Iceland’s proposed circumcision ban

For a small country, Iceland makes a big impact globally.

Recently, the Nordic island proposed legislation that would, before the age of consent, criminalise male circumcision that is unnecessary “for health reasons,” stating individuals who remove “part or all of the sexual organs shall be imprisoned for up to six years.”

The bill claims circumcision violates children’s rights to “express their views on the issues concerning them” and “protection against traditions that are harmful.”

According to the bill’s spokesperson, Icelandic politician Silja Dögg Gunnarsdóttir, a key reason for the bill is that all forms of female genital cutting (FGC), no matter how minor, have been illegal in Iceland since 2005, but no similar legislation exists for males.

“If we have laws banning circumcision for girls,” she says, then for consistency “we should do so for boys.” Consequently, the bill is not specific to male circumcision, but adapts the existing law banning FGC, changing “girls” to “children.”

But there is a lot to unpack regarding Iceland’s bill.

Circumcision supporters often argue that young children are incapable of giving or withholding informed consent to decisions affecting them. But where should the limits of parental decision-making lie?

So far, in the media-driven debate regarding Iceland’s bill, most of the coverage has focused on religiously-motivated circumcision. Indeed, some have interpreted the bill as applying only to religious circumcisions.

Most practicing members of Jewish and Muslim groups regard male circumcision as central to their faiths. Circumcision is usually performed on the eighth day after birth in the Jewish faith and at 10 years (with considerable variance) in the Muslim faith. Understandably, Iceland’s bill has been criticised by many within the Jewish and Muslim communities, with some labelling it “a dangerous attack on freedom of religion.”

There are therefore two competing rights’ claims at stake - children’s rights to bodily integrity and protection from harm, and parents’ rights to practice their religion.

The relevant question is not whether parents’ decisions are religiously motivated, but whether they fall within reasonable limits.

What counts as a reasonable decision and who should get to decide?

Medical ethics scholar Akim McMath states that, in the case of circumcision, people “disagree over what constitutes a harm and what constitutes a benefit.” Given this, some have concluded that the circumcision decision should rest with the parents.

However, an alternative conclusion could be drawn. As Mr McMath notes, “the child will have an interest in living according to his own values, which may not reflect those of his parents.” Therefore, “if disagreement over values constitutes a reason to let the parents decide, it constitutes an even stronger reason to not perform circumcision before the child himself can decide.”

In the context of female genital cutting or FGC, parents’ decisions are almost universally not regarded to fall within reasonable limits, even if they are religiously motivated and the cutting is less severe than male circumcision.

This is demonstrated by the attempted “Seattle Compromise” of the 1990s, where a Seattle hospital received requests from Somalian mothers to circumcise their daughters and sons. The doctors agreed to circumcise the boys, but initially refused to cut the genitals of the girls. However, concerns were raised that the mothers might take their daughters elsewhere for a more severe procedure.

The hospital, worried about harms associated with these more severe forms of FGC, negotiated with the mothers to perform a symbolic ‘nick’ instead, which would draw blood but not involve scarring or removing tissue. Opponents of FGC, however, campaigned against the hospital and the compromise did not proceed, suggesting the bar for relatively acceptable harm is set extremely low in cases of FGC.

But male circumcision, particularly in the USA, is regularly requested for non-religious reasons. In fact, most circumcisions in the USA are performed for psychosocial, aesthetic or cultural reasons, and yet it is widely treated as permissible even in those cases.

A common reason given by American parents requesting circumcision is they want their son to “look like dad.” Other reasons include concerns their son will be teased if not circumcised, and mistakenly believing a circumcised penis is easier to clean. Similar findings have been reported in surveys of Canadian parents.

Clearly, if religious motivations are required to justify non-therapeutic alteration of children’s genitals, far fewer circumcisions should be permitted than currently occur.

This raises important questions about the ethical significance, if any, of parents’ reasons. Should these reasons be considered when deciding whether parents’ circumcision requests should be followed?

Politician Silja Dögg Gunnarsdóttir suggests no, claiming that it is not about the “intention” of circumcision; “it’s about the children.” Conversely, South Africa’s Children’s Act 2005 bans non-medical circumcision of males under 16, but makes an exception for religiously-motivated circumcisions, suggesting parents’ reasons do matter.

Some may argue Iceland should adopt a similar ‘middle-ground’ approach and permit religiously-motivated circumcisions before an age of consent.

However, if a child should be protected from the harms associated with non-therapeutic genital cutting, and if the decision about whether to remove a valuable and functional body part should be left to the individual whose body part it is - making an exception for religious reasons may send a confusing signal.

Specifically, it seems to imply children of religious parents are less worthy of being protected from harm than children of non-religious parents.

In any case, reasons can be multifactorial, complex and challenging to tease apart. In some cases, parents’ actual reasons for requesting circumcision may be different to reasons they disclose to providers. In other cases, parents may be unaware of their true motivations. Furthermore, assessing parents’ motives would be challenging in practice.

Parents likely believe their child will later find their reasons for requesting circumcision convincing, but this may not be the case.

The child may later resent his parents for authorising the surgery. As circumcision is irreversible, he will have no recourse to “undo” what was done.

By contrast, an individual who was not circumcised as a child can always choose to undergo the surgery as an adult.

This asymmetry in options for rectifying a potentially undesired situation is morally significant, and should factor into parental decisions about whether to authorise an irreversible genital surgery - whether for religious or other reasons.

A version of this article is also published on the Practical Ethics Blog.

Banner: Medieval fresco of the Circumcision of Jesus by the priest Zacharias, a biblical narrative in Tingsted church, Denmark/ Shutterstock