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Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines

The Centers for Disease Control and Prevention (CDC) have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. I offer a critique of the CDC position. Among other concerns, I suggest that the CDC relies mor...

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Autor principal: Earp, Brian D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364150/
https://www.ncbi.nlm.nih.gov/pubmed/25853108
http://dx.doi.org/10.3389/fped.2015.00018
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author Earp, Brian D.
author_facet Earp, Brian D.
author_sort Earp, Brian D.
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description The Centers for Disease Control and Prevention (CDC) have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. I offer a critique of the CDC position. Among other concerns, I suggest that the CDC relies more heavily than is warranted on studies from Sub-Saharan Africa that neither translate well to North American populations nor to circumcisions performed before an age of sexual debut; that it employs an inadequate conception of risk in its benefit vs. risk analysis; that it fails to consider the anatomy and functions of the penile prepuce (i.e., the part of the penis that is removed by circumcision); that it underestimates the adverse consequences associated with circumcision by focusing on short-term surgical complications rather than long-term harms; that it portrays both the risks and benefits of circumcision in a misleading manner, thereby undermining the possibility of obtaining informed consent; that it evinces a superficial and selective analysis of the literature on sexual outcomes associated with circumcision; and that it gives less attention than is desirable to ethical issues surrounding autonomy and bodily integrity. I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy.
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spelling pubmed-43641502015-04-07 Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines Earp, Brian D. Front Pediatr Pediatrics The Centers for Disease Control and Prevention (CDC) have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. I offer a critique of the CDC position. Among other concerns, I suggest that the CDC relies more heavily than is warranted on studies from Sub-Saharan Africa that neither translate well to North American populations nor to circumcisions performed before an age of sexual debut; that it employs an inadequate conception of risk in its benefit vs. risk analysis; that it fails to consider the anatomy and functions of the penile prepuce (i.e., the part of the penis that is removed by circumcision); that it underestimates the adverse consequences associated with circumcision by focusing on short-term surgical complications rather than long-term harms; that it portrays both the risks and benefits of circumcision in a misleading manner, thereby undermining the possibility of obtaining informed consent; that it evinces a superficial and selective analysis of the literature on sexual outcomes associated with circumcision; and that it gives less attention than is desirable to ethical issues surrounding autonomy and bodily integrity. I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy. Frontiers Media S.A. 2015-03-18 /pmc/articles/PMC4364150/ /pubmed/25853108 http://dx.doi.org/10.3389/fped.2015.00018 Text en Copyright © 2015 Earp. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Earp, Brian D.
Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title_full Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title_fullStr Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title_full_unstemmed Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title_short Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines
title_sort do the benefits of male circumcision outweigh the risks? a critique of the proposed cdc guidelines
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364150/
https://www.ncbi.nlm.nih.gov/pubmed/25853108
http://dx.doi.org/10.3389/fped.2015.00018
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