Ethics of Circumcision - Circumcision To Reduce The Risk of HIV Infection

Circumcision To Reduce The Risk of HIV Infection

Rennie et al. (2007) remark that the results of three randomised controlled trials, showing reduced risk of HIV among circumcised men, "alter the terms of the debate over the ethics of male circumcision."

Supporters of circumcision argue that using circumcision and other available means to halt the spread of HIV is in the common good. They argue that the reduced risk of catching HIV and other alleged benefits of circumcision make it worthwhile. Rennie et al. argue that "it would be unethical to not seriously consider one of the most promising—although also one of the most controversial—new approaches to HIV-prevention in the 25-year history of the epidemic." However, there remains a risk of HIV while engaging in unprotected sex and other high risk behaviors.

The World Health Organization (2007) describes the efficacy of circumcision as "proven beyond reasonable doubt", but states that provision of circumcision should be consistent with "medical ethics and human rights principles." They state that "nformed consent, confidentiality and absence of coercion should be assured. ... 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."

Critics of non-therapeutic circumcision argue that advocating circumcision to prevent HIV infection may detract from other efforts to prevent the spread of the virus such as using condoms. They argue that a child's sexual behaviour as an adult is very difficult to predict, as is the future of HIV and treatment or prevention of AIDS. If the child chooses to remain celibate or if a couple remain faithful to each other, or if HIV is eliminated by the time the child is an adult, the surgery would not have been needed. Moreover, they argue that circumcising a child strictly to protect him from HIV infection may be seen as permission, or even entitlement to engage in dangerous sexual practices. Others would argue that baby boys do not immediately need such protection and can choose for themselves, at a later stage, if they want a circumcision.