government

California doctors back bill to prevent circumcision ban

The measure comes in response to a November ballot initiative to prohibit the procedure in San Francisco. A judge ordered the initiative off the ballot.

By Alicia Gallegos — Posted Aug. 22, 2011

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California physicians are supporting a bill that would block lawmakers from restricting the practice of male circumcision.

California Assembly Bill 768, which is scheduled to go before the state's Senate Judiciary Committee on Aug. 23, would prevent any local statute, ordinance or administrative measure from limiting a doctor's ability to perform circumcisions. The bill comes after a legal battle in San Francisco over a proposed circumcision ban that was set to appear on the ballot for the city's November elections. Anti-circumcision activists secured more than 10,000 signatures to bring the proposal before voters.

If passed, the ban would have criminalized doctors for performing circumcisions on patients under age 18 unless medically necessary. A group of community organizations, doctors and religious leaders challenged the proposal in court. They argued that a ban would restrict religious freedom and illegally regulate a medical procedure.

County of San Francisco Superior Court of California Judge Loretta Giorgi on July 27 agreed, ruling that the measure was prohibited by state law. She struck the ban from the ballot.

California physicians said the ruling protects doctors and patients from harmful medical regulations.

"You cannot have a referendum on the practice of medicine," said pediatrician Charles Wibbelsman, MD. He's president of Chapter 1 for Northern California District 9 of the American Academy of Pediatrics. "We all have been taught to practice medicine in the most ethical and forthright way, and so much of what we do comes from experience. [The ban] would be taking the practice of medicine out of the profession and into the hands of a layperson."

Circumcision has proven health benefits, he added, including a decrease in urinary tract infections among infants and a lowered risk for HIV later in life.

Matthew Hess, president of MGMbill.org, a California-based nonprofit that supported the ban, is considering an appeal. Male circumcision is akin to female genital mutilation, serves no purpose and leaves permanent nerve damage, according to MGMbill.org. The medical benefits associated with circumcision are exaggerated and do not justify valid reasons to "amputate a functioning body part," the group said on its website.

Ban's effect on doctor-patient relationship

The California Medical Assn. opposes the criminalizing of medical procedures, including that of circumcision, said obstetrician-gynecologist Ruth Haskins, MD, chair of the CMA Council on Legislation.

"It's very clear a ban would disrupt the doctor-patient relationship," she said.

Regulation of circumcision also could lead to more ballot initiatives or proposed rules on other procedures, such as abortion and tubal ligation, Dr. Wibbelsman said.

The CMA supports Assembly Bill 768 and has written a letter to the Senate Judiciary Committee requesting its approval.

"From political to religious, there are many differing views on the practice of male circumcision. However, in the medical world, the CMA has long endorsed the concept of newborn circumcision as an effective public health measure," the association's letter said.

American Medical Association policy strongly opposes interference by the government or other third parties that "causes a physician to compromise his or her medical judgment as to what information or treatment is in the best interest of the patient."

The AMA also advocates that the decision for neonatal circumcision be determined by parents in circumstances in which the procedure is not essential to the child's current well-being. "To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision," AMA policy states.

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