Against Circumcision, pt. 2 (by Connor Kianpour)

This is the second of two posts where I have teamed up with a friend and colleague, David Simpson, to address our problems with circumcision. If you’re interested in contacting David, reach out to him via email at dsimpson17@student.gsu.edu. 

Suppose that you are a doctor who is responsible for helping nurse an 8-year-old patient with leukemia back to health. Your expertise tells you that, without a blood transfusion, this 8-year-old girl will die. You find out, however, that the girl has parents who are Jehovah’s Witnesses. Jehovah’s Witnesses believe that it is morally impermissible to receive blood, and so a choice must be made between respecting the religious convictions of parents and promoting the medical interests of children. Which should be the priority here? 

Someone reading this may gawk at such a question, since the answer seems so obvious: We should prioritize the lives of children over the religious beliefs of parents. Still, I think it is a fair question to ask, since there are many scenarios in which the interests of children do take a backseat to the religious beliefs of parents. Generally, people think it is permissible for parents to drag reluctant toddlers to Church on Sundays even if they express dissent. People also generally find it permissible for parents to forbid their children from dating until the age of sixteen, even if they have found somebody they feel strongly about dating. 

Perhaps what differentiates the blood transfusion case from the cases just mentioned is the fact that the child’s life is at stake in the former. But does this mean that we can only prioritize children’s interests over the religious beliefs of parents when it is likely the child will die if the religious beliefs are not overridden? Clearly not. You might imagine a scenario in which parents provide an ad hoc religious justification for brutally beating their child in a manner that does not threaten his life. Still, it would be impermissible for parents to subject their children to such a beating because affronting the bodily integrity of a child requires a particular kind of justification. Religious reasons, just as they are inadequate in justifying the refusal of life-saving medical treatment for the children of religious parents, are inadequate in justifying medically unnecessary interventions for the children of religious parents or children of parents with particular cultural convictions. 

This is roughly how the argument against circumcision advanced in this blog post runs: 

P1. Circumcision is a medical procedure that affronts the bodily integrity of children.
P2. Affronting the bodily integrity of a child requires a particular kind of justification.
P3. Circumcision cannot be adequately justified.
C. Therefore, circumcision is impermissible. 

To respect bodily integrity is, roughly, to respect the right of people to determine what happens to their bodies. We might argue that respect for bodily integrity is valuable because it is instrumental to some end, like allowing people to lead minimally decent lives free from unjust interference by others. Similarly, some might say that people experience resentment and pain when their bodily integrity is affronted, which is a strong reason for protecting it. Others might claim that bodily integrity is valuable in its own right. In any case, bodily integrity is something that everyone has reasons to value and support. We recognize that there might be room for reasonable debate about what constitutes an affront to bodily integrity. However, circumcision is a clear-cut case of a medical procedure that affronts the bodily integrity of the child on whom it is performed because it involves the permanent removal of healthy tissue without the person’s consent. They clearly are deprived of the ability to control what happens to their genitals when they are circumcised as an infant. If this does not count as a violation of bodily integrity, then almost nothing does.

That we value bodily integrity, however, does not mean that we must categorically oppose any sort of medical intervention for a child. If bodily integrity is valuable insofar as it allows us to lead minimally decent lives, then we can justify affronting bodily integrity when doing so is necessary to help someone unable to consent lead a minimally decent life. Even if we value bodily integrity for its own sake, we might justify affronting the bodily integrity of a child when doing so gives the child more control over what happens to their bodies later in life. For example, performing open heart surgery on a baby does affront their bodily integrity, but it enables them to enjoy greater bodily integrity later. Needless to say, affronting the bodily integrity of a child requires a special justification. 

Imagine that you live in a society with unconventional beauty standards. In particular, people are perceived to be more attractive when they have the tips of their pinky fingers chopped off at a young age. Does the fact that there are some minor benefits associated with chopping off your child’s pinky in this society justify doing so? Beauty standards evolve, and individuals sometimes decide for themselves that they want to pursue a standard of beauty that diverges from the norm. By chopping off the tip of your child’s pinky, you are rendering him incapable of having a say in how he exercises control over his body later in life. This may harm him psychologically, especially if he decides at some point that he would have preferred to have the tip of his finger. The likelihood of him resenting this decision is greater if he lives in a multicultural society where not everyone practices pinky-finger-cutting. 

These same concerns appear relevant when what informs a parent’s decision to modify their child’s body is religious conviction. Peoples’ understanding of what piety demands evolves over time, and individuals sometimes grow up to abandon the religious beliefs they were raised with. By chopping off the tip of your child’s pinky in the name of religion, you are rendering him incapable of exercising control over his body in ways that reflect his views about religion later in life. The same sorts of psychological harms pose a threat to the well-being of the child in this case as they do in the previous case. 

If, on the other hand, the tip of your child’s pinky was infected and would, if untreated, spread and pose a major threat to your child’s health, affronting his bodily integrity may be justified. Does this mean that removing the tip of his pinky will necessarily be justified under these circumstances? Well, no. If the infection could be contained and treated by either (a) treating it with antibiotics or (b) removing the tip of the child’s pinky, one should defer to (a) as it is the available option that least affronts the bodily integrity of the child in question. So, removing healthy tissue from a child to save them from a health-threatening medical condition is only justified when it is the least intrusive of all available medical interventions. 

In other words, affronting the bodily integrity of a child can only be justified when the procedure in question is medically necessary. As we discussed in our previous post, circumcision is more often than not, if not always, medically unnecessary. Some proclaim that circumcision reduces one’s chances of getting UTIs, developing penile cancer, and contracting sexually transmitted infections later in life. Removing the foreskin of an unconsenting child, however, is not the least intrusive of all available medical interventions that achieve similar ends. UTIs can be treated with antibiotics, penile cancer can be prevented with standard hygienic practices, and sexually transmitted infections can be prevented with proper sexual health education. To the extent that circumcision is medically unnecessary, it is an impermissible medical intervention that unjustifiably affronts the bodily integrity of those whom it is performed on. 

In our last post, we argued that those who oppose clitoral hood cutting should likewise oppose male circumcision. In this post, we argue that there are reasons to oppose clitoral hood cutting and circumcision independent of the way that these two practices relate to one another. They are both impermissible practices because they represent instances where the bodily integrity of unconsenting individuals is wrongly violated. Religious and cultural defenses of circumcision fail because they do not take seriously the importance of respecting claims to bodily integrity, and medical defenses of circumcision fail because they do not establish circumcision as a medically necessary medical intervention.