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Introduction
Circumcision is the surgical removal of the foreskin of a male childs penile skin. In some African tribes, this ritual takes place in girls as well, namely, circumcision of the clitoris and the labia minora. However, this paper focuses on the procedure in males. Circumcision of newborn boys for medical or traditional reasons is widely practiced in North America and the Muslim world yet is rare in Western Europe and many other parts of the world. Most of the male population of the United States has undergone this procedure in their infancy. Nevertheless, the number of newborns undergoing this operation is reduced in the country, and now only 50 percent of parents decide in favor of circumcision. Presently, about 75percent of the male population of the USA is circumcised each year in US hospitals where more than a million of operations are carried out (Hebblethwaite, 2012). However, their number began to decrease because parents are increasingly abandoning this tradition. The US Centers for Disease Control and Prevention reports that 55-57 percent of newborn boys in the United States are subject to the operation while the number is reduced by one percent every year (Hebblethwaite, 2012).
Circumcision is regarded as a cultural, traditional, or medical indicator. In any case, it is an intervention in a very intimate area associated with the human body. As a rule, the expediency of circumcision causes the most heated discussions. On the one hand, some people strongly believe that circumcision is a health-enhancing measure or a cultural tradition that should be followed. On the other hand, others state that the infection can be prevented by adherence to the rules of hygiene and that circumcision violates the childs rights.
Human and Ethical Issues Surrounding Circumcision
Attention to the subject of male circumcision has brought up sentiments from the side of health communities and those who view the procedure as moral and ethical issues. Human and body integrity and respect are major concerns in our communities and have always been issues of high contention. Human respect for the disposition of what happens with their bodies is a subject of law and individual self-governance (Cagno & Gordon, 2012). The issue of circumcision has various platforms for an argument where some acknowledge the practice and advocate for it on the stance of religious and cultural freedom to exercise it, and others unequivocally censuring it.
The practice of circumcision takes place during the neonatal stage of the male, which understandably prevents the subject from consenting to the practice and consequently may oppose it later in life. The ethical issues imposed in the subject of circumcision are based on the potential psychological and sexual impact on a subject who is nonconsenting of the practice (Sorokan, Finlay & Jefferies, 2015). Regardless of related traditions and cultural values, medical professionals must adhere to ethical standards that weight the non-consensual mutilation of a minor for nonmedical reasons with that of the parents or guardians religious or cultural beliefs which can be said to be discriminated against if not respected.
Arguments For and Against
The subject of circumcision stems from religious convictions that approve of circumcision as a form of purification based on religious dogma. Other individuals also believe in the practice of circumcision, but lack the religious conviction to back their belief system about this practice. This group in the community contend that the scientific community has brought forth numerous studies that assert the advantages of circumcision; namely, it lessens the frequency of urinary tract infections, it lowers the incidence of sexually transmitted infections, such as the transmission of HIV and other STDs, and it might decrease the likelihood of cancer in this area.
Contentions against circumcision are also numerous and usually evoke differing emotions. Some contend that nature does not make errors in physiology and males are conceived uncircumcised because it was expected to be so. In men, the foreskin appended to the glans shields it from excrement, bacteria, and urine as well as, it keeps contaminants from entering the urinary tract. Including that circumcision is genital mutilation, subsequently, it abuses human rights (Simpson, 2012). Different assessments bolster that there is no therapeutic relationship in the United States or other parts of the world, that suggests circumcision as a medical form of therapy for any condition known to affect males. This part of the body assumes an imperative part in sexual pleasure where nerve endings must remain intact to function as intended to. Another important point to consider regarding the arguments against circumcision is the pain males experience when circumcised, even with anesthesia, the agony can be enduring. Also, surgery always poses various risks, for example, the risk for infection, disease, urinary issues, and in some cases, death (American Academy of Pediatrics Task Force on Circumcision, 2012).
Why Are People So Against it&Why Are Some So for It?
Circumcision, the act of cutting the foreskin of a childs penile skin off, is an issue, due to the nature of skin removal, pain, and arguable trauma from the pain that is involved with the process. Generally, the removal is done following birth at hospitals, but in some cases, it is done later in life. People have less commonly had their children circumcised in the recent past, due to information coming to light that there are no major (if any) health benefits to this custom, but it is still common. Moreover, in addition to the pain, the child may experience health consequences, such as major scarring, discomfort, and less awareness of themselves during sexual intercourse (Brady, 2016).
The main reason that people are against circumcision is because of these potential health consequences, while the pain involved arguably causes at least some extent of psychological trauma to the child. Adding to the trauma of birth, circumcision may be more frightening and painful to the child, as such a sensitive area is affected while the child is likely aware that they are losing a sensitive part of their body. Without the procedure involving anesthetics or potentially reducing their risk of disease, people commonly feel that continuing to circumcise children is a violent and unnecessarily traumatic ritual based on religion. Therefore, some may argue that continuing to do it is not only unintelligent, but it is a form of abuse (Svoboda, Adler, & Van Howe, 2016).
Meanwhile, people that continue to follow religious traditions for the sake of custom or faith feel that there is something about the process that is spiritually valuable to the child. Opinions regarding what exactly this spiritual benefit is may vary from person to person. Others may feel that there are health benefits to doing it, and the potential for these and slight ease in the ability to clean are worth the aspects of painful removal and living without the foreskin (Hainz, 2015).
Role of the Nurse in Relations to an Ethical Dilemma Involving Circumcision
Faced with an ethical dilemma of circumcision, a nurse is expected to understand the patients or their parents concerns, goals, and peculiarities. It is quite difficult to decide between the two issues and, as a rule, there is no perfect solution. It should be noted that some nurses refuse to take part in circumcision procedures due to their ethical principles. In this regard, the paramount issue for the nurse is to identify their attitude towards the dilemma. At the same time, it is not enough to decide as there is a need to thoroughly reflect on the issue. In such a situation, people tend to conflict becoming irritated or even aggressive. The role of the nurse is to act constructively (Sardi & Livingston, 2015). This means that the nurse should carefully listen to the patients noting any changes in their tone and body language and making adequate conclusions. At that, the nurse should guide the patients towards the decision but not to decide instead of them as it can lead to a deeper misunderstanding.
The ethical dilemma associated with circumcision requires a specific approach based on information provision. According to the research by Sardi and Livingston (2015), the nurses have the continuing ability to play an important role in the proxy consent process surrounding circumcision (p. 112). Therefore, it is of great importance to explain to parents the context of both decisions. In particular, potential risks, benefits, statistics, and other information related to the topic should be clearly explained. After that, using gentle questions, the nurse should make sure that the information was understood properly. Following the identified strategies, the nurse will promote parents decision-making in the context of this controversial issue.
Conclusion
In conclusion, it is worth noting that circumcision is a procedure of cutting the foreskin of a male childs penile skin. It was revealed that despite the wide popularity of male circumcision in the United States, there is a tendency to reduction of surgical interventions in the mentioned area. This primarily is caused by new studies and continuous debates around the topic. In particular, there are the two sides of the dilemma: supporters of circumcision claim that it is beneficial from the medical and traditional points while the opponents argue that this procedure violates the childs rights and causes pain affecting the psychological condition of the child. The first group of the community believes that circumcision decreases the risk of HIV and other urinary infections and prevents cancer in this area. Moreover, according to their religious and cultural beliefs, circumcision provides purification related to religious dogma. In turn, the second group of the community considers this procedure as one that can lead to potential health problems associated with psychological trauma as the procedure is provided without anesthesia and causes pain in neonates. Among potential physiological problems, one might note the risk of infection, urinary issues, and even death.
In this connection, the role of the nurse remains one of the most essential in assisting parents to decide. The nurse is to act accurately and taking into account that plenty of parents tend to doubt their intentions. Explaining both positive and negative outcomes of circumcision, the nurse can significantly help parents to come up with their solution. In turn, before deciding on the circumcision of their son, parents are to carefully evaluate all the advantages and disadvantages of the procedure and decide on their own.
References
American Academy of Pediatrics Task Force on Circumcision. (2012). Male circumcision. Pediatrics, 130(3), e756.
Brady, M. (2016). Newborn male circumcision with parental consent, as stated in the AAP circumcision policy statement, is both legal and ethical. Journal of Law, Medicine & Ethics, 44(2), 256-262.
Cagno, C. K., & Gordon, P. R. (2012). Neonatal circumcision. New England Journal of Medicine, 367(2), e3. Web.
Hainz, T. (2015). The enhancement of children versus circumcision: A case of double moral standards? Bioethics, 29(7), 507-515.
Hebblethwaite, C. (2012). Circumcision, the ultimate parenting dilemma. Web.
Sardi, L., & Livingston, K. (2015). Parental decision-making in male circumcision. The American Journal of Maternal Child Nursing, 40(2), 110-115.
Simpson, G. (2012). Male circumcision. Internal Medicine Journal, 42(11), 1282-1282. Web.
Sorokan, S. T., Finlay, J. C., & Jefferies, A. L. (2015). Newborn male circumcision. Paediatrics & Child Health, 20(6), 1.
Svoboda, J., Adler, P., & Van Howe, R. (2016). Circumcision is unethical and unlawful. Journal of Law, Medicine & Ethics, 44(2), 263-282.
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