Circumcision for non-Jewish babies reflects cultural values (and/or
misunderstandings) more than anything else.

When I lived in Omaha, NE, a change from the OB doing it in the hospital
and making it an out-patinet procedure (no longer covered by insurance
insofar as it was not considered a medical requirement, but was now
elective) resulted in a drop from 85% to about 35%. It meant the parents
had to come up with $125 or so.
In that case, money talked!

In cases where I have explained to parents (pregnant) how it is done and
that they should ask if the baby can be given lidocaine to reduce the pain,
many opt not to have it done. What is most revealing is the routine
crossing of legs of fathers when they find out it is done without
anesthesia or any pain-killers of any kind!

I recall more than one African-American mother citing the bible stating
that it was a requirement. When I agreed that this was true for Jewish
babies (and they were not), they often rethought why they wanted it done.

In all cases where mothers and fathers are informed of how it is done and
the effect it has (baby either screams and then shuts down or screams and
continues to be fussy) on behavior and breastfeeding, they often think much
more seriously about whether it is necessary, or could be delayed. (There
is much to be said for the Jewish method of having it done on the 8th day
when baby is stable and nursing well, and wine helps dull feelings)
Whatever they decide, these parents are then in a much better position to
assess and conclude (accurately) WHY their son nurses so poorly or is so
unconsolable for such a long time. I won't even mention the "slips" that
cause other problems...

I suspect I know why the OB residents I have observed who are sent in to
get consents for same do not mention the baby's pain, but I do not consider
that to be truly informed consent.

What about the MDs on LACTNET who have to do this procedure?  Are they
taught how to get consent for this procedure? And when is incomplete
consent desirable to full disclosure?



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