Response on the Ombudsman for Children’s Initiative Concerning Boys’ Non-medical Circumcision in Finland

Response on the Ombudsman for Children’s Initiative Concerning Boys’ Non-medical Circumcision in Finland

In Finland, the Ombudsman for Children has sent an initiative on the 8th of October (LAPS/368/2013) to the Finnish Social and Health Ministry concerning the drafting of legislation concerning boys’ non-medical circumcision in Finland. The Ombudsman for Children wants the minimum requirement of the law to be that non-medically motivated circumcision is to be allowed on a minor only when he is able to give his informed consent to the procedure. As a second alternative the Ombudsman for Children suggests, that non-medically motivated circumcision on underage boys is to be forbidden under all circumstances. The Ombudsman for Children is himself of the latter opinion, meaning forbidding non-medical circumcision on underage boys completely.

The issue of non-medical circumcision concerns mainly the Jewish and Muslim communities in Finland. According to the Jewish faith an eight day old boy is to be circumcised in a ceremony called Brith Milah and that in some regards corresponds to baptism in Christianity.
It is noteworthy that in the Jewish world this commandment is followed very broadly, even surprisingly so when taking into account the variety of opinions on most issues among Jews. This is also the case in Finland.
In its directive concerning boys’ non-medical circumcision, the Finnish Social and Health Ministry (STM/242/2015) states, that non-medical circumcision of boys is not forbidden in any country, and neither does any international treaty forbid it explicitly. On the contrary, in countries that have laws concerning boys’ non-medical circumcision, it is done in a way that allows this Jewish practice to continue. This is the case in e.g. Sweden (2001), Norway (2014) and Germany (2012).

It is good to mention also the Parliamentary Assembly of the Council of Europe’s fresh decision
(2076/2015, section 9), according to which boys circumcision is not forbidden under certain prerequisites. These prerequisites have to do with the professional qualifications of the circumciser, but not with the age of the boy. Thus they are in line with the Finnish Social and Health Ministry’s instructions published early this same year. The stand of the Ombudsman for Children is at stark odds with the prevailing general view globally. The Ombudsman for Children’s meandering references to international treaties does not change this fact.
The forbidding or conditioning of boys non-medical circumcision in a way that it could not be done without the explicit consent of the child, would mean in practice for the Jews of Finland the impeding and withering of Jewish life in Finland. Taking into account the traditional law abiding nature of the Finnish Jews the Ombudsman for Children’s suggestion would mean a hard blow for Finnish Jews on a practical level, to whom this sudden change in direction and carelessness of its’ old minority would put in question the future of the Jews of Finland. With this in mind the question of Boys non-medical circumcision is a freedom of religion and human rights issue of the highest level. This aspect needs to be taken into account with higher severity than was done in the Ombudsman for Children’s statement.

To avoid this superficiality the Ombudsman for Children need not look for guidance further than from the Finnish Supreme Court, which in its decision (KKO:2208:93) has stated among other facts, the following: “Circumcision performed for religious reasons can be estimated to have a positive influence particularly for the boy himself, for the development of his identity and for attaching him to his religious and social community. Due to these reasons the medical adequacy of non-medically motivated circumcision and tampering with the boy’s bodily inviolability can be found defendable and judging as a whole to be such a minor procedure, that the child’s custodians conduct by having such a procedure done on their child cannot be seen as an act violating the child’s best interest and justice that would be punishable as assault.”
The Supreme Court could hardly have come to that conclusion, unless non-medically motivated circumcision of boys would also be a procedure which is medically defendable. This is further proven by the fact that medically motivated circumcisions are performed approximately a thousand per year in Finland. This means it is a medically approved treatment. We understand the difference easily if we compare this to girls and women’s genital mutilation (sometimes also referred to as circumcision). We are not aware of any clinical illness or disease, that could be treated or prevented by mutilating girls’ genitals, on the contrary to boys circumcision. Female genital mutilation is not defendable or justifiable from this perspective, on the contrary to boys’ circumcision, even if some group would deem it an essential cultural or religious ritual.
Let us assume correspondingly that the group ”XYZ” habits include amputating the left hand’s pinky finger as a sign of belonging. The Ombudsman for Children would in this case be correct when referring to the laws and international treaties concerning a child’s right to bodily inviolability. They are however not suited for estimating the issue of non-medically motivated circumcision and the Ombudsman for Children has been unable in his statement to show how they would be relevant. From a medical and treatment ethics perspective non-medically motivated circumcision is comparable mostly to the fairly standard removal of the wisdom teeth, which is often done in an anticipatory fashion without making sure that the teeth at hand are in fact going to cause harm or inconvenience to the person receiving treatment.

The commandment to circumcise infant boys in Judaism is not per se based on health reasons, but if the practice would be detrimental from a health perspective, it could not be defended from a Jewish or any (other) Western moral perspective. Due to this it is noteworthy the American Association of Pediatrics (AAP) has come to the following conclusion in 2012 defending non-medically motivated circumcision: “Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it.” Even if some other sources have decide to question the net benefit using other emphasis, the research result of the AAP is unsurpassable that it is impossible to claim that a medically adequately performed circumcision would be physical assault or something similar that would lead the male infant in question in need of protection of the lawmaker.

An important detail to note is that the recommendation by the AAP concerns newborns.
Should the recommendation of the Ombudsman for Children be put into effect it would lead to the increase in the age of circumcision, which would be harmful from a health perspective. A procedure performed on a child or adult is a somewhat demanding surgical procedure with risk factors, whereas circumcision of newborns is a harmless and relatively risk free medical procedure. This same has been stated in the instructions of the Finnish Health and Social Ministry, where they state that ailments are very rare, but in comparison more frequent when the procedure is performed after infancy.
As an end deduction we must state that the suggestions of the Ombudsman for Children are harmful from a health perspective, ethically unsustainable and offensive to the civil rights of Finnish Jews.

The Central Council for Jewish Communities in Finland does not object devising new legislation concerning non-medically motivated circumcision presupposing that it corresponds to a large degree to the legislation prevalent in Sweden, Norway and Germany.

In Helsinki, the 22nd of October 2015

Central Council of Jewish Communities in Finland
Yaron Nadbornik