Ethics

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Ten good practice points when dealing with non-therapeutic male circumcision

This page is intended as a reminder of some of the main good practice points when dealing with non-therapeutic male circumcision (NTMC), but doctors are advised to read the whole toolkit.

  1. Doctors must act in a child’s best interests (see our guidance on best interests).

  2. A child’s best interests include not only a child’s health interests but also their social and cultural interests (see our guidance on best interests).

  3. Children who are able to express views about NTMC should be involved in the decision-making process (see our guidance on consent and refusal).

  4. Where a child (with or without competence) refuses NTMC, the BMA cannot envisage a situation in which it will be in a child’s best interests to perform circumcision, irrespective of the parents’ wishes (see our guidance on consent and refusal).

  5. Parental preference alone does not constitute sufficient grounds for performing NTMC. It is the parents’ responsibility to explain and justify requests for circumcision, in terms of the individual factors in relation to that child’s best interests (see our guidance on best interests).

  6. Consent for NTMC is valid only where the people (or person) giving consent have (or has) the authority to do so and understand(s) the implications and risks (see our guidance on consent and refusal).

  7. Where a child lacks competence, and where there are two parents, both must give consent for NTMC (see our guidance on consent and refusal). 

  8. Where people, and/or agencies, with parental responsibility for a child disagree about whether he should be circumcised, doctors should not circumcise the child without the leave of a court (see our guidance on disputes). 

  9. As with all medical procedures, doctors must act in accordance with good clinical practice and provide adequate pain control and aftercare, including being registered in England with the CQC), in Wales with HIW and in Scotland with HIS (see our guidance on providing NTMC).

  10. Doctors must make accurate, contemporaneous notes of discussions, details of best interests assessments, consent, pre-operative clinical assessments, the procedure itself and its aftercare (see our guidance on record-keeping).
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