life, liberty, and bodily integrity: thoughts on routine infant circumcision

A while back, I shared this blog post on Twitter:

the only necessary argument against routine infant circumcision

Although I’ve lost track of the @replies, I recall that there was significant pushback from a couple of my followers, and so I wanted to say more about the issue.

Basically the argument offered at L’Hôte is this:

“In a free society, individuals are free to make their own choices. And they should particularly be free to make their own choices about their bodies. Any adult man is fully free to go get a circumcision if he wants one. (The fact that none do, outside of the coercion involved in religious conversion in order to get married, should tell you something.) Men who were circumcised as infants are denied that right. One position in this debate increases human autonomy and human liberty, and one restricts it. To oppose routine infant circumcision, you don’t need to be convinced by the arguments against circumcision! You only need to recognize the right of the individual to make his own choice and to have sovereign control over his own body.”

Now let’s recognize at the outset that even the seemingly clear call to give individuals freedom of choice regarding what happens to their own bodies cannot have as straightforward of implications as we might like. On any reasonable moral theory, parents have duties to care for their children, and this will inevitably involve doing things to those children’s bodies well before they are capable of giving informed consent.

Where to draw the line as to which parental actions are liberty-compatible and which are liberty-violating will be tricky and controversial. But to refuse to take a middle position, however subtle, is absurd, given that the remaining options are to claim either that all parental actions towards children are morally permissible, or that none are. The former treats children as mere property, the latter treats children as adults; neither is appropriate.

Using bodily integrity as a guide to which parental actions are morally permissible gives us a way to think about concrete cases, but it doesn’t readily solve them because all of the middle ground between the extreme positions is murky. What constitutes “liberty” is contestable, and even many of the most ardent supporters of individual liberty recognize that it is not the only value worth pursuing. The criteria of bodily integrity definitely suggests, however, that we are to err on the side of leaving children’s bodies alone.

I think it best to understand the permissibility of actions like circumcision as a function of two primary factors: the invasiveness of the proposed action, and what’s at stake in performing it, or not. So, take two examples that readily arise in this context: vaccinations and ear piercing. In the case of childhood vaccinations like that against polio, what’s at stake can be whether or not a child will become immune to a life-threatening disease. There is a risk that the vaccination will have adverse effects, even death, but we can roughly compare the threat of these to the threat of the disease in order to reach a rationally defensible decision regarding the vaccinations. The vaccination is somewhat invasive, being permanent and possibly dangerous, but there is sometimes alot at stake. So vaccinations, depending on the particulars of the vaccine, disease, and child, are often justifiable. The liberty to be free from nonconsensual medical procedures doesn’t mean anything to the victims of easily preventable childhood diseases, after all.

Take now the case of ear piercing. This procedure ranks low both in terms of invasiveness and what’s at stake. Most ear piercings will heal without incident if the piercee later decides (s)he doesn’t want them, but their value is simply cosmetic. Some cosmetic procedures, such as reconstructive surgery for this kid, may stand to dramatically improve children’s current and future quality of life but ear piercing?… not so much. So I would say in this case that parents can and should err on the side of bodily integrity by refraining from piercing their children’s ears until at least such time when the children say that they want the piercings (they may later change their minds, but anyway so do adults). This implication of the bodily integrity view seems ridiculous to some, who take for granted the permissibility of ear piercing and would discount any theory prohibiting it. However, I hasten to add that since ear piercing is minimally invasive and generally reversible, parents do their children no gross wrong in having them pierced without consent.

I understand that the vast majority of parents love their children and have no interest in doing them harm. Of these parents, those who chose routine infant circumcision do so for at least comprehensible reasons: faith, culture, tradition, cleanliness, whatever. But, when bodily integrity is at stake, the bar of justification for parental action is set much higher than these reasons can reach. We do not generally accept religion or culture as properly justifying what would otherwise count as the physical abuse of children, and the procedure by many accounts lacks significant hygienic value. Bottom line: routine infant circumcision – like childhood vaccination – is invasive and irreversible, but – unlike childhood vaccination- is without equally as weighty values at stake. Considerations of religion and culture may explain why so many parents do in fact chose routine male circumcision, and they explain why so few men subjected to it feel victimized, but they do not morally justify the practice.

8 Comments

  • Lillian Gwen Taylor wrote:

    My question is this: if male circumcision is acceptable, why is female circumcision not equally acceptable? Why condemn one and permit the other? What accounts for this double standard?

  • Like I said, female circumcision is potentially less acceptable than male circumcision because it is more invasive, and there is no medically important reason offered in favor for it. And if there is good reason to believe that the two practices are relevantly dissimilar, then it’s not necessarily a double standard to permit one but condemn the other.

  • Lillian Gwen Taylor wrote:

    But IS female circumcision any less invasive than male circumcision? And IS male circumcision really as medically beneficial as some of its proponents argue?

  • I think you meant “is female circumcision any *MORE* invasive than male circumcision” – the answer to that one is, as it is practiced, almost always yes (with the exception of the American pediatricians’ concession to female circumcisers, a ‘ritual nick’). The answer to the second question is probably no, from what I understand, but even if MC is *not* medically necessary judging from the evidence, it’s still less bad of a harm because it’s less invasive.

    But in any case, these are essentially factual questions upon which the moral judgments rest, which I am happy to admit. I will follow my arguments where they lead factually, even if that were to change.

  • You have considerable talent in forming clear and rational arguments.

  • I think there is sound reasoning for male circumcision which has got lost through the centuries.

    Female circumcision on the other hand, in my opinion, is meant exclusively to deprive a woman the possibility of sexual pleasure. Among rationalizations for female circumcision are that it eliminates excessive libido and improved hygiene. Consequently there is absolutely no comparison between the two.

    I just wanted to point out that those reading this post and it’s responses may want to look-up on the co-relationship between uncircumcised males and penile yeast infections or Candida Balanitis.

    Usually yeast infections are thought of as occurring in women only. But in men it can become a really serious health issue, both reproductively and otherwise.

  • Biraj, almost a year ago, argued that the reasoning for male circumcision got lost through the centuries, but female circumcision is meant exclusively to deprive a woman from sexual pleasure.

    In the case of “medical” circumcision practiced in English speaking countries (and now almost exclusively in the U.S.), we have documentation of the reasoning that started male circumcision. See for example the following quote from 1915:

    “Circumcision not only reduces the irritability of the child’s penis, but also the so-called passion of which so many married men are so extremely proud, to the detriment of their wives and their married life. Many youthful rapes could be prevented, many separations, and divorces also, and many an unhappy marriage improved if this unnatural passion was cut down by a timely circumcision.” L.W. Wuesthoff, MD. Benefits of Circumcision. Medical World, (1915) Vol.33. p.434.

    (“Irritability” is meant to express the attraction that causes the child to touch himself) In other words, the rationale was exactly that which Biraj attributes to female circumcision, to “cut down this unnatural passion”.

    The degree of invasion of circumcision is difficult to measure. For one, it eliminates the possibility of gliding the skin, and it does so by design. The foreskin is meant to glide, it’s removal destroys this.

    Biraj also brings attention to candida balanitis. Well, it’s clearly better to understand the causes of a disease or condition rather than eliminate the part of the body to eliminate the disease or condition. Among other reasons, candida balanitis can be related to excessive consumption of sugar, diabetis, meatal stenosis (which is often a complication of circumcision) and use of harsh soaps on the penis.

  • I see that Pamela also argued that “female cir­cum­ci­sion is poten­tially less accept­able than male cir­cum­ci­sion because it is more inva­sive”.

    I disagree with this statement. For one, female circumcision as practiced in Malaysia and Indonesia is often less extensive – and is also practiced during the new born period, in clinics and in sterile condition. However, this practice itself is also condemned by the U.N.

    The U.N. in condemning FGM did not state that some forms were acceptable and some were not. They lumped all forms of FGM in a single package condemned and destined to eradication. This clearly means that it’s not the degree of invasion what justifies or not the practice. FGM is seen as an attack on female dignity, on female body, and on her right to consent (nevermind that teenage African girls sometimes submit voluntarily to it, or that Western women do the same by seeking Female Genital Cosmetic Surgery – which was called “female circumcision” just thirty years ago).

    As for medical criteria, we all have seen the rationalization of FGM as hygiene, reducing secretions (smegma), reducing inflammation, etc. And there are also at least two studies linking female circumcision to less prevalence of HIV. So the argument that there are no medical benefits could be equally said of male circumcision, as there are those who will argue that there are.

    The acceptance of male circumcision vs. female circumcision is a matter of us vs. them. It is clear that those who practice FGM condemn the hypocrisy of the West in requiring them to abandon their practice while still subjecting male infants to a similar procedure; and it’s also clear that almost all cultures where FGM occurs also perform MC.

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