Circumcision is not a barrier to an individual's religious freedom

Was a German court justified in interfering with centuries of religious tradition?

A court in Cologne has ruled that circumcision, performed for religious reasons on male children below an age where they can meaningfully consent to the operation, amounts to an unwarranted and irreparable interference with their bodily integrity. Furthermore, it interferes with the right of a child "to decide for himself later on to what religion he wishes to belong".

The ruling, in a case involving a four-year-old Muslim boy who was injured in a botched procedure, has been strongly criticised by both Muslim and Jewish groups in Germany and beyond. In the UK Jonathan Arkush, vice-president of the Board of Deputies described it as "intolerant, ill-informed and deeply troubling."  Andrew Copson of the British Humanist Association, by contrast, supports it. He thinks it is "an open and shut case, ethically speaking" on the grounds that "respect for the autonomy of a person requires that they give consent for irreversible procedures affecting their body like cutting pieces off their genitals". And Pavan Dhaliwal, speaking publicly on behalf of the BHA, suggests that a ban on infant circumcision "would not constitute an attack on religious freedom, because boys would still be allowed to be circumcised when they reach an age to consent".

While Copson has some sympathy for Jews and Muslims who may interpret a ban as oppressive, he appears to locate the source of their discomfort in an emotional attachment to their traditions and, in the case of men, intimate feelings towards their own bodies. But this is more than a merely cultural or psychological issue. It would have especially serious consequences for Jewish religious practice. To ban the circumcision of infant boys would, in effect, be to ban Judaism itself, at least as it has been practised for almost three thousand years. Islam expects males to be circumcised but lays down no specific age for the procedure. Jewish law on the other hand requires circumcision on the eighth day after birth, an age at which even the most precocious infant would be unable to give informed consent. No uncircumcised boy would be able to celebrate his Bar Mitzvah at the traditional age of thirteen. It would be potentially catastrophic. That a German court should have produced such a ruling has only added to the disquiet. 

Along with the Sabbath and the rules of kosher, circumcision has always been one of the non-negotiable features of Judaism, indeed central to Jewish identity. The requirement is laid down in the book of Genesis (in chapter 17), which describes circumcision as the "token of the covenant" between God and Israel and goes on to warn that that "the uncircumcised man child whose flesh of his foreskin is not circumcised shall be cut off from the people; he has broken my covenant." 

The importance attached to the procedure is repeatedly stressed in the Hebrew Bible. In one incident recounted in Exodus, God threatens to kill Moses, apparently because the prophet's (non-Jewish) wife has not had their son circumcised. He is only saved when Zipporah takes the knife to her son's foreskin herself. The message is clear: so much does God care about circumcision that's he's prepared to kill the man without whom there would be no Judaism (nor any Christianity or Islam) at all rather than see one Israelite child in possession of a foreskin. It's that serious.

If circumcision were obviously a bad thing, then religious freedom could and should be overridden. No religious justification would suffice to permit human sacrifice, or indeed female genital mutilation (FGM), which most Western countries have specifically banned. But male circumcision is not obviously harmful, as FGM is. Performed properly, it is not dangerous. The World Health Organisation positively encourages it, the theory being that it protects against HIV and other sexually transmitted infections. The effect on sexual pleasure in later life is disputed. Men who are in a position to know offer differing opinions, with those who report improvement somewhat outnumbering those regretting the procedure. All agree, however, that even with anaesthetic during the operation it is very painful afterwards and it takes at least a month to recover.

This matters. If circumcision for religious reasons is restricted to adults, not only would this interfere with long-held custom (and in the Jewish case, Biblical law), it would also force men or older boys to undergo a painful procedure as a price of belonging to their ancestral religion. Uncircumcised male converts to Judaism or Islam already face this dilemma, of course, but it's not hard to see that the prospect would act as a deterrent to many men lacking in the zeal of a convert. At the same time, a circumcised man leaving the religion is not forced to be painfully uncircumcised. It's thus hard to follow the logic that sees the procedure as an interference with a boy's freedom to choose his religion later in life. Quite the reverse.

 

A young boy cries after being circumcised. Photograph: Getty Images
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The big problem for the NHS? Local government cuts

Even a U-Turn on planned cuts to the service itself will still leave the NHS under heavy pressure. 

38Degrees has uncovered a series of grisly plans for the NHS over the coming years. Among the highlights: severe cuts to frontline services at the Midland Metropolitan Hospital, including but limited to the closure of its Accident and Emergency department. Elsewhere, one of three hospitals in Leicester, Leicestershire and Rutland are to be shuttered, while there will be cuts to acute services in Suffolk and North East Essex.

These cuts come despite an additional £8bn annual cash injection into the NHS, characterised as the bare minimum needed by Simon Stevens, the head of NHS England.

The cuts are outlined in draft sustainability and transformation plans (STP) that will be approved in October before kicking off a period of wider consultation.

The problem for the NHS is twofold: although its funding remains ringfenced, healthcare inflation means that in reality, the health service requires above-inflation increases to stand still. But the second, bigger problem aren’t cuts to the NHS but to the rest of government spending, particularly local government cuts.

That has seen more pressure on hospital beds as outpatients who require further non-emergency care have nowhere to go, increasing lifestyle problems as cash-strapped councils either close or increase prices at subsidised local authority gyms, build on green space to make the best out of Britain’s booming property market, and cut other corners to manage the growing backlog of devolved cuts.

All of which means even a bigger supply of cash for the NHS than the £8bn promised at the last election – even the bonanza pledged by Vote Leave in the referendum, in fact – will still find itself disappearing down the cracks left by cuts elsewhere. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.