title: Risks, benefits, complications and harms: neglected factors in the current debate on non-therapeutic circumcision.
abstract: Much of the contemporary debate about the propriety of non-therapeutic circumcision of male infants and boys revolves around the question of risks vs.
  
  
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  With its headline conclusion that the benefits outweigh the risks, the current circumcision policy of the American Academy of Pediatrics [AAP] (released 2012) is a typical instance of this line of thought. Since the AAP states that it cannot assess the true incidence of complications, however, critics have pointed out that this conclusion is unwarranted. In this paper it is argued that the AAP's conclusion is untenable not only for empirical reasons related to lack of data, but also for logical and conceptual reasons: the concept of risk employed-risk of surgical complications-is too narrow to be useful in the circumcision debate. Complications are not the only harms of circumcision: the AAP and other parties debating the pros and cons of circumcision should conceptualize their analysis more broadly as risk of harm vs. prospect of benefit, thereby factoring in the value of the foreskin to the individual and the physical and ethical harms of removing it from a non-consenting child.
authors.forename: Robert
authors.initials: R
authors.lastname: Darby
mesh_terms: D001315:Australia; D002755:Choice Behavior / Q000941:ethics; D019093:Circumcision, Female / Q000009:adverse effects / Q000941:ethics / Q000523:psychology; D002944:Circumcision, Male / Q000009:adverse effects* / Q000941:ethics* / Q000266:history / Q000523:psychology*; D003075:Coitus / Q000502:physiology / Q000523:psychology; D004992:Ethics, Medical / Q000266:history; D005260:Female; D052816:Foreskin / Q000502:physiology* / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D006806:Human Rights; D006801:Humans; D008297:Male; D057228:Masculinity; D008418:Masturbation; D033282:Parental Consent / Q000941:ethics*; D010372:Pediatrics / Q000592:standards / Q000639:trends; D026684:Personal Autonomy; D017410:Practice Guidelines as Topic; D011678:Punishment; D011902:Rape; D012068:Religion and Medicine; D018570:Risk Assessment; D012649:Self Concept; D012955:Societies, Medical; D006113:United Kingdom; D014481:United States