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Chancellor Larry Isaak
Whose Job Is It Anyway? 

Higher Education   ASAPT   Child Protection Services   NDBME 
   
     

This page contains a letter to Larry Isaak, PhD, Chancellor, North Dakota University System, requesting a change in how the System has handled the topic (or its failure to handle the topic) of infant circumcision in the various relevant departments of the University, such as, law, ethics, medicine, psychology and sociology. This letter (and a similar one sent to Isaak's predecessor, Chancellor Douglas Treadway two years earlier in 1992) were never answered nor acknowledged.


11/14/94

Larry Isaak, Chancellor
North Dakota University System
State Capitol, 600 E. Boulevard Ave
Bismarck, ND 58505

Dear Chancellor Isaak:

This letter is similar to a letter sent two years ago to Chancellor Treadway. It concerns the North Dakota University System’s involvement in a social practice many find deplorable and intellectually indefensible: routine neonatal circumcision. Since I think our education institutions are negligent in discussing the medical, moral, social, psychological and legal ramifications of this sexual child abuse, I feel I must speak out.

Let me fill you in on how I became in­volved and what I have found out about this issue, especially in regard to the function of the University of North Dakota's School of Medicine in our university system. I am disturbed that the educational system of which I have been a proud part since my appointment at UND as Assistant Professor of philosophy in 1969 (later chairman for 3 years) and now as instructor at Bismarck State College, seems to be silent (or miseducating its physicians, psychologists, lawyers and citizens) about the reasons and effects of infant male circumcision.

I ran into this issue doing research on the rise of patriarchal societies and religious philosophies, which hap­pened about 5,000 years ago. I found that genital mutilations seem to have begun in the matriarchal systems out of which patriarchy arose. The operations ranged from complete removal of penis and testicles to the vari­ous forms of circumcision and subincisions still carried out today. Some native tribes today say they do subincisions as a way to imitate the female bleeding they believe is the source of life and also to make the penis like a vulva. The point here is that genital bleeding and mutilation is a very old practice, and the reasons given for them then were based on an outdated understanding of reproductive physiology and on a socio-religious order democratic systems cannot condone.

We also know that the Hebrews adopted the practice of circumcision, probably from the Egyptians, as a way of showing their relationship and subordination to Yahweh, the dominant male god introduced to the region, probably by the Hittites (or a subgroup or the Hittites we now know as the Levites) as they conquered the whole eastern Mediterranean region in the third and second millennia BCE. The Old Testament demonstrates the element of submission by metaphorically stating in Deut. 30:6 that you should “Circumcise yourselves to the Lord, [that is,] remove the foreskin of your hearts...or else my [Yahweh’s] wrath will go forth like fire.” Rabbi Moses Maimonides (1135-1204), a Jewish philosopher, said the practice is done to help one control his sexual passions by desensitizing the penis (Guide for the Perplexed Part III, Chap. 49) and that “No one should circumcise himself or his son for any reason but pure faith.”

Another factor in my increasing concern with genital operations came when I was given a scholarly article presented at the First International Symposium on Circumcision, 1989, dis­cussing what I had until then dismissed as unbelievable, namely, female clitoridectomies and infibulations (suturing up the vulva). Nearly 100 million young girls alive today have had this done to them in many of the strongly patriarchal so­cieties of Africa, Mideast and Southeast Asia (in addition to the male circumcisions done there). See, for example, the article “The Open Wound” in the Washington Post, 11/22/92. A few of these female operations are even being done by physicians in North America according to Fran Hosken, editor of Women’s International Network News. European physicians, upon discovering we routinely circumcise males, ask whether we do female mutilations also.

I have since learned at the Third International Symposium on Circumcision in Washington, DC, (where I delivered a paper on the origin of male genital mutilation) of a woman who was taken to the Wahpeton, ND, clinic when she was three years old and had her clitoris excised by physicians in the Breckenridge hospital because she was masturbating (some BlueCross insurance plans covered this operation until 1977!). Now fifty years old this woman, who lives in Minnesota, is just beginning to be able to speak out on the horror of the operation and the wreck it has made of her life. I have also learned that male circumcision is the most common of all male operations, but still ranks second to episiotomies as the most often performed operation, another unnecessary genital mutilation.

People here generally recognize there are no medical reasons to justify the female mutilations, at least of the African type. In fact, they are the major cause of death of women in countries where they are routinely done. So what about the reasons for male circumcision? I had to find out. I wrote my colleagues at the UND School of Medicine. I finally received replies from George Johnson, MD, Chairman of Pediatrics, and Dennis Lutz, MD, Chairman of Ob/Gyn. Though they did not answer all my questions, they did indicate there are specific medical reasons to justify the amputation.

The medical reasons they gave, however, simply do not stand up under scientific scrutiny. Much to my surprise, when I first began to look into the reasons for neonatal circumcision, I found most other North Dakota physicians did not think the operation can be justified on medical grounds, even those who do them. Many physicians did seem to agree with Drs. Lutz and Johnson that they are morally justified in amputating parts of healthy penises, if parents request it, and most medical institutions make sure they ask the parents whether they want it done. Such solicitation of unnecessary surgery suggests to the parents it is a healthcare issue and probably should be done. Others, like Mary Margaret Mooney, Chair, Department of Nursing, University of Mary, said this moral justification is greased by financial considerations or by the fact most physicians are circumcised themselves.

 At this point I began to have serious misgivings not only about the procedure but also about the course content of the UND School of Medicine, as well as the information parents are given or are able to get prior to signing the Consent for Surgery Form. Parents are supposedly giving “informed consent” when they sign. Every other physician except Lutz and Johnson was telling me that the reason he or she did circumcisions (if at all) was based on parents’ choice. The physicians often characterized this choice as being based on emotion, not reason (as did Roger Allen, M.D., neonatologist, on KXMB TV, Minot.) or on custom and ritual. Parents continued to tell me they request it because they are told it is a good thing to do.

I have seen videotaped circumcisions, so I know it is a very painful operation. Allen Lindemann, M.D., Ob-Gyn in Fargo, said he was taught at UND that infants do not feel pain. Even though the Medical School now seems to recognize this pain, the professors who wrote me still understate it. I’ve found some credible evidence that such early pain imprints one for a lifetime (for example, see the work of the clinical psychologists in primal therapy, Thomas Verny who founded the Pre- and Perinatal Psychological Association of North America and Arthur Janov who wrote Prisoners of Pain and Imprints). Also the natural function of the foreskin is lost for life. The foreskin is both protective and sexually sensitive tissue, as much so as the glans penis.

So if there are no good medical reasons for the operation which outweigh the known and sometimes serious risks like infection, mutilated and lost penises (a case occurred in Glendive MT) and even death, then what reasons are good enough to do this to a helpless, non-consenting infant? These reasons would have to be similar to those given for other operations if they are to have any legal and moral justification (and probably applicable to both sexes).

I have asked lawyers, physicians and parents whether there is any other operation that removes or muti­lates a healthy, normal body organ they think could be done to a non-consenting child; and also whether the law can distinguish the removal of the male prepuce from the female’s. I have not received any satisfactory answers to these questions.

A case in point: Roger Minch, attorney and producer of the State Bar Association’s program “Ask-A-Lawyer” wrote, “the law does not allow one to mutilate another without consent and the law, on its face, cannot discriminate between the sexes. However, the law often blindly follows custom and usage without much reflection.” A published letter to the Canadian Attorney General from McGill law professor, M. A. Somerville expresses her failure to understand why male circumcision is not a blatant sexist practice. The responses from the North Dakota Attorney General’s Office, the North Dakota Board of Medical Examiners and other state agencies have been largely silence.

Most people are so habituated to the situation they do not seriously question the ethical appropriateness of preputial amputation. Most of us just believe there are good reasons for doing it. And when faced with facts, for example, that European countries do not circumcise their boys and do not have all the maladies that pro-circumcision advocates say will happen, most people just get defensive. The pain of thinking we may be harming our young for no good reason is too much to face.

This issue finally comes down to cultural or philosophical reasons, not medical ones. Since as a philosopher I have not been able to see the justification for a person (even if the person is a well-meaning parent) to cause physical and mental pain and lifelong physical deformity to another without that person’s consent, I felt it necessary to do what I can to expose the weaknesses in the rationalizations used to continue the practice of circumcision. This practice went from 5% in the late 1800’s (ostensibly to stop masturbation and the medical problems it supposedly caused) to 80% in the 1980’s (now down to 59% nationally).

Bismarck State College agreed to sponsor a circumcision information seminar (December 4, 1992) despite its controversial nature as any good institution of learning would. Even so, I think the administrators deserve to be complimented on how they handled me and this issue and the preparations for the seminar. This, of course, does not mean anyone associated with the college agreed or disagreed with me or with Marilyn Milos, RN, the executive director of NOCIRC I brought here from California. In order to hear all sides I asked many physicians in several North Dakota cities to come and give their reasons for continuing to circumcise. However, finding people to speak for the pro-circumcision side was not easy. Eventually, after receiving Milos’ published articles, all three physician, who initially said they would come, refused to debate.

Several physicians in this state have told me they agree with former pediatrician and State Health Officer, Dr. Robert Wentz, that “time has come to stop the practice of routine infant circumcision.” Rhonda Ketterling, MD, Chair of the North Dakota Board of Medical Examiners, wrote she is sympathetic with those who “desire to have infant circumcision become a thing of the past.” Shari Orser, MD, now Chair of Medcenter’s department of Ob/Gyn, wrote: “the evidence is not strong enough to support circumcision as a routine...the practice should be discontinued.”

So why is there such a contrast between what seems to be the reasonable thing to do, namely, “Leave the poor little penises alone,” as Dr. Benjamin Spock says, and the continuing practice of routine infant circumcision in this state which physicians (such as Drs. Richard Grassy and Charles Severn in Bismarck, and Craig Shoemaker and Ron Miller in Fargo) tell me is more than 90% in some hospitals?

I hope this letter has made clear why I feel something must be done to educate North Dakotans despite the pain I know awareness is causing. I hope in the long run less pain will be suffered by all. I hope this letter also clarifies why I think someone needs to take a hard look at the UND School of Medicine’s curriculum regarding circumcision. Legislation is being proposed for the upcoming 1995 session to outlaw this mutilation. Lawyers are looking into possible class action suits. Time has come to teach in our educational institutions that routine infant circumcision is sexual child abuse.

Respectfully yours,

Duane Voskuil, Ph.D.
Philosophy and Ethics
Bismarck State College

cc. Kermit Lidstrom, President, Bismarck State College

 

 

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