of course, since the founder of Christianity—Paul (or Saul) of Tarsus—was explicitly and even energetically opposed to the practice of circumcision, as he made very clear in his letters to the earliest Christian churches. And, as Sami Aldeeb pointed out in his speech yesterday (see Aldeeb, 2012), this was the official church position for a pretty long time.
But, leaving that aside, what this reaction to the Cologne decision means is that we can look at some objections to the argument I have given that are not just hypothetical, but that have actually been given—and very recently—as serious attempts to defend ritual circumcision against the charge that it is an unethical practice. And I would like to consider a few of these objections one at a time.
The first objection is that religious circumcision is an ancient tradition, and one that is felt to be very important to the practice of Judaism or Islam. For example, Dieter Graumann, the president of the German Central Council of Jews, has said, “Circumcision of newborn boys is a fixed part of the Jewish religion and has been practiced … for centuries” (quoted in Hall, 2012). He then went on to criticize the Cologne ruling as being “outrageous” and “insensitive.” An Islamic representative, Ali Demir, made a similar point: “this is a … procedure,” he said, “with thousands of years of tradition behind it and [a] high symbolic value” (ibid.).
Now, as I was preparing this talk, I wondered about whether I should count these sorts of statements as being actual “objections” to the ethical case made by the German court. Seemingly, it should go without saying that something’s having been done for a long time does not in any way amount to an argument for its moral permissibility. The thing might actually be morally permissible, of course, but this just wouldn’t be the way to show it. The more I thought about it, however, the more I came to believe that I couldn’t just pass over the “ancient tradition” argument as a sort of a straw man. This is because this exact line of reasoning has been repeatedly cited in recent weeks, by a number of influential religious leaders, in a seemingly sincere attempt to shape public discussion on this topic. So I need to spend a little bit of time responding to this view, with what would otherwise be a statement of the obvious:
Many practices that are now regarded as being very clearly unethical had been going on for an extremely long time before anyone had the idea to question them. Examples include slavery, footbinding, the cutting of female genitals, and beating disobedient children with sticks. Usually these practices persisted without much alarm for one of two reasons. Either the moral standards that they would eventually be seen as violating had not yet had been developed, or those standards did exist for other cases but just weren’t commonly seen as applying to the practice itself until enough people sat down and made the connection. I think what’s happening right now with circumcision is not so much the first of these, but more the second. In other words, the relevant ethical principles—about bodily integrity, consent, protecting the vulnerable in society, and so on—have been available to us for quite some time now. It’s just that we’re so used to circumcision as a cultural habit, that many people fail to see how patently inconsistent this practice is with the rest of their own moral landscape.
My colleague Anders Sandberg has given an argument for this view that I think is worth considering in a little bit of detail. He writes:
It is interesting to consider a fictional case: suppose I come up with a religion that claims [that] male nipples are bad, and should be removed in infancy in order to prevent various spiritual and medical maladies, as well as showing faith. I have no doubt that getting this new practice approved anywhere would be very hard, no matter how much I and my adherents argued that it was a vital part of our religion. No doubt arguments about unnecessary mutilation and infringement of children’s self determination would be made, and most would find them entirely unobjectionable. If my religion joined the chorus of religious critics to the German decision it is likely that the others would not appreciate our support: after all, they do not want approval for all religious surgery, just a particular one. And nobody likes to be supported by an embarrassing supporter.
But this seems to suggest that what is really is going on is [a] status quo bias and [something about] the social capital of religions. We are used to circumcision in Western culture, so it is largely accepted. It is very similar to how certain drugs are regarded as criminal and worth fighting, yet other drugs like alcohol are merely problems: policy is set, not based on actual harms, but … on a social acceptability scale and who has institutional power. This all makes perfect sense sociologically, but it is bad ethics. (Sandberg, 2012)
Now, I don’t think that Anders’ scenario is completely water-tight, and I don’t think that a theologically sophisticated religious person would find the “male nipples” example to be an appropriate or a complete analogy. But I do think that Anders is onto something when he suggests that if the “ancient tradition” objection does carry any weight in this conversation, it is for sociological reasons rather than ethical ones. In fact, I don’t see that this objection does any argumentative work for the defender of religious circumcision: It might work as a rhetorical strategy to affirm the social capital of his religion, but it isn’t an argument.
OK, I would like to move on to a second objection that I have heard a number of times in response to the Cologne decision, and one that is potentially a little harder to deal with. This objection is that circumcision is divinely mandated and hence obligatory for religious Jews and, according to some interpretations, maybe Muslims as well. In Judaism, as we all know, the mandate is even specific about the exact timing of the procedure: according to the book of Genesis, the baby’s foreskin must be removed on the eighth day after birth. And this timing is, according to a number of vocal religious commentators, quote, “non-negotiable.”
I want to start with this idea about non-negotiability. My first question is, according to whom? Certainly people like Dieter Graumann, the president of the German Central Council of Jews I mentioned before, has repeated this claim (see, e.g., Gedalyahu, 2012). And so have a number of influential, usually conservative or Orthodox Jews, some of whom have been saying some very authoritative-sounding things on behalf of, quote, “the Jewish people” (see, e.g., Harkov, 2012). But this seems to me to be somewhat disingenuous. As anyone who knows any actual Jewish people can attest, “the Jewish people” is not a collection of uncritical sheep who all think the same thing. “The Jewish people” do not uniformly adhere to the exact same theology. And, specifically, “the Jewish people” includes a large and growing number of individuals—including, in my view, individuals with exceptional moral insight—who simply do not believe that circumcision is a “non-negotiable” component of their religion (e.g., Goldman, 1998; Goodman, 1999; Glick, 2001; Milgrom, 2012; Pollack, 2013; Sadeh, 2013; Ben Yami, 2013; Ungar-Sargon, 2013; Steinfeld, 2013). I suppose someone could argue that certain conservative representatives within Judaism are theologically correct, and everyone else is deluded, but that would take a lot of time and energy and it would be an argument that would probably fail to convince anyone who didn’t already hold that view. Also, it would be much harder to express as a simple axiom, which is what the newspapers seem to appreciate. So instead we are confronted with a string of public declarations that make it sound like Judaism a monolith and that there are no meaningful debates to be had about the religious requirements implied by certain passages within the Torah.
Another point is this—and, again, I wish I were attacking a straw man here, but based on the mainstream, public debate I have seen going on in the last few weeks, I feel that some very basic points about the philosophy of religion need to be brought up as reminders. First, even though a person or a group of people may sincerely believe that a given practice is divinely mandated, it doesn’t necessarily follow that it is divinely mandated. Second, even if something really is divinely mandated, it doesn’t necessarily follow that it is non-negotiable. Third, even if something is felt to be non-negotiable, it doesn’t necessarily follow that it is morally permissible. And this brings us very quickly to the classic dilemma about what you’re supposed to do when God tells you to do something unethical.
We all know the puzzle about Abraham and Isaac: God tells Abraham that he must sacrifice his son. So what should Abraham do? There are a couple of well-known possibilities in logical space here. One option is that Abraham should assume that he’s misunderstood something. Since killing innocent children is unethical, and since God is a morally perfect being, God must not really have said that. Another option is that he starts to wonder if maybe he wasn’t really talking with God after all, but maybe it was Satan, or maybe just a voice in his own head. Or he can conclude that God is not as morally developed he used to think, or is even a source of evil. Whichever way he chooses to go, the correct answer from an ethical perspective is: No, I will not kill my son.
Obviously a lot of people have looked at this case over the centuries, and I’m not the first one to give the analysis you just heard. As a number of commentators have noticed, there is a pretty big conflict in this story between the requirements of morality and the requirements of the divine mandate. Kierkegaard (1843) thought he could solve the puzzle by talking about the “teleological suspension of the ethical.” This is the idea that we should use our faith to rise above mere ethics and morality and enter into a higher, and more absolute relationship with the divine. Now I think that this is a very dangerous thing to propose. And I think it has real consequences, one of which is that the religiously-motivated suspension of morality has been a source of a lot of suffering, for a lot of people—including marginalized and vulnerable people—for a very long time.
But my sense, in fact, is that the large majority of contemporary religious believers don’t actually do this. What I mean is, when something is felt to be unethical, what they actually do is one of two things. Either they revise their understanding of what is divinely required in the first place; or else they engage in some very complicated psychological maneuvers—many of them unconscious—that lead them to conclude that the thing must not be unethical after all, even though it really looks like it is from every other perspective. So for circumcision, for example, they might downplay the harms, risks, and drawbacks of the procedure; or they might use euphemisms like “snip” or “flap of skin” when they talk about what it is that is being cut off; or they might emphasize the postulated health benefits (while ignoring disputes over their scientific credibility); or they might exaggerate the differences with female genital cutting, or exaggerate the similarities to vaccination, or whatever: a whole range of strategies that make it seem like circumcision isn’t so bad to begin with.
I have seen one major exception to this approach, however. And this comes from an interview conducted by the filmmaker Eliyahu Ungar-Sargon (see Ungar-Sargon, 2007). The clip starts with an Orthodox Rabbi named Hershy Worch talking about circumcision. He says:
It’s painful, it’s abusive. It’s traumatic, and if anybody who’s not in a covenant [with God] does it, I think they should be put in prison. I don’t think anybody has an excuse for mutilating a child. … Depriving them of [part of their] penis. We don’t have rights to other people’s bodies, and a baby needs to have its rights protected. I think anybody who circumcises a baby is an abuser, unless it’s absolutely medically advised. Otherwise – what for … ?
After a moment of what I interpreted as stunned silence, you can hear Eliyahu ask a pertinent question:
How does this covenant alleviate your ethical responsibility that you just so articulately posed? How is it that being in this covenant exempts you from that term … How can you not call yourself an abuser?
The Rabbi actually cuts him off and says:
I’m an abuser! I do abusive things because I am in covenant with God. And ultimately God owns my morals, he owns my body, he owns my past and future, and that’s the meaning of this covenant – that I agreed to ignore the pain and the rights and the trauma of my child to be in this covenant.
Now, I must tell you that—in an important sense—I have a lot of respect for this Rabbi. I think that his statements reach a level of honesty, and accuracy, and even Kierkegaardian philosophical consistency, that has otherwise been lacking from the public conversation on this issue. Here is someone who acknowledges, without hedging or qualification, that he is mutilating the penis of an infant. But he doesn’t take this knowledge as an excuse to go back to his scripture and re-interpret the original commandment, nor does he allow himself to believe that circumcision is a harmless little snip. He just doesn’t resolve the dissonance. Instead, he takes responsibility for his religious commitments, as well as for his behavior—and I think that in doing this, he gives us a rare and unmediated example of the power of religious belief to justify (what the Rabbi himself acknowledges is) the painful assault of a child.
So what should we do with this? I started with the idea that it should be considered morally impermissible to remove healthy, functional tissue from another person’s body without obtaining that person’s permission. And since circumcision violates that rule, I said it was unethical. Then I tried to show that the “ancient tradition” objection doesn’t get us off the hook, nor do the points about circumcision’s being divinely mandated or non-negotiable. So at this point, it seemed like we should be able to stick, at least provisionally, with the conclusion that circumcision is indeed a morally impermissible act.
But now we have something different. Now we have this idea to think about that maybe there’s something bigger than ethics – something like this direct relationship to the divine.
I said at the beginning that I thought there was a hidden meta-ethic behind religious defenses of circumcision, and I think that now we’re beginning to see what it might be. I think it’s this idea that an individual human being, such as a child, is not really the ultimate object of moral analysis. Instead there are other obligations, obligations that come from a community identity, from concern about historical continuity, or ritual continuity; obligations that come from a special covenant between a god and a group of people. And the effect of all this is that the individual child becomes a sort of non-entity. His body becomes not his body. His pain becomes an instrument in fulfilling a higher purpose.
And so, I think before we can get anywhere in this discussion, we are going to have to acknowledge that that is a very different meta-ethic. I think we have to acknowledge that certain religious commitments are based on a particular view of the universe, and that this view is in direct conflict with a “Western” moral focus on: individuals, on human rights adhering to those individuals as individuals, and on the notion that children and infants, above all, need special protection because they can’t defend those rights on their own.
I don’t have a good answer to this conflict. Obviously one can, in theory, adopt any meta-ethical view under the sun. One can adopt a view that says that parts of children’s bodies may be removed without their consent, if that is what a god requires; or one that says that animals should be set on fire and burnt at the altar (again, if that is what a god requires); or one that says that sparing the rod will spoil the child; or that our daughters should be stoned to death if they disobey, or whatever we want. All of these views are logically possible, and many of them are historically accurate. Many of them find direct textual support as well in the holy books of major religions.
But that isn’t how we tend to think about things in modern, Western societies; and it isn’t how we’ve set up our laws. We have a different sort of worldview that we use to make sense of concepts like individual rights, including the right to bodily integrity. So the idea I want to leave you with is this. If we think that there is any chance that we should give up these basic concepts—so that we can defer to a worldview that says that things like community identity are more important than individual identity (and the right to decide what happens to one’s own flesh)—then we’ll have to pay the price of that choice and face it honestly. And that means that the very same individuals who are asking for the religious freedom to perform circumcisions in a secular society, might have to be prepared to give up their own right to complain if someone wanted to cut off a part of their body, or interfere with their genitals without their consent. That is, as I say, a logically possible universe. But it isn’t one that I would want to live in, and I am not convinced that you can have it both ways.
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Steinfeld, R. (2013, Noveber 26). It cuts both ways: A Jew argues for child rights over religious circumcision. Haaretz. Available at: http://www.haaretz.com/jewish-world/the-jewish-thinker/.premium-1.560244.
Ungar-Sargon, E. (Producer and Director). (2007). Cut: Slicing through the myths of circumcision [Film]. Los Angeles: White Letter Production Studios.
Ungar-Sargon, E. (2013). On the impermissibility of infant male circumcision: a response to Mazor (2013). Journal of Medical Ethics, doi:10.1136/medethics-2013-101598.
 Just as with Mr. Meislahn, he did nevertheless go on to say more. See: http://blogs.bmj.com/medical-ethics/2012/07/17/more-on-circumcision-in-germany/.
 Some of these articles were published after the present lecture was delivered. They are cited here simply to give an indication of some of the most recent Jewish voices opposed to circumcision.
UPDATED as of 27 May, 2013. See the bottom of the post.
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 outweigh the known risks and harms. Not enough to 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. The AAP position statement is characterized by equivocations, hedging, and uncertainty; and the longer report upon which it is based includes a number of non-sequiturs, instances of self-contradiction, and cherry-picking of essential evidence.
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.
An article in the Israeli newspaper Haaretz reports on the (alleged) frequent use of psychiatric drugs within the Haredi community, at the request of the religious leaders, in order to help members conform with religious norms. Haredi Judaism is the most conservative form of Orthodox Judaism. It is sometimes referred to by outsiders as ultra-Orthodox. Haredim typically live in communities that have limited contact with the outside world. Their lives revolve around Torah study, prayer and family.
In December 2011, the Israel Psychiatric Association held a symposium entitled “The Haredi Community as a Consumer of Mental-Health Services”. One of the speakers was Professor Omer Bonne, director of the psychiatry department at Hadassah University Hospital. Professor Bonne is claimed to have said that sometimes yeshiva students (yeshiva is a religious school) and married men should be given antidepressants even if they do not suffer from depression, because these drugs also suppress sex drive.
By Brian Earp
Rick Santorum, birth control, and “playing God”
Rick Santorum thinks that birth control is immoral. Santorum, a former Senator from Pennsylvania, is one of two human beings – if the polls have it right – likeliest to become the Republication nominee for President of the United States this election cycle.
On the ethics of non-therapeutic circumcision of minors, with a pre-script on the law
By Brian D. Earp (Follow Brian on Twitter by clicking here.)
PRE-SCRIPT AS OF 25 SEPTEMBER 2012: The following blog post includes material from an informal article I wrote many years ago, in high school, in fact, for a college essay competition. I would like to think that my views have gained some nuance since that time, and indeed with increasing speed, as I have researched the topic in more detail over the past several months–specifically during the period of a little over a year since the blog post first appeared online. Since quite a few (truthfully: many thousands of) people have come across my writings in this area, and since I am now being asked to speak about circumcision ethics in more formal academic company, I feel it is necessary to bring up some of the ways in which my thinking has evolved over those many months.
The most significant evolution is away from my original emphasis on banning circumcision. I do maintain that it should be considered morally questionable to remove healthy tissue from another person’s genitals without first asking for, and then actually receiving, that person’s informed permission; but I also recognize that bringing in the heavy hand of the law to stamp out morally questionable practices is not always the best idea. It is a long road indeed from getting one’s ethical principles in order, to determining which social and legal changes might most sensibly and effectively bring about the outcome one hopes for, with minimal collateral damage incurred along the way. Until enough hearts and minds are shifted on this issue, any strong-armed ban would be a mistake.
In the long term, however, I think the moral goal remains: that each male newborn should have the same legal protections enjoyed by his sisters, designed to preserve his sex organs in their healthy, intact form until such time as he is mentally competent to make a decision about altering them, surgically or otherwise.
The project for the meantime is to work on hearts and minds.
I am grateful to the many hundreds of individuals who have left thoughtful comments on my sequence of posts on the ethics of circumcision, and I look forward to developing my arguments in ever more sophisticated ways in the coming months and years as this important debate continues. I am especially grateful to those of my interlocutors who have disagreed with me on various points, but who have done so in a thoughtful and productive manner. May we all aim at mutual understanding, so that the best arguments may emerge from both sides, and so that the underlying points of genuine disagreement may be most clearly identified. — B.D.E.
* * *
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. What could be going on?