To avoid circumcision complications, avoid circumcision

Darby, Robert

doi:10.5489/cuaj.1709

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Finally, Charlie and David, like Adam, would also represent cases of undercounting: both deaths are plausibly attributable to circumcision, in that, had the circumcision not occurred, neither would the deaths from the more immediate causes 21 (although this is less certain in the case of Charlie). However, the deaths occurred sometime after the original hospital discharge and so would not be included in our data set.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010

Earp

Allareddy

et al. 2018

Clin Pediatr (Phila)

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We sought to quantify early deaths following neonatal circumcision (same hospital admission) and to identify factors associated with such mortality. We performed a retrospective analysis of all infants who underwent circumcision in an inpatient hospital setting during the first 30 days of life from 2001 to 2010 using the National Inpatient Sample. Over 10 years, 200 early deaths were recorded among 9 833 110 subjects (1 death per 49 166 circumcisions). Note: this figure should not be interpreted as causal but correlational as it may include both undercounting and overcounting of deaths attributable to circumcision. Compared with survivors, subjects who died following newborn circumcision were more likely to have associated comorbid conditions, such as cardiac disease (odds ratio [OR] = 697.8 [378.5-1286.6]; P < .001), coagulopathy (OR = 159.6 [95.6-266.2]; P < .001), fluid and electrolyte disorders (OR = 68.2 [49.1-94.6]; P < .001), or pulmonary circulatory disorders (OR = 169.5 [69.7-412.5]; P < .001). Recognizing these factors could inform clinical and parental decisions, potentially reducing associated risks.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010

Earp

Allareddy

et al. 2018

Clin Pediatr (Phila)

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“…Lempert et al [ 19 ] disparage the AAP’s infant NTMC policy statement, saying it “was met with unprecedented criticism from international experts for falling short of its usual scientific standards and exhibiting strong evidence of cultural bias”[ 95 - 98 ]. However, they fail to acknowledge the detailed rebuttals that those claims attracted[ 15 , 99 - 103 ] (Table 2 ).…”

Section: Evidence-based Vs Non-evidence Basedmentioning

confidence: 99%

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

Moreton,

Cox,

Sheldon

et al. 2023

World J Clin Pediatr

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The British Medical Association (BMA) guidance on non-therapeutic circumcision (NTMC) of male children is limited to ethical, legal and religious issues. Here we evaluate criticisms of the BMA’s guidance by Lempert et al . While their arguments promoting autonomy and consent might be superficially appealing, their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits. Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies, as well as risk-benefit analyses, have found that the medical benefits of infant NTMC greatly exceed the risks, and there is no reduction in sexual function and pleasure. The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom. The consequence is higher prevalence of preventable infections, adverse medical conditions, suffering and net costs to the UK’s National Health Service for treatment of these. Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based. Indeed, that document called for a review by others of the medical issues surrounding NTMC. While societal factors apply, ultimately, NTMC can only be justified rationally on scientific, evidence-based grounds. Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision. Their decision either for or against NTMC should then be respected.

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“…Evaluation of those arguments have revealed flaws . Arguments criticizing the AAP's policy statement on ethical and legal grounds were followed by evaluations undermining the arguments used . Articles critical of the CDC's draft recommendations in 2014 69,329,358 have also been shown to contain serious flaws .…”

Section: Physical Harmmentioning

confidence: 99%

“…26,69,320,[357][358][359][360][361][362] Evaluation of those arguments have revealed flaws. 342,[363][364][365][366][367][368][369][370][371][372][373][374] Arguments criticizing the AAP's policy statement on ethical and legal grounds 1,2,26,311,320,357,375,376 were followed by evaluations undermining the arguments used. 363,364,367,374,[377][378][379] Articles critical of the CDC's draft recommendations in 2014 69,329,358 have also been shown to contain serious flaws.…”

Section: Ethical and Legal Issuesmentioning

confidence: 99%

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Critical evaluation of arguments opposing male circumcision: A systematic review

Morris

Moreton²,

Krieger

2019

J Evidence Based Medicine

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Objective To systematically evaluate evidence against male circumcision (MC). Methods We searched PubMed, Google Scholar, EMBASE and Cochrane databases. Results Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high‐quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high‐quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk‐benefit analyses reported that benefits exceed risks by 100‐200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low‐risk, high‐benefit interventions such as MC for better health. Expert evaluations of case‐law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost‐saving to health systems. Conclusions Arguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

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To avoid circumcision complications, avoid circumcision

Cited by 5 publications

References 7 publications

Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010

Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

Critical evaluation of arguments opposing male circumcision: A systematic review

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