By Nathan Risinger

To snip, or not to snip?  That seems to be the question.  Over the past several months there has been a great deal of discussion about religious circumcision.  In a recent ruling, a court in Cologne, Germany axed the legal protection that circumcision had previously enjoyed.  Circumcision immediately following birth, ruled the court, violates the rights of the infant male. Now, the devout are caught in an ethical conundrum.  Do they obey the law of the state? Or do they obey what they see as the law of God?

Circumcision as a religious practice has been around for millennia.  It is one of the primary male identifiers of several Abrahamic faiths (most notably Judaism and Islam).  The first mention of the rite occurs fairly early within the Old Testament, with God saying to Abraham, “…This is my covenant, which ye shall keep, between me and you and thy seed after thee; Every man child among you shall be circumcised.” (Genesis 17:10).  The practice crops up throughout the Old Testament, and is also mentioned in the New Testament (John 7:22).  Also, while it is not explicitly mentioned in the Qur’an, the practice, called Khita in Arabic, is referenced in the hadith.

More recently, circumcision has become a medically-accepted procedure in the West.  Beginning in the second half of the twentieth century, it became commonplace in the US for hospitals to perform the procedure on newborn male infants.  It was seen as a matter of health and hygiene, and thus also entered into the medical realm.  Over the ensuing decades circumcision became a common and widely-accepted procedure in the US and was seen as an integral part of male health.

In the last decade or so, the procedure has dropped off sharply, with only 32.5% of male infants in the US being circumcised in 2009, compared with 56% in 2006.

Thinking about circumcision medically, there are both potential risks and benefits associated with the procedure.  Circumcised men are, according to the American Academy of Pediatrics (AAP), at a decreased risk from both penile cancer and urinary tract infections;

There has also been research showing circumcision can help prevent the spread of HIV/AIDS.  A recent report by the World Health Organization (WHO) found that circumcision could decrease infection in men by as much as 60%. Only last month several members of Zimbabwe’s parliament elected to become circumcised in an effort to raise awareness regarding the procedure’s potential effectiveness.  The current debate, however, focuses on developed Western countries, and circumcision as a religious rite, not as a preventative measure against the spread of HIV.

The risks associated with circumcision are primarily minor, and linked to the mechanics of the actual procedure (infection, bleeding, etc.), and less with long-term outcomes. The AAP holds that there is not a strong enough body of empirical medical evidence to make the case either way.  Therefore they leave the choice up to the discretion of the parents.

The German ruling on circumcision presents complex and nuanced questions about government involvement in religious activities. The government is stepping into a field where it arguably has no business (the religious beliefs of its citizens), yet it is doing so in order to protect the interests of vulnerable individuals (a perfectly reasonable governmental activity).  The case is different from the more common complaints about overbearing federalist systems usurping individual liberties.  Instead, here we have an interesting clash between the rights of different individuals (the infant and the parents – who also have very special relationship with each other), and the right (or obligation) of the government to intervene.

After the ruling, German Chancellor Angela Merkel issued comments condemning the decision, and advocating religious freedom.  In a country that champions the freedom of individuals, both in terms of their bodies (the freedom of choice to change, or not to change their physical appearance), and also their minds (the freedom to believe what they want, be it a religious creed, a political dogma, or just bad science), which comes first: religious freedom or the physical freedom of the body?  Also, whose freedoms come first? Those of the child? Or those of the parent?

Most would support limits to how far governments can go in regulating how parents raise their children.  Obviously, in cases of abuse or neglect the government has an obligation to protect children. But, circumcision does not seem to fall into either category.  Why not? Simply put, the risks associated with male circumcision seem to fall short of abuse. Unlike forms of female circumcision, or the bloodless surgery promoted by Jehovah’s witnesses, male circumcision does not typically result in permanent physiological or psychological harm to the child.

Circumcision is not the only practice that falls into this moral (and medical) gray area.  Different cultures practice different traditions, and there has been a long history of parents making choices for their children that could potentially be seen as a violation of the children’s rights.  In addition to the example mentioned above, one that comes to mind is the Chinese tradition of foot-binding, where the growth of a girl’s feet was deliberately stunted for aesthetic reasons.  First outlawed in China in 1912 the practice has lost almost all of its popularity over the last century, and is now seen as a barbaric, and cruel, abuse of young women.

There are also less harmful (and less controversial) physical modifications that are engaged in without the consent of the child.  For example, the Latino communityin the US practices the piercing of female children’s ears when they are merely weeks old.  Pierced ears aren’t nearly as controversial as bound feet.  Why? Because there is a significant demonstrable harm affiliated with bound feet that is simply not there with pierced ears.  It is the same question of permanent harm that we see in the circumcision cases.  Without a lasting, and debilitating outcome there does not seem to be a strong medical case to ban a procedure.

Returning again to circumcision as a medical intervention, it is common practice for parents or guardians to make medical decisions for their children. The ambiguity around circumcision as a medical procedure, at the very least, does not present a strong medical case for prohibiting circumcision of infants as a religious practice.

According to the BBC, the ruling in Cologne stated that, a child’s right to physical integrity trumped religious and parental rights. The concept of “physical integrity” is key.  Integrity seems to lose some of its moral weight when there are no significant demonstrable harms being foisted upon the child. We would find it laughable if someone claimed that giving a child a haircut without informed consent was unacceptable, as it would constitute a threat to that child’s physical integrity. Without the presence of significant harm the concept of physical integrity is relegated to the realm of the trivial.

After the court issued its’ ruling there was a wave of outcry from several religious communities.  Jewish and Islamic advocacy groups united in an attempt to have the ruling overturned.  This unusual alliance may be the proverbial silver lining of the entire affair.  It seems as if Jews and Muslims have found a common cause in a shared threat, the German judicial system.

Nathan Risinger, B.A., is a research assistant at the Johns Hopkins Berman Institute of Bioethics.  He is interested in the concept of free will, especially in relation to the possibility of objective moral truths.

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