A report has warned that if doctors do not perform circumcisions, non-experts will, writes Martin Wall
The number of non-medically managed circumcisions carried out in Ireland is not known. However, a report produced in 2004 by the then North Eastern Health Board at one of the country's largest centres for asylum seekers at Mosney found that there had been 44 such procedures carried out on infants in the course of a year.
Two years ago the issue of home circumcisions was highlighted following the death of a 29-day-old infant in Co Waterford. Last October a Nigerian man was found not guilty of reckless endangerment in relation to the case.
Following the death of the young boy the Government established an expert committee to look at whether there was a need for the provision of cultural male circumcision services in Ireland, and if so to make recommendations on the timing and procedures to be followed.
The committee comprised a consultant paediatrician, a consultant urologist, a consultant surgeon, a consultant anaesthetist, a GP and health service and Department of Health personnel.
The committee's report says cultural male circumcision is one of the most contentious issues in medicine today. The procedure raises difficult questions about the rights and freedoms of individuals, it adds.
The report warns that if doctors are unwilling or unable to carry out the procedure in a timely fashion, parents will turn in greater numbers to individuals who lack the skills and expertise to perform circumcisions safely and competently.
It points out that there are concerns regarding the ethics of the procedure and the demands that such services would place on hospitals.
However, it stresses that the welfare of children who are circumcised must be paramount, whatever the reason for undertaking the procedure.
In its submission to the committee, the National Consultative Committee on Racism and Interculturalism warned that if cultural circumcisions were not made available in Irish hospitals, emergency services would be likely to be called out to deal "with the consequences of botched operations on an emergency basis".
The report of the committee, which has been sent to Minister for Health Mary Harney, recommends that cultural male circumcision should be provided in the Irish health services and that the HSE should provide a regional service.
It maintains that male circumcision is generally assumed to be lawful provided that it is performed competently, is believed to be in the child's best interest and that there is valid consent.
Circumcisions carried out by an incompetent person and resulting in injury to the child could be deemed to be a form of child abuse and be subject to child protection legislation or criminal law, it states.
It also maintains that circumcisions should be carried out where adequate paediatric anaesthetic services are available.
The committee says that it recognises that Orthodox Jewish circumcisions are competently performed by trained rabbis in Ireland.
"The committee is not aware that any significant problems have been attributed to Orthodox Jewish circumcisions in Ireland.
"Rabbinical circumcisers are trained by the Initiation Society in the UK.
"The committee is satisfied that the practice of neo-natal Orthodox Jewish circumcision be permitted to continue in this jurisdiction but recommends that the situation be kept under review," it states.
The report says that depending on immigration trends, family size in Irish Muslim society, and population demographics, it is estimated that between 1,500 and 2,000 cultural male circumcision procedures could be required annually. Additional personnel and resources will be needed to provide the service and investment should be allocated for this, it states.