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Whose decision is it? The long-term legal implications of informed consent.

Article Excerpt
Even today, this scenario is all too common:

Shortly before or after giving birth at a hospital, a woman is handed a sheaf of papers to sign. Some are insurance forms. One form asks, "Do you want your baby boy circumcised?" The question appears routine, almost a formality.

If her doctor has explained the surgery--and a national survey indicates that nearly half of all physicians who perform circumcision do not educate both parents in advance of the surgery'--it is likely the mother has been told that circumcision is "quick, simple, and doesn't hurt the baby," and that her son's penis would stay clearer and healthier that way. She is given the impression that this is just one more minor procedure done to all baby boys before they leave the hospital. She signs.

Has this mother given her informed consent to have the surgery performed on her infant? What are the medical and legal standards that constitute informed consent for any type of surgery? Can a parent legally or ethically "consent" to surgery that will be performed not on the person who signs the paper but on someone else, in particular on an infant only one or two days old?

That these questions are now even being asked represents a movement toward increased awareness of the issue in an country that continues to have one of the highest rates in the world of routine newborn circumcision. Currently about half of all American newborn males, roughly a million babies year, are circumcised. Israel maintains a high rate on the grounds that circumcision is required by God for all Jewish males, and in some parts of the world Sunni Muslims also circumcise for religious reasons.

Countries with high circumcision rates stand out in the world community because about 85 percent of all males worldwide are not circumcised. However, it is only in recent years that some in the American medical and legal fields have begun to look seriously at how and why the procedure continues in the US on a routine basis and for nonreligious reasons. One of the issues being examined is that of informed consent....

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