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The Draft CDC Circumcision Recommendations: Medical, Ethical, Legal, and Procedural Concerns

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The Centers for Disease Control and Prevention (“CDC”) is poised to recommend that physicians counsel the parents of every newborn boy and heterosexually active adolescent and man in the United States – approximately 36 million boys and men – that the benefits of circumcision outweigh the risks, that parents should take non-medical factors into account in making the “circumcision decision”, and that Medicaid should pay for it.The draft CDC recommendations are not medically correct, ethically sound, legally permissible or procedurally valid. Accordingly, they should not be implemented and would be legally invalid if they are. They provide erroneous and misleading advice to physicians that exposes them to the threat of lawsuits by men and parents. The CDC must revise its draft guidelines to comport with the correct and prevailing view in the Western world that circumcision is on balance deleterious to health; that men have the right to make the “circumcision decision” for themselves; that physicians are not permitted to circumcise healthy boys; and that it is unlawful to use Medicaid to pay for unnecessary surgery.

Affiliations: 1: Legal Advisor, Attorneys for the Rights of the Child, Berkeley, California, USA,


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1. cdc Background Materials. Background, Methods, and Synthesis of Scientific Information Used to Inform the “Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of hiv infection, stis, and other Health Outcomes”: .
2. Frisch M. et al, Cultural Bias, “"Cultural bias in the aap’s technical report and policy statement on male circumcision”", Pediatrics , Vol 131 (2013): 796800 (Criteria for Preventive Medicine).
3. Draft cdc Recommendations. Draft cdc Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of hiv Infection, stis, and Other Health Outcomes: .
4. Kupferschmid C. et al, European cdc Critique, Commentary on the cdc “Recommendations for providers counseling male patients and parents regarding male circumcision and the prevention of hiv infection, stis, and other health outcome (2015): .
5. Peer Review Plan. Peer Review Plan For Draft cdc Recommendations and The Background, Methods, and Synthesis of Scientific Information Used to Inform the Recommendations for Providers Counseling Male Patients And Parents regarding Male Circumcision in the Prevention of hiv Infection, stis, and Other Health Outcomes:.
6. Public Comments on Proposed cdc Circumcision Guidelines: .
7. Van Howe R. S., Van Howe Peer Review , “"A cdc-requested, Evidence-based Critique of the Centers for Disease Control and Prevention 2014 Draft on Male Circumcision: How Ideology and Selective Science Lead to Superficial, Culturally-biased Recommendations by the cdc"” (2015).
8. 1999 ama Circumcision Report. Council on Scientific Affairs. Report 10: Neonatal circumcision. Chicago: American Medical Association, 1999.
9. 1999 Hammond Poll. The National Organization to Halt the Abuse and Routine Mutilation of Males (noharmm) sent a survey to individuals who had previously contacted organisations opposed to circumcision. T. Hammond, “"Preliminary Poll of Men Circumcised in Infancy or Childhood"”, bju International Vol 83, Supp. 1, 8592 (1999): .
10. aap Policy, 2012, "American Academy of Pediatrics Task Force on Circumcision". Circumcision Policy Statement, Pediatrics, 130, no. Vol 3 (2012): 585586.
11. aap Technical Report, 2012, Technical Report, Male Circumcision, Task Force on Circumcision, Pediatrics, vol. Vol 130, No. 3, 1 September 2012, e756e785: .
12., Lower Your Sexual Risk of hiv (“Anal sex is the highest-risk sexual activity for hiv transmission”).
13. Bossio et al., (2014) (Bossio Review), “"A review of the current state of the male circumcision literature"”, The Journal of Sexual Medicine , Vol 11(12), 28472864, at 2853.
14. Boyle et al. (Boyle and Hill), “"Sub-Saharan randomised clinic trials into male circumcision and hiv transmission: Methodological, ethical and legal concerns"”, 19 J. Law. Med . 316334 (2011).
15. Boyle Psychosexual Sequelae (Boyle et al.), “"Male circumcision: Pain, trauma and psychosexual sequelae"”, J. Health Psychol . 2002; Vol 7: 329343.
16. Cold C. J., and Taylor J. R. (Cold and Taylor), “"The prepuce"”, bju Int 1999; Vol 83 Suppl. 1:3444.
17. Bundick S. (Bundick Critique), “"Promoting infant male circumcision to reduce transmission of hiv: A flawed policy for the us"”, Health and Human Rights Journal (31 August 2009).
18. "Canadian Paediatric Society", Canadian Paediatric Society, Circumcision: Information for Parents (November 2004).
19. Christakis et al., “"A trade-off analysis of routine newborn circumcision"”, Pediatrics , 2000; Vol 105(1 Pt. 3): 246249.
20. Doctors Opposing Circumcision (doc Critique), Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement: .
21. Position Dutch: Royal Dutch Medical Association, Non-therapeutic circumcision of male minors (2010).
22. Frisch M., and Simonsen J. (Frisch, Autism), “"Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark"”, J. R. Soc. Med. (8 January 2015).
23. Garber. S. T., The Circular Cut: Problematizing the Longevity of Civilization’s Most Aggressively Defended Amputation , Wesleyan University Thesis (2013).
24. German Critique: (translated).
25. Johns Hopkins Medicine, News and Publications, As Circumcision Wounds Heal, hiv-Positive Men May Spread Virus To Female Partners, Study Shows (28 April 2015).
26. Joudi M. et al (Joudi, Meatal Stenosis), “"Incidence of asymptomatic meatal stenosis in children following neonatal circumcision"”, J. Pediatr. Urol . Vol 7(5): 526528 (2011).
27. Learman L.A., “"Neonatal circumcision: a dispassionate analysis”", Clin. Obstet. Gynecol., 1999; Vol 42(4):849859.
28. Richters et al., “"Are Condoms the Right Size(s)? A Method for Self-Measurement of the Erect Penis"”, Venereology , Vol. Vol 8, no. 2 (1995).
29. Sorrells M. L.,, Snyder J. L.,, Reiss M. D. et al. (Sorrells, Fine-Touch), “"Fine-Touch Pressure Thresholds in the Adult Penis”", bju International , Vol 99 (2007): 864869, 864.
30. Taddio et al., (Taddio, Vaccination), “"Effect of neonatal circumcision on pain response during subsequent routine vaccination"”, The Lancet , 1997; 349(9052):599–603 (“Circumcised infants showed a stronger pain response to subsequent routine vaccination than uncircumcised infants”).
31. Poll Hammond, 2012, unpublished. Available from the author.
32. Van Howe R. S."(Van Howe, Meatal Stenosis), “Incidence of meatal stenosis following neonatal circumcision in a primary care setting”, Clin". Pediatr . 2006; Vol 45(1): 4954.
33. 18 U.S.C. Ch. 7, Sec. 116.
34. 42 usc 42 usc § 1396a(a)(10)(C).
35. 44 U.S.C. 3506(c)(2)(A) (“provide 60-day notice in the Federal Register”).
36. Adler Peter W. (Adler, Legal), “"Is Circumcision Legal?"”, 16 Rich. J.L. & Pub. Int . 43983 (2013).
37. Adler Peter W. (Adler, Medicaid), “"Is it lawful to use Medicaid to pay for circumcision?"” 19 J. Law. Med . 33553 (2011).
38. ama Code of Medical Ethics, Opinion 8.03, Conflicts of Interest: Guidelines.
39. American Academy of Ophthalmology, Advisory Opinion of the Code of Ethics, Unnecessary Surgery and Related Procedures (2008): .
40. American Academy of Pediatrics, Informed Consent, Parental Permission, and Assent in Pediatric Practice (aap Informed Consent), 95 Pediatrics 314, 315 (1995).
41. arc Judgments and Settlements. See <>.
42. Armstrong v. State, 989 P.2d 364 (Mont., 1999).
43. Doe Beal v., 432 us 438 (1977).
44. Brigman William E., “"Circumcision as Child Abuse: The Legal and Constitutional Issues"”, 23 J. Fam. Law . 337 (1985).
45. Burden of Proof. See generally: .
46. cdc Mission, Role and Pledge: .
47. Affidavit Diekema, Plaintiff’s Reply Memorandum of Law, Superior Court of Washington in and for Jefferson County (Diekema Affidavit), (18 January 2006) (available from the author).
48. Diekema et al., Clinical Ethics in Pediatrics, A Case-Based Textbook (2011), (Diekema Clinical Ethics).
49. Earp B. (Earp, Critique of the cdc ), “"Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed cdc Guidelines"”, Front in Pediatr 2015; 3: 18 (2015). doi: 10.3389/fped.2015.00018: .
50. First Amendment and Religion. See generally: .
51. Executive Order 13563. Improving Regulation and Regulatory Review (18 January 2011).
52. "German Case. Landgericht Köln; 7 May 2012; Urteil Ns 169/11".
53. Heyman S., “"The First Duty of Government: Protection, Liberty and the Fourteenth Amendment"”, 41 Duke L.J. 507 (1991); Equal protection, Legal Information Institute, Cornell University Law School.
54. hhs Guidelines for cdc. hhs Information Quality Web Site, Guidelines for Ensuring the Quality of Information Disseminated to the Public, D. Centers for Disease Control and Prevention: .
55. Merkel R.,, Putzke J. (Merkel, Criminal Assault), "J. Med. Ethics, “After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault?"”, British Medical Journal (4 June 2013).
56. New Hampshire Criminal Statute. New Hampshire rsa 167:61-a (‘1. It is a felony crime when a Medicaid provider—with intent to defraud—2. Submits a false claim for payment; submits a claim for a good or service that was not medically necessary according to professionally recognized standards.’).
57. omb Final Information Quality Bulletin for Peer Review, (omb Quality Bulletin): .
58. Massachusetts Prince v., 321 U.S. 158 (1944).
59. Royal Dutch Medical Association, Non-therapeutic circumcision of male minors (2010): .
60. Schweiker v. Hogan , 457 us 569 at 573 (1982), citing 42 usc 42 usc § 1396a(a)(10)(C).
61. Svoboda et al. (Svoboda, Fatal Flaws), “"Out of step: fatal flaws in the latest aap policy report on neonatal circumcision"”, J. Med Ethics (2013) (a critique of the similar 2012 aap circumcision policy statement).
62. Svoboda J. (Svoboda, Human Rights), “"Circumcision of male infants as a human rights violation"”, J. Med. Ethics 2013;Vol 39:469474 doi:10.1136/medethics-2012-101229.
63. Svoboda et al. (Svoboda, Unethical and Unlawful) “"Circumcision is Unethical and Unlawful," The Journal of Law, Medicine & Ethics (accepted for publication in 2016 after peer review).
64. Tortorella v. Castro , 140 Cal.App.4th 1, 43 Cal.Rptr.3d 853, Cal.App. 2 Dist. (2006).
65. Union Pacific Railway Company v. Botsford, 141 U.S. 250 (1891).
66. bbc News. German court rules circumcision is ʻbodily harm’, bbc News 26 June 2012: .
67. Papal Bull. Pope Eugene iv, The Council of Florence (A.D. 1438–1445) From Cantate Domino – Papal Bull of Pope Eugene iv (16 March 2005).
69. unaids, Male circumcision, Global trends and determinants of prevalence, safety and acceptability, unaids.
70. Washington Times:.

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