Pros And Cons Of Circumcision

Controversy Surrounding Circumcision For male population either newborn or adult, does circumcision offer medical health benefits on individuals? There are a lot of arguments over the issue of circumcision and researchers are working on finding an answer to prove its effectiveness on individual’s health. The author believes that circumcision is a safe procedure and its benefits to one’s health is substantial. Below are the information and facts pertaining to the legality of circumcision, the procedure, the risk, and its health benefits. What is circumcision? Male circumcision is a surgical procedure that removes the foreskin of the head of the penis. This procedure has existed for many years and has been in practice by many cultures around
the world for religious reason, family tradition, and as part of introduction into adulthood, particularly in Africa (Buie, 2005). The majority of Muslim and Jewish people practiced circumcision as part of their religious tradition. The procedure is permanent and the child has to live with it for the rest of his life, whether he likes it or not. Advocates for non-circumcision are protesting the government to ban circumcision due to the fact that circumcision has no proven health benefits on individual’s health. According to American Academy of Pediatrics, there are some valid reasons that support the health benefit of performing circumcision on male infants but research hasn’t shown sufficient data to implement new provision on routine neonatal circumcision (AAP, 2012). Although there hasn’t been a conclusive evidence that shows enough information about its health benefits, it is still a good practice to circumcise a male child, which makes it easier to maintain good hygiene.
Law and Ethics of Circumcision People are wondering if circumcision is legal and if there are guidelines and requirements needed in order to perform such procedure. It has been an issue in America, whether or not to alter human body parts, as with male circumcision. Critics are opposed to the idea of subjecting a newborn to pain and mutilation. Presently, circumcision is legal in all 50 states, but circumcision has dropped dramatically in the US due to the fact that people do not think that it is a necessary procedure for their newborn to endure. Furthermore, babies who were born to Latin Americans contributed to the low numbers of circumcision in the US where majority of Latin American immigrants do not practice circumcision (Jia, L. et al., 2009). The National American Medical Association states that “ the associations have never recommended non-therapeutic circumcision; since 1971 they have continuously asserted that parents have the right to make the circumcision decision for religious, cultural, or personal reasons” (Adler, 2013).
Therapeutic Circumcision In the presence of medical condition, it is highly recommended that male individual undergo the procedure to correct the medical issues. Some common problems with male genital are: phimosis, paraphimosis, and balanitis. Phimosis is the failure of foreskin to retract which can be difficult to clean and may result in infection. On the other hand, paraphimosis is the opposite of phimosis, the foreskin will not pull over back the head of the penis. Balanitis is the swelling of the head of the penis which can be caused by poor hygiene (Milos, M. F. & Macris, D., 1992). As the author mentioned earlier, circumcision promotes good hygiene and prevents a male child from having an infection. The foreskin of the penis is susceptible to infection especially if not clean properly.
Non-Therapeutic Circumcision The attitude of non-therapeutic practice of circumcision varies among different cultures. As with neonatal surgery it is still considered as elective and non-therapeutic surgery. Parents should be informed of the pros and cons and let them decide what is best for their child, but advocates for non-circumcision asserted that parents should wait until the child is able to understand the procedure and have the child get involved in making the decision (Milos, M. F. & Macris, D., 1992). Advocates may be right but it is still parents’ absolute power to make the decision for their child to undergo circumcision, either it is based on culture, religious belief or simply believing its health benefits through research findings.
The Procedure For minors, parental consent is needed before the procedure has to take place. By law, health professionals and licensed religious individuals can perform circumcision on newborn infants. The doctor will either use one of the three instrument: GOMCO clamp, the Plastibell, or Morgen clamp. During the procedure the baby is awake, the penis area is cleansed, and the doctor will assess the amount of skin to be cut. Then, the doctor will widen the preputial orifice, separate the foreskin from the penis glans, place the penis on the device, and cut the foreskin of the penis (Buie, 2013). In the past, according to Adler, “the prevailing medical opinion was that infants do not feel pain, or not to the same degree as adults, and operations on children without anesthesia were commonplace in 1999, however, some American medical associations stated that neonatal circumcision is painful and that anesthesia should be used” (Adler, 2013). Even though the steps of the procedure seem painful, its result has a lifetime benefits.
The Risk of Surgery As with any other surgeries, circumcision has its own risk but minimal compared to other invasive surgeries. A study conducted on 100,157 circumcised infant males, 193 infants were reported to suffer from complications and 85% of the complications were done by traditional or medically untrained individuals. Hemorrhage is the most common complication noted, at 0.1% to 35%, meatitis and meatal stenosis at 8% to 20%, and infection at 10%. Glans amputation is considered the most serious complication but this complication rarely happens, which would need grafting to correct the problem (Buie, 2013). Complications is very common in any kind of surgeries but there are no reported incidence of mortality rate of circumcision. If the procedure is done correctly and after care education is given to family then recovery and healing should be fast and smooth.
Health Benefits According to American Academy of Pediatrics, “New evidence points to greater benefits of infant circumcision, but final say is still up to the parents” (AAP, 2012). The following health benefits are mentioned in their website: decrease the risk of contracting HIV, genital herpes, HPV, syphilis, penile cancer, cervical cancer in sexual partners, and decrease the risk of urinary tract infections. Also, circumcision decreases the occurrence of infection of the head of the penis and eases the problem relating to the constricted foreskin (AAP, 2012).
Nursing Implications It is important for the nurse to respect parents’ autonomy of care for their child and whatever reason they may have in mind for having their baby undergo circumcision.
The reason could be based on morality principle that dictates parents to continue their cultural, traditional, or religious views and practices. Before the procedure, the nurse must ensure that consent is signed and that the parents understand the procedure that their newborn son is going to have. If questions arise and need further clarification, the nurse must call the attention of the doctor to clarify the issue. After the procedure is done and the baby is ready to be discharged, it is vital for the nurse to give education to the parents on how to care for their newborn at
home.
Personal Opinion When I had my first male child, I never thought that circumcision became an issue with my husband.
In my opinion, circumcision is a family tradition and part of my culture to circumcise male child. Circumcision is preferably done between seven and twelve years of age. There are different places that parents and boys can go to have the procedure done. For example, clinic, hospital, but in rural villages where clinic is far and money become an issue, they go to a local “Manunuli” (experienced individual), who uses a knife and herbs for treatment. Also, part of the treatment is to bathe in the sea to help speed up the healing process. The procedure is typically done during summer time when school is closed. For the boys it is a fun and challenging event of their lives. They would rather go through the process of initiation to manhood, feeling strong and tough than being mocked and teased by peers. I never heard an issue of any complications brought by circumcision. On the other hand, my husband’s culture does not believe in circumcision. The dilemma about circumcision made me mad and sad but my husband being the head of the family has the authority to make the decision. When my son was six years old, he developed an infection on his penis and I told him that if he had circumcision he would not have this problem. I explained everything to him that by the time he turned 18 he can make the decision to undergo the procedure. My son and I have an agreement not to talk about
circumcision with his cousins and relatives in the Philippine because it is a disgrace to break a tradition. I believe that circumcision is a cosmetic procedure that is available to those who believe on its benefits and effectiveness. I would not want my kids to undergo a procedure without knowing its purpose.
Conclusion
The author believes that the benefits of having the procedure done on male infants and adults outweigh the danger everyone is thinking of. Research studies have shown that most of the complication arises due to poor performance of an inexperience provider or licensed individual. Circumcision promotes good hygiene and therefore protects individual from infections or inflammation. The idea of losing a body part due to circumcision is an individual’s choice and should not be judged.