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Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis. The ethics of circumcision in children has been a source of controversy. Adult circumcision. 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. Circumcision of adults as a public health measure for the purpose of reducing the spread of HIV also involves ethical concerns such as informed consent and concerns about reducing attention paid to other measures. According to the CDC website, research has documented a significant reduction of HIV/AIDS transmission when a male is circumcised.〔(), Page last updated: April 2013. Last checked: October 2014〕 Child circumcision. 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.〔 The circumcision of children for non-therapeutic reasons is controversial. Since children are unable to consent, informed consent for circumcision must be granted by a surrogate. Some believe that surrogates are not empowered to grant consent for non-diagnostic and non-therapeutic procedures. Some believe that parents have a right to circumcise a child. Some believe that non-therapeutic circumcision of a child violates the human rights of the child and can not be in the child's best interests. Some believe that their religion requires males to be circumcised. Some believe that circumcision is a life-long irreversible injury. Some believe that non-therapeutic circumcision provides certain health benefits. Some believe that the foreskin has numerous physiological functions and should be preserved. These conflicts have created a wide diversity of opinion regarding the propriety and ethics of child circumcision as discussed below. ==Surrogate consent== Patient autonomy is an important principle of medical ethics. Some believe that consent for a non-therapeutic operation offends the principle of autonomy, when granted by a surrogate. Since children, and especially infants, are legally incompetent to grant informed consent for medical or surgical treatment, that consent must be granted by a surrogate — someone designated to act on behalf of the child-patient, if treatment is to occur.〔J. Steven Svoboda, Robert S. Van Howe, James C. Dwyer, Informed Consent for Neonatal Circumcision: An Ethical and Legal Conundrum. 17 J Contemp Health Law & Policy 61 (2000).〕 A surrogate's powers to grant consent are more circumscribed than the powers granted to a competent individual acting on his own behalf.〔〔 Reaffirmed May 2011.〕 A surrogate may only act in the best interests of the patient.〔 A surrogate may not put a child at risk for religious reasons.〔 A surrogate may grant consent for a medical procedure that has ''no'' medical indication ''only'' if it is the child's best interests.〔 The attending physician must provide the surrogate with all material information concerning the proposed benefits, risks, advantages, and drawbacks of the proposed treatment or procedure.〔〔 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.〔 There is an unresolved question whether surrogates may grant effective consent for non-therapeutic child circumcision.〔〔Peter W. Adler. (Is Circumcision Legal? ) 16(3) Richmond J. L. & Pub. Int. 439 (2013).〕 Richards (1996) argues that parents may only consent to medical care, so are not empowered to grant consent for non-therapeutic circumcision of a child because it is not medical care. The Canadian Paaediatric 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."ウィキペディア（Wikipedia）』 ■ウィキペディアで「ethics of circumcision」の詳細全文を読む スポンサード リンク
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