Boys hurt in backstreet circumcisions

DOCTORS HAVE been warned of an emerging underground market in circumcision operations, with young boys exposed to the risk of being mutilated by untrained people.

Hospitals have reported a number of cases where doctors have had to deal with the horrendous results of operations that have gone wrong.

The problem is that while many people want their sons to be circumcised for doctrinal or other reasons, a growing number of doctors will not perform the operation unless it is medically necessary. Some doctors see male circumcision as a form of child abuse.

A leading urologist has now warned that circumcision is in danger of going the same way as abortion once did, into the back streets. "With the trend for urologists to refuse circumcision on demand, some people are being driven away from trained surgeons into alternative sectors where quality and safety is variable," Guy Dawkins, specialist registrar at the Institute of Urology at the Middlesex Hospital, said in a letter to the British Medical Association News Review.

"We must not let circumcision falls into unskilled hands in the way that abortion did. The problem has to be addressed."

Yesterday Mr Dawkins said he and colleagues had treated a number of cases where problems had arisen. "From time to time most urologists have to sort out a child who has had a circumcision done for non-medical reasons.

"There are a lot of non- medical circumcisions, and while the rabbis do a good job, some of the other circumcisions are sub-optimal.

"Surgeons are getting more conservative because we are having to account, quite rightly, for the morbidity we create. Circumcision is an operation and carries a risk. You may therefore be exposing a child to unnecessary risks.

"The problem is that there are parents who are demanding it, and who will go elsewhere. They may approach a surgeon in the private sector and get the same reaction, and then approach people who make themselves available for doing these things who are not trained as surgeons.

"We don't know who they are, but we see the effects. It is not yet a big problem, but when you see a nine-year-old child whose penis has been chopped about and glans cropped off, you have to question who would have had that done to a child."

Some doctors fear the problem will get worse because of the trend against circumcision, including campaigns by some pressure groups.

"Circumcision as a medical treatment is unnecessary, ineffective and harmful. It is not good practice to cut off the foreskin when no treatment is needed," said John Dalton, archiver of the National Organisation of Restoring Men, also writing in the BMA review.

Dr Michael Wilks, chairman of the BMA medical ethics committee, said: "Whatever treatment doctors provide for children must be in their best interests. But assessment of best interests is not based only on what parents want for their children."