People in liberal societies tend to feel a little uncomfortable talking about male genital cutting, but generally do not think it is morally abhorrent. But female genital cutting is widely consider...

This article addresses how bodily integrity has been mobilised in the context of genital cutting of male infants and the extent to which the concept is taken into account in legal decision-making in the United Kingdom. While bioethicists have debated whether interventions on children's bodies are more appropriately determined on the basis of hypothetical consent or in the child's best interest, it is clear that in law the relevant test is whether interventions are in the child's best interest. As the (...) issue of nonconsensual genital cutting of infants has become more contested, courts have been asked to adjudicate on the best interests of infants in situations where their caregivers disagree about procedures. Although this body of jurisprudence remains (surprisingly) small, in this article we argue that, while there are now discernible trends in such cases (e.g. deferring decision-making until the child has the requisite capacity to decide, engaging with certain human rights norms), too often judicial reasoning about a child's best interests remains largely empty of reasoned content, and in certain respects is regressing. Using the recent case of Re P to exemplify this logic, and drawing on our previous work advocating the value of embodied integrity, we argue that judges should adopt a more substantive framework of values in judging the child's corporeal and other interests in such cases. This would move best interests assessments beyond a mere formalistic exercise and lead to better reasoned legal judgements. (shrink)

Current General Medical Council guidelines state that any doctor who does not wish to carry out a non-therapeutic circumcision (NTC) on a boy must invoke conscientious objection. This paper argues that this is illogical, as it is clear that an ethical doctor will object to conducting a clinically unnecessary operation on a child who cannot consent simply because of the parents’ religious beliefs. Comparison of the GMC guidelines with the more sensible British Medical Association guidance reveals that both are biased (...) in favour of NTC and subvert standard consent procedures. It is further argued that any doctor who does participate in non-therapeutic circumcision of a minor may be guilty of negligence and in breach of the Human Rights Act. In fact, the GMC guidance implies that doctors must claim conscientious objection if they do not wish to be negligent. Both sets of guidelines should be changed to ensure an objective consent process and avoid confusion over the ethics of NTC. (shrink)

A UK doctor was recently acquitted of charges of reinstating a variety of female genital mutilation after delivering a child. In this paper, I contend that this incident reflects a broader confusion concerning the ethico-legal status of non-therapeutic genital surgeries for children and adults, which are not derivable from tenets of medical ethics, but rather violate them. I argue that medical professionals have an obligation to announce and address this confusion in order to motivate legislative reform, since the inconsistency of (...) the current law entrenches the underlying sexism and ethnocentrism upon which its sense depends. Without convincing arguments for condoning male circumcision and female cosmetic genital surgery and for treating adult women of colour as lacking the capacity to consent, the current legislation stands in need of urgent revision. (shrink)

This article deals with the specific claim that prophylactic male infant circumcision should be employed to prevent HIV transmission in countries in which the prevalence of HIV is relatively low. In a recent editorial, Australian researchers sought to promote the procedure as a ‘surgical vaccine’ against HIV in their country. This raises the question whether it would be reasonable for the UK to adopt a policy of mass infant male circumcision in order to protect individuals from heterosexually acquired infection with (...) HIV. A review of the relevant data and associated commentary indicates that the actual benefits of real-world circumcision policies to prevent HIV transmission are disputed and that circumcision, at best, provides partial protection. In addition, it is uncertain whether infant circumcision confers the same benefits that the adult procedure is proposed to provide. Reasons for performing circumcisions on infants include that the procedure is easier, less complicated and cheaper. However, it is not risk free. Despite arguments to the contrary, this article contends that it is morally problematic to operate on thousands of male infants each year for little benefit to children qua children. It is also argued that the use of the term ‘surgical vaccine’ to describe the procedure is both inaccurate and misleading. (shrink)