One should note that circumcised men, who have lost some much sensory tissue, from their penis have an acute emotional need to minimize that loss. When they can no longer minimize the loss, they seek to justify it by citing illusory medical benefits.

You say it’s a medical decision parents can make, but infant circumcision is not endorsed by any national medical association of doctors anywhere on earth – not even Israel’s. The cost of American juvenille corrective surgeries and other circumcision re-dos matches the total cost of 1.3 million infant procedures allowed in the US each year.

You mention HIV, but infants aren’t at risk for sexually transmitted infections. If they were, infant condoms would be the most effective and cost-effective means of prevention, just as in adults. Most of the US men who have died of AIDS were circumcised at birth. The US has a mostly-cut adult population and THREE TIMES the HIV incidence that Europe has, even though circumcision is very rare Europe. You should also know that the Africa researchers announced this summer that the HIV+ men they circumcised were 50% MORE LIKELY to transmit HIV to a monogamous partner than the HIV+ men they left intact were.

All males can decide at a rational fully-informed age whether to use a condom and other safer sex measures, or trust in a pleasure-reducing amputation to fight HIV. If he does choose circumcision then, he’ll get real pain management, less risk, a more precise cut, healing that’s not in a fouled diaper, and some say in the style of the result.

How should I read that, if not as placing the criterion of no harm to the child before the criteria of parental preference and potential benefits.

You’re correct that I presume that cultural factors, parental preference and the medical community’s consensus on medical risk should have no weight at all, but I specifically add the condition that the person being circumcised is healthy and can’t consent. That obviously includes children. He may not value those factors in the same subjective way as the others involved. I don’t value them the same as my parents, the doctor they chose, or many of my fellow citizens. And circumcision causes harm, as I stated in my last comment. It meets my test for prohibiting parents from making the decision. Again, I think it meets the test you established, as well.

The (subjective) cost-benefit discussion of HIV is a distraction from the primary test you established. It should be involved, I suppose, but not until the other questions have been addressed first. The problem is that you’re taking the science of a study conducted with adult volunteers as a substitute for the ethics of cultural circumcision of infants. Why is it unreasonable to expect circumcision in America as an HIV-risk reduction method to involve adult volunteers rather than children? If circumcision is useful, the arguments for choosing circumcision should be powerful enough to convince adult males to voluntarily undergo the procedure.

The only opinion you’re ignoring in your analysis is the person being circumcised. Even the reasonably objective consensus on medical risk and benefits is still subjective in its application to each patient. (Let’s not forget the medical consensus on the objective health of newborn foreskins, which is also scientific.) We can talk about complication rates versus risk reductions but there are males who constitute those statistics. Why shouldn’t their opinions matter before the unnecessary surgery rather than after when they must deal with the outcomes? They can take actions to prevent the diseases. They can’t take actions to prevent the complications.

To your HIV example, this utilitarian evaluation should include the tens of millions of American males circumcised at birth to achieve an HIV+ rate in America that is higher than every other Western nation. Most of those countries don’t have anywhere near 10% of males circumcised since before the rise of HIV. Why is our HIV+ rate higher? It’s reasonable to posit that lack of circumcision is not the problem.

More importantly, those 4,500 men would not be HIV+ if they hadn’t engaged in unsafe sex. Their foreskin isn’t the cause of infection. They didn’t deserve HIV because they didn’t use condoms, of course, but their unfortunate reality doesn’t permit us to dismiss the rights of their male peers upon birth, peers who will mostly be responsible or at very low risk.

One might also evaluate education and increased use of condoms using similar calculations. The difference, of course, is that there is zero risk of physical harm in education. How many infections were helped along by the Pope proscribing the usage of condoms?

Did it appear that there were any socioeconomic or cultural factors accounted for in the study? If not, I would think you’d have plenty of room for correlative error along cultural and socioeconomic lines.

The medical benefits of circumcision are statistically insignificant, or at least only significant in specialized populations. Other remedies would achieve better gains without the harm of surgery — condoms, education, familial/cultural guidance.

I know the following is a fantastic, hyperbolic argument, but we could prophylactic-ally give all female children mastectomies and end the scourge of breast cancer. We’d have to wrestle with the same questions about surgical harm, sexual pleasure, personal body image, etc. How many of those women would miss the breasts they never knew? Especially if mass culture depicted a breasted woman as an anomaly, as the uncircumcised penis is?

You wrote that parents may circumcise their sons “presuming no harm is done.” You are making a rights-based argument that centers on the child possessing an individual right to be free from unnecessary harm. According to you, there are limits to how much culture may play a role. This makes the role and influence of the family and culture irrelevant here as the initial test; your claim hinges first on the merits of circumcision as surgery on a healthy child.

Circumcision is surgery. It removes healthy, functioning tissue. There is scarring. There is an inherent risk of further complications, starting with “excessive” bleeding and infection and extending all the way to death. The more extreme complications are, of course, rare, but the risk itself is a form of harm. Parents cannot know if their son will be the statistic. Good intentions are not a substitute for objective criteria. Using objective criteria, surgical intervention on healthy body parts is harm. Prophylactic and cultural child circumcision fails that test, which prevents moving to cultural considerations as a defense. Proxy consent is valid only where medical treatment is indicated (i.e. necessary). Parents do not have a right to impose medical treatment – in this case, surgery – because they like that medical treatment, for whatever reason they value it. This is precisely because it causes harm, the test you (correctly) established.

I suspect we disagree on whether or not circumcision is objective harm. But you didn’t attempt a defense of circumcision on that claim, the core of your dismissal. Instead, you essentially propose that subjective preferences are valid for parental decisions as long as the parents (and possibly a majority of society) believe them to be culturally valid and not harmful. That’s incorrect.

Well, at least you’re not wasting your time with Megan McArdle anymore.