A close reading of the Children's Act indicates that it does not prohibit elective neonatal medical male circumcision for medical reasons, and providing all informed consent requirements are met by obtaining consent from the parent or guardian of a newly born boy prior to performing a neonatal male circumcision, the procedure may be carried out.
Section
12 (8) of the children's act regulates circumcision of male children under 16.
It states in full:
8 Circumcision of male children under the age of 16 is prohibited,
except when –
- circumcision is performed for religious
purposes in accordance with the practices of the religion concerned and in
the manner prescribed; or
- Circumcision is performed for medical reasons on the recommendation of a medical practitioner.
The key term here would appear to be “medical
reasons”'. The children's act does not provide a definition of medical reasons.
Bearing in mind local and international studies that have shown that male
circumcision significantly reduces the risks of HIV infection, and that
neonatal circumcision carries far lower risks of complications than circumcision
in later life, a reasonable practitioner would have sufficient “ medical reason” to perform circumcision.
As with any medical/surgical procedure informed
consent is essential. For infants, consent is governed by sections 6-8 of the
National Health Act [1]and
section 129 of the children's act:
129 Consent to medical treatment and surgical
operation
1.
Subject to section 5(2) of the Choice on
Termination of Pregnancy Act, 1996 (Act 92 of 1996), a child may be subjected
to medical treatment or a surgical operation only if consent for such treatment
or operation has been given in terms of either subsection (2), (3), (4), (5),
(6) or (7).
. . .
5.
The parent or guardian of a child may, subject to
section 31, consent to a surgical operation on the child if the child is –
a.
under the age of 12 years; or
b.
over that age but is of insufficient maturity or is
unable to understand the benefits, risks and social implications of the
operation.
In order
to obtain informed consent, the practitioner needs to explain the risks of
complications as well as the potential benefits of circumcision.
Bearing
the above in mind, the Children's Act does not prohibit male circumcision for
medical reasons.
