Medical Science, Grassroots Activism, and Informed Consent to Male Circumcision in the USA and Canada

• In Event: 118 - Regular Session. Ethics and Science

Abstract

This paper uses the case of male circumcision—a controversial surgery typically performed in childhood with parental consent—to investigate how sociological factors shape debates over key aspects of informed consent in the United States and Canada. My qualitative analysis asks how different stakeholder groups, with different levels of power, resources, and authority, negotiate over right (and wrong) behavior in the medical realm. Whose interpretations of informed consent to circumcision prevail? What role does cultural context play? Employing a multi-sited ethnography approach, I gathered textual data (newsletters, websites, policies, etc.) from, and conducted interviews (n=35) with, key stakeholders including grassroots activists; medical associations; biomedical, legal, and social science scholars; religious leaders; journalists; and state institutions. I also engaged in participant observation at three conferences. Mainstream medical actors have focused primarily on the adequacy of consent, assuming that parents may consent by proxy, whereas grassroots activists have shifted from (in)adequacy arguments to claims that boys/men have the human right to choose or reject circumcision for themselves. Recently, however, some Canadian medical leaders have framed consent in human rights terms and U.S. medical elites have addressed such arguments, albeit chiefly to dismiss them. Legal and political challenges suggest that medical interpretations will prevail for the foreseeable future, especially in the USA. These patterns make sense in light of the Canadian government’s more emphatic embrace of international human rights conventions, but tend to contradict research finding that grassroots movements have greater influence in the USA.

Author

• Laura M. Carpenter, Vanderbilt University