[6] Generally, circumcision on a minor is not ethically controversial or legally questionable when there is a clear and pressing medical indication for which it is the accepted best practice to resolve.
Where circumcision is the chosen intervention, the physician has an ethical responsibility to ensure the procedure is performed competently and safely to minimize potential harms.
Additionally, this procedure does not present substantial harm compared to its potential benefits, so parents should be allowed full decision-making capacity as long as they are educated properly.
[12] The Danish Medical Association (Lægeforeningen) has released a statement (2016) regarding the circumcision of boys under the age of eighteen years.
[13] According to Dr. Lise Møller, the chairwoman of the Doctors' Association's Ethics Board, allowing the individual to make this decision himself when he is of age respects his right of self-determination.
The KNMG argues against circumcising male minors due to lack of evidence the procedure is useful or necessary, its associated risks, and violate the child's autonomy.
[18] The medical doctors at Sørland Hospital in Kristiansand, Southern Norway have all refused to perform circumcisions on boys, citing reasons of conscience.
Since circumcision has associated risks with, in their view, no unequivocally proven medical benefits, they advise physicians to keep up with clinical evidence and only perform this procedure if it is in the child's best interest.
[20] Commenting on the development of the 2003 British Medical Association guidance on circumcision, Mussell (2004) reports that debate in society is highly polarized, and he attributes it to the different faiths and cultures that make up BMA.
[21] In a paper published June 2006, the British Medical Association Committee on Medical Ethics does not consider circumcision of an adult male to be controversial, provided that the adult is of sound mind and grants his personal consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.
[23] In the same British Medical Association paper, circumcision of a child to treat a clear and present medical indication after a trial of conservative treatment also is not considered to be ethically questionable, provided that a suitable surrogate has granted surrogate consent after receiving all material information regarding the known risks, disadvantages, and potential benefits to be derived from the surgical operation.
[25] British law professors Fox and Thomson (2005), citing the House of Lords case of R v Brown, challenged this statement.
Frisch et al. further comment: "The AAP report lacks a serious discussion of the central ethical dilemma with, on one side, parents' right to act in the best interest of the child on the basis of cultural, religious, and health-related beliefs and wishes and, on the other side, infant boys' basic right to physical integrity in the absence of compelling reasons for surgery.
"[29] Van Howe and Svoboda (2013) criticize the AAP's statement because they believed that it failed to include important points, inaccurately analyzed and interpret current medical literature, and made unsupported conclusions.
[31] In August 2017, the American Medical Association Journal of Ethics featured two separate articles challenging the morality of performing non-therapeutic infant circumcision.
[32] He states that this decision should be considered in the context of benefit vs risk of harm, rather than simply risk-benefit due to the non-therapeutic nature of the procedure.
[34] The symposium published the original version (2003) of the BMA policy statement and six articles by various individuals with a wide spectrum of views on the ethicality of circumcision of male minors.
[36] Short (2004) disputes Hutson's claims and argues that male circumcision has future prophylactic benefits that make it worthwhile.
He believes that as a result of living in a developing world, we have the facilities that enable this surgery to take place without "physical cruel nor potentially dangerous".
He suggests that medical professionals, and bioethicists especially, "must take as their starting point the fact that reasonable people will disagree about what is valuable and what is harmful.
[39] Mussell (2004) examined the process by which the BMA arrived at a position on non-therapeutic circumcision male minors, when the organisation had groups and individuals of different ethnicities, religion, culture, and widely varying viewpoints.
The BMA produced a document that set forth legal and ethical concerns but left the final decision on whether or not to perform a non-therapeutic circumcision to the attending physician.
[49] Fox and Thomson (2005) state that in the absence of "unequivocal evidence of medical benefit", it is "ethically inappropriate to subject a child to the acknowledged risks of infant male circumcision."
[50][51] The process is irreversible, has no medical justification in most cases, and is performed on minors unable to give their own permission, according to the committee.
[52] The World Health Organization (2007) states that provision of circumcision should be consistent with "medical ethics and human rights principles."
... Parents who are responsible for providing consent, including for the circumcision of male infants, should be given sufficient information regarding the benefits and risks of the procedure in order to determine what is in the best interests of the child.
Moreover, they argue that circumcising a child purportedly to partially protect him from HIV infection in adulthood may be seen as granting permission to engage in dangerous sexual practices.
[57][58] The Committee on Bioethics of the AAP (1995) states that parents may only grant surrogate informed permission for diagnosis and treatment with the assent of the child whenever appropriate.
[45] The Canadian Paediatric Society (2015) recommends that circumcisions done in the absence of a medical indication or for personal reasons "should be deferred until the individual concerned is able to make their own choices.
"[12] Regardless of these issues, the general practice of the medical community in the United States is to receive surrogate informed consent or permission from parents or legal guardians for non-therapeutic circumcision of children.