"I would like to ask questions about your policies and procedures for infant circumcisions."
- Do you ask the new parents whether they want their child to be circumcised?
- When do you ask?
- How often might they get asked (by different doctors or nurses)?
- What information are they provided?
- Does that information include the anatomy, physiology, and functions of what is removed? (including innervation that the Sorrells study shows)
- Is EMLA cream used for an anesthetic and are they told about the dangers?
- Is the tool used (i.e. Gomco, Mogen, Plastibell, etc.) explained?
- Are they provided information on how the different tools have a different effect on what is removed?
- Are they provided information about why the practitioner prefers one over the other?
- Are they told about the incidence rates of:
- Skin bridges and adhesions?
- Tight erections (which may not be noticed until puberty or later)?
- Meatal stenosis or meatitis?
- Genitalia develops into male or female parts in utero. Is it likely that the development is not complete after the individual is born? Is the practitioner able to determine whether the clitorophallus will be 3 inches or 6 inches when they finish growing?
- Is there any reason that the procedure can't be done at a later age?
- If there is, what reason is that
- if they refer to it being more complicated, ask why. If they say there are more chances for mistakes, ask if they are referring to the study that found that the number of adverse events (AEs) that are reported are higher and ask if that might only be because, the older they are, the more likely they are to complain using their words instead of just crying.
- How old does an individual need to be before you would consider putting them under full anesthesia (with an anesthesiologist attending)?
- Is it harmful when removing the prepuce from a healthy person?
What to ask a clinic (where the baby is NOT born):
"We are going to have a baby boy soon. I am shopping around for places to get him circumcised. May I ask some questions about how you perform the procedure?"
- What tool do you use? (e.g. Gomco, Mogen, Plastibell, free-hand)
- How do you know how much to remove?
- What anesthetic(s) do you use? If EMLA, ask whether they are aware of the FDA concerns like how mucosal tissue reacts. And, how does the EMLA reach the inner layer of the prepuce?
- How old/young does the child have to be and why.
- What are the pros and cons?
- If I were to bring in my 15yo and requested that it be done against his will, would you do it? Where does proxy consent stop?
