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German court's circumcision ban does not affect US military clinics

HEIDELBERG, Germany — U.S. military doctors will continue performing circumcisions on male infants when parents request it, officials say, despite a controversial German court decision that banned the procedure as inhumane.

The June decision by a court in Cologne applies only in that jurisdiction, not in any of the German states in which U.S. military clinics are located, said Ed Rohan, a spokesman for Europe Regional Medical Command.

“If another jurisdiction in which we have military treatment facilities were to pick up the same legal reasoning, there is a possibility that it would apply to health care providers” there, he said.

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“At this point they will continue to perform circumcisions, but our legal experts will continue to follow this issue and provide advice based on any other court or legislative actions,” Rohan said.

U.S. facilities may be among the few places now in Germany to do the procedure that removes some or all of the foreskin from the penis. After the June court ruling, the head of Germany’s medical association said he was advising colleagues throughout the country against performing circumcisions to avoid any risk of criminal prosecution.

Even before the ruling, however, many German pediatricians would not perform them.

“For example, in Heidelberg, all circumcisions (on Americans) are performed in the Army Health Clinic. But in Stuttgart, about half were performed by host nation providers in the local community,” Rohan said.

Rohan agreed that the ruling had muddied the legal waters surrounding the procedure, which has never been embraced in Europe, but since the 1900s had been done on the majority of U.S. male babies.

Teams of U.S. and German lawyers had been discussing the implications of the court ruling, Rohan said, and had “reached varying conclusions as to its impact” on U.S. military facilities, he said. “The general consensus, however, is that we will not see a wave of prosecutions based upon this singular and narrowly applied interpretation of law.”

Jews and Muslims, whose religions require circumcision on male babies or toddlers, criticized the ruling as an abridgement of their religious freedom and an intrusion on parental rights.

Leaders of groups including the Rabbinical Centre of Europe, the European Jewish Parliament, the European Jewish Association, Germany’s Turkish-Islamic Union for Religious Affairs and the Islamic Centre Brussels issued a joint statement.

“We consider this to be an affront [to] our basic religious and human rights,” it said.

German Chancellor Angela Merkel agreed, saying the ruling could make Germany a “laughing stock.”

On Thursday, Germany’s lower house of parliament approved a resolution calling for the government to present a law in the next few months that would overrule the court decision and guarantee that “the circumcision of boys, carried out with medical expertise and without unnecessary pain, is permitted,” Reuters reported. “Jewish and Muslim religious life must continue to be possible in Germany. Circumcision has a central religious significance for Jews and Muslims,” the resolution said.

It’s not the first time circumcision has been subject to restrictions in Europe.

In 2001, Sweden passed a law allowing only people certified by the National Board of Health to circumcise infants. Swedish Jews and Muslims objected to the law and the World Jewish Congress called it “the first legal restriction on Jewish religious practice in Europe since the Nazi era.”

In 2006, a Finnish court ruled the circumcision of a 4-year-old boy to be an illegal assault, but in October 2008 the Finnish Supreme Court ruled that the circumcision, “carried out for religious and social reasons and in a medical manner,” was not criminal.

The swiftness of the German parliament’s response seeking a law allowing circumcision is attributed to the sensitivity surrounding Germany’s Nazi past.

Circumcision rates vary throughout the world. The U.S. has had one of the highest rates: The conventional view was that a foreskin-free penis was healthier and cleaner. But the procedure became increasingly controversial, with some arguing that it was a sort of mutilation that conferred few benefits and caused harm, such as pain to the baby and later decreased penile sensitivity.

Circumcision may reduce transmission of sexually transmitted infections, some studies have shown. It has been shown to significantly reduce female-to-male HIV transmission in sub-Saharan Africa.

In 1999, the American Academy of Pediatrics advised that evidence showed “potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.”

The academy noted that in other countries, pediatricians advised against the procedure but said: “In the pluralistic society of the United States in which parents are afforded wide authority for determining what constitutes appropriate child-rearing and child welfare, it is legitimate for the parents to take into account cultural, religious, and ethnic traditions, in addition to medical factors, when making this choice.” All circumcisions should be done with pain relief, the academy added.

Rohan said circumcision rates in the U.S. were falling, from some 63 percent in 1999 to 54.5 percent in 2009. The German circumcision rate is about 20 percent, he said.

In 2011, 518 boys were born at Landstuhl Regional Medical Center, officials there said, and 145 of them were circumcised shortly after birth, which is when doctors say it is least traumatic.

The Cologne court case came about after a 4-year-old boy had complications from the surgery. The court decided that the “fundamental right of the child to bodily integrity outweighed the fundamental rights of the parents.” It also said that religious freedom would not be curtailed because the child would be able to choose later whether he wanted to be circumcised, but that a parent’s decision was irreparable and permanent.

montgomeryn@estripes.osd.mil
 

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