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To Circumcise or Not to Circumcise?


WebMD Health News

Feb. 27, 2001 -- Deciding if your son should be circumcised isn't a decision to be taken lightly, yet many parents may make this literally life-altering move without getting the information they deserve, some experts warn.

About 77% of men born in the U.S. have the operation that removes the penis' foreskin, according to the 1997 National Health and Social Life Survey. The procedure generally is performed within a couple of days of birth and is less risky if performed early in life, yet an increasing amount of parents are requesting the surgery when their babies are 2 to 6 months old.

Children's Hospital Los Angeles associate chairman of pediatrics Robert Adler, MD, MsED, wondered why the option was being considered so late in a child's life. So he and his colleagues launched a study of parents' attitudes about circumcision and their level of satisfaction in deciding to have or not have the operation for their sons. Results of the investigation were published in this month's issue of the journal Pediatrics.

"The reason we're seeing a lot more parents asking for circumcision later is that they aren't getting adequate information from their doctors," Adler tells WebMD. "We're just not doing such a good job of talking to the families and the moms about this."

This is a form of denying the parents informed consent, says Adler, who also is University of Southern California pediatrics vice chairman.

The American Academy of Pediatrics' policy on circumcision states "parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision." Despite this, according to Adler's study, many parents are not given the knowledge they need to make the determination or are receiving it too much too late or at an inappropriate time.

In the survey, three-quarters of the parents whose sons were circumcised said they believed that their doctor gave them enough information, whereas only half of those who didn't have their babies circumcised felt they were well-enough informed.

Adler says this means the parents are often making the decision for circumcision "by default," and in many cases the obstetrician or pediatrician had not even talked with them about it.

"I think they need to be talked to by the obstetrician before the birth, especially if this is their first child," he says. "If it's their second child and they have an ongoing relationship with a pediatrician, then they should talk to that physician."

Though almost 36% of the participants in the study said they were asked before their babies' birth about their decision to circumcise or not, 14% said the first time they were questioned was in the delivery room.

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