The necessity for legislative reform concerning the circumcision procedure is now highly evident.
Circumcision providers have demonstrated an inability to self-regulate as evidenced by widespread false, misleading, and deceptive advertising.
A high proportion of circumcision providers have been implicated for the misappropriation of Medicare funding.
Poorly applied and inconsistent standards of operation are evident including failures to ensure and verify informed consent from both parents.
Poorly applied pain relief measures have resulted in numerous accounts of harm including death as a result of complications from injectable opioids.
Permissibility of circumcision being performed by non-registered, non-medical persons has resulted in elevated risk and limited access to current protections.
Children under six months of age subjected to non-medical circumcision are being placed at an unjustified level of risk should complications require a general anaesthetic be applied.
We advocate for greater protections mandated in law including –
- Mandating the use of anaesthetic in conjunction with the circumcision procedure by a qualified and registered medical practitioner.
- Prohibiting circumcision from being performed by non-medical persons.
- Mandating a government regulated and issued process of consent including an account of risks and benefits that includes the benefit of intact genitals.
- Increase penalties associated with the misappropriation of government funding including de-registration.
- Prohibit circumcision in the absence of a legitimate medical condition prior to the age of six months when a general anaesthetic can be more safely applied.
- Mandate the circumcision procedure can only be performed in a hospital setting where complications can be adequately and safely resolved.
Informed Consent process
Informed consent is in general very poorly applied in the private sector by circumcision service providers. Inconsistencies and omissions to the consent process are commonplace and often tailored to deceptively encourage the use of their services.
The Urological Society of Australia and New Zealand (USANZ) specify in their guidance –
“The consent process must include information to parents/guardians that the risks of request circumcision exceed the benefits and thus it is not recommended and not performed in public hospitals.”
Most private sector circumcision providers fail to issue this notification to their clients as this would discourage the use of their services.
In contrast consent forms mandated by state government for use in the public sector are comprehensive and include –
- An account of the risks from circumcision in general that are not understated or intended to conceal the extent of the risks.
- An account of what condition is evident that would justify the procedure.
- Specific risks and procedure options.
The private sector, motivated by monetary gain are incapable of applying these measures in a consistent and honest manner.
We advocate for –
- Mandated use of government issued consent forms when Medicare funding for circumcision is sought.
- Mandated use of government issued consent forms for all elective circumcisions in the private sector that includes notification “the risks of the procedure exceed the benefits” and is “not recommended” by the USANZ.
Example – Consent Form Queensland Government