Tuesday, January 29, 2008

Religion of the Father?

AP reports that the Oregon Supreme Court has ruled that a 12 year old boy's preferences on whether or not to be circumcized should guide the decision in the dispute between his parents.


The father, James Boldt, converted to Judaism in 2004 and wants the boy to be circumcised as part of the faith. The mother, Lia Boldt, appealed to the high court, saying the operation could harm her son physically and psychologically.

The state Supreme Court ruled that earlier court decisions failed to determine whether the boy wanted the circumcision, as his father contended, or opposed it, as his mother alleged.

The Supreme Court sent the case back to the trial court to answer that question.

If the trial court finds the child agrees to be circumcised, the Supreme Court said, it should deny the mother's requests. But if the trial court finds the child opposes the circumcision, the court has to determine if it will affect the father's ability to care for the child.

The custody dispute began when the child was 4 and the circumcision issue began three years ago when he was 9.

We have several interesting issues impacting this case. First: informed consent of the patient. Is a 12 year old mature and competent enough to make a decision about this permanent operation? There is a precedent in our society that denies non-medically indicated permanent procedures. For reference, most physicians deny elective sterilization operations to women even if they are of legal, consenting age (depending on the state, 25 is often used as a "no questions approval" cutoff).

Second, what is the nature of the circumcision procedure? Ought it be considered a ritual fully protected by free exercise of religion, or an elective permanent surgical procedure for non-health related reasons, thus violating the non-maleficence clause of the Hippocratic Oath? Note the sliding scale of the perceived magnitude of circumcision - from something akin to a piercing to mutilation of one's body and bodily function.

Third, the dispute between the parents should be considered carefully, and both parties' motives must be separated from what is in the best interest of the teenager. However, the "father's ability to care for the child" should not be used as a factor, as it should be categorically seen as a sign of unfit parenting to abuse or neglect one's child for not conforming to religious practice.

In my opinion, a case would be made for supporting such a procedure on someone not legally competent only if 1) there were a medical indication or 2) there were a time-sensitive factor to the procedure in terms of reducing side effects or discomfort. Thus, there is potential for supporting circumcision of infants over children or teenagers because some believe less pain is felt at that time (I do not endorse this position, I simply present it for argument) than would be felt later on. And there are rare cases where a circumcision is medically indicated in a child or a teenager due to developmental or other impairments.

However, this situation does not fulfill either criterion - a 12 year old does not have time-sensitive reasons for seeking a circumcision, there is no medical indication, and even the religious argument falls short due to the father's recent conversion. I do not see a reduction in suffering that would result from the operation occuring now or occuring six years from now, but the difference legally, cognitively, and ethically would be significant. Therefore, while I applaud the court's intent to look to the teenager's wishes, I do not feel that he is able to ethically consent to such a procedure at this time, and there should not be a circumcision until he comes of legal age of consent.

Addendum: Upon further reflection, I suspect that this is an attempt by the court to foist responsibility for the act (or non-act) onto the teenager so they do not have to risk appearing to be anti-religion. If so, that is an irresponsible course of action.


Anonymous said...

How would you extend this view to the sometime Muslim practice of "circumsizing" a girl's clitoris?

Evelyn said...

An interesting theological component of the question- is the boy actually Jewish? Generally, Jewish law recognizes that you can be Jewish one of two ways- by birth or by conversion. To be Jewish by birth, one's mother must be Jewish (according to the strictest intreptations- Reform Judaism recognizes patrilineal descent). Since a 12-year-old is not a yet man according to Jewish law, I doubt that he is old enough to convert under that law (but I don't know how most Rabbis would handle the problem) and if his mother is a gentile, than so is he, his father's conversion notwithstanding.
Of course, the Oregon Supreme Court is a court of US law, not Jewish law, but it seems to be to be a fair consideration in this case.

SabrinaW said...

In my personal assessment, I see no ethical/moral difference in permanent procedures performed that result in loss or change of functionality of organs without the patient's consent, especially for children - if there is no compelling medical reason, I do not support it until the child comes of legal age of consent and is demonstrated capable at that age of making decisions for themselves.

In order to present a consistent standard, I cannot give religious reasons license for doing what would by other standards be unethical.

I am a little puzzled by your comment because in America, there is generally support for male circumcision but less support for female genital mutilation (actual circumcision of the skin covering the clitoris does occur on occasion, but is less notable than FGM).

I have written more on my opinion about male circumcision and female genital mutilation here.

On a side note, I do not believe that FGM is unique to Muslim culture.

Kelly Hills said...

Nor is FGM perceived as a requirement of Muslim culture - which is another common misconception. It's performed by people of a variety of faiths in areas of the world that have different cultural views of sexuality and its function.

Regarding the Oregon case - teenagers are allowed to modify their body in all sorts of ways, so long as they have parental consent. This includes tattoos and genital piercing; in the case of a tattoo, a typically viewed as permanent choice, and in genital piercings, something that can affect the body permanently, as well.

Yet we don't see people debating it on any grand level, because the teen has approached the parent, expressed their wish, and the parent granted it.

I would also wonder if circumcision falls under sexual health laws. If so, there might be an argument that the teen has the right to act as he choose - and the autonomy to make his own choice - at whatever age Oregon mandates a teen is able to make their own sexual health decisions.