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North Dakota Quotations
Compiled
by Duane Voskuil and Jody McLaughlin--1992-Present
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Request to Change or Add
Quote NDBME
1995 |
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Quoted groups on this page:
Physicians
Insurance Companies
Nurses & Professors of Nursing
Government,
Educational, Association and Hospital Statements
Attorneys and Judges
Religious Leaders
Other Citizens
North Dakota College Students
Our Thanks
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Physicians
Rhonda Ketterling, M.
D., Rugby physician, former Chair of the North Dakota Board of Medical
Examiners (NDBME) and Medical Director for U.S. Healthcare, in a letter,
November 20, 1992, to Duane Voskuil: “I sympathize with your
desire to have infant circumcision become a thing of the past,...” She
wrote further, “You will not get the
medical profession to overwhelmingly alter its practice by coming on
with an accusation of child abuse and/or sexual abuse....your best bet
in this program [to stop routine infant circumcision] is that of
education, not only of the general public, but of physicians...[and to]
get insurance companies not to reimburse for circumcision...[since] this
is not a medically necessary procedure.” In a phone conversation taped
with permission by Jody McLaughlin, 1993, she also said that
giving consent for surgery forms to parents to sign, who do not ask for
them, could be considered solicitation for elective surgery.
Robert Wentz, M.D., pediatrician and North Dakota State Health Officer: “Time
has come to stop the practice of routine infant circumcision,” He
wrote further “that the purported medical indications are outweighed
by risks and disadvantages and that circumcisions represent an
unnecessary health care cost.” Letter to Duane Voskuil, October
1, 1992.
Roger Allen, M.D.,
neonatologist, Minot, during an interview on KMOT TV, November 1992: “Parents
have usually made a firm decision [whether or not to circumcise] before
they ever talk to me. Their decisions are 95% based on emotions and 5%
based on fact...There is no compelling reason to do a circumcision, but
on the other hand, there is no compelling reason not to.” He repeated
essentially the same words again during a TV interview, May 1994. [See
Janet Wentz’ appropriate response below under Government Officials: “If
there is no compelling reason to do a circumcision, that is a compelling
reason not to do one.”]
Craig Shoemaker, M.D.,
Director of Neonatal Services and Chairman, Department of Pediatrics,
Fargo Clinic, MeritCare during a phone conversation: “You’re right.
We only circumcise healthy babies.”
He also agreed that the medical reasons for routine circumcision
are not compelling, and also wrote, November 3 1992: “I personally do
not feel that I have the right to decide for my patients [parents or
newborn?] whether or not they should be circumcised.” [Many people
have a hard time seeing the patient––the infant––as the patient.
Elective surgeries must be elected by the patient to be morally
justified.]
“We only remove the over-growth.” To a reporter, June 1996, during a
TV interview broadcast in Fargo, ND.
"It [the AAP Task Force on Circumcision (1999)]
essentially takes the position that for healthy new born male infants
circumcision is up to the parents."
But for conditions like phimosis or balanitis, "which is an
infection of the space between the foreskin of the foreskin itself,
circumcision is an accepted form of therapy, to prevent the infections
from reoccurring." The infections are "very painful."
Newspaper article, October 11, 2000.
Shoemaker still thinks the parent is the patient and is not up to date
on noninvasive procedures to treat infections. Phimosis is not
diagnosable in infants, and balanitis is most often caused by
harmful retraction (as with the
Price's child that Shoemaker is
commenting on) contrary to accepted standard of practice.
Ron H. Miller, M.D.,
pediatrician, Fargo Clinic, letter to Duane Voskuil, September 26 1992:
“What risk is acceptable when one is tampering with something that is
normal?...Physicians in general are very divided on this....although
most pediatricians take a fairly moderate if not anticircumcision
approach, most urologists and surgeons in the United States, even ones
who trained in Canada, seem to take a position advocating circumcision.”
He also was successful several years ago to get BlueCross BlueShield to
stop covering it. They later reversed this policy and have continued
paying for routine
circumcision
Shari L. Orser, M.D., Ob/Gyn,
Q&R/Women's Health Center and UND medical school graduate in a
letter to Duane Voskuil, November 24, 1992: “I personally am opposed
to circumcision....I feel that the evidence is not strong enough to
support circumcision as a routine and that the practice should be
discontinued.”
Shari L. Orser, M.D. Chair, Department of OB/GYN,
Medcenter One: “It was felt that educating the parents should be the
key focus, and the members of the Department of OB/GYN have agreed to
make a concerted effort to provide parents with information regarding
[the risks of] circumcision. However, if after reviewing the information
the parents wish to proceed with the procedure, we will abide by their
wishes, and they will be required to provide the hospital with a signed
informed consent.” Letter, October 5, 1994.
Alan Lindemann, M.D., Ob/Gyn,
Fargo, November 1992: “If we were to take routine infant circumcision
outside the present circumstances, it would clearly be child
abuse....Parents should be forced to watch a circumcision before they
agree to one....I was taught at UND that it didn’t hurt.”
Dennis J. Lutz, M.D.
Chairman UND Medical School Department of Obstetrics and Gynecology in a
letter to Duane Voskuil, 10/30/92: “Obviously there are design
problems with some of the studies,...[but] Enough studies linking STD’s
[sexually transmitted diseases] to uncircumcised males have been
published to give rise to the often repeated admonition ‘it doesn’t
matter what you do with your sons, but don’t let your daughters sleep
with uncircumcised males.’” [I find Dennis Lutz and George Johnson,
below, fellow faculty members of the ND University System, to hold
intellectually embarrassing positions.]
George Magnus Johnson,
M.D., Chairman, Department of Pediatrics, UND School of Medicine in a
letter to Duane Voskuil, September 7, 1992: “Urologists stoutly
maintain that cancer prevention (squamous cell carcinoma of the penile
foreskin) is one of the major reasons for circumcisions. This is a
reason above and beyond prevention of urinary infections in the males.” [More babies die from circumcision than old men do from
penile cancer (about 200 per year), and Wiswell’s UTI correlation’s
have been shown to be systematically flawed and statistically trivial
even if true. 100 healthy babies would need surgery to prevent one
treatable UTI. Not all, or even most (hardly any in Europe and Asia),
urologists will put their credentials on the line to defend this
practice. See Robert Pathroff above.]
Charles Severn, M.D., St.
Alexius and Robert Grassy, M.D., formerly of Medcenter One, both
told Duane Voskuil in phone conversations, fall of 1992, that the
surgery is not medically indicated, though they do them because the
parents want them.
Robert Roswick, M.D. and Jeffrey Smith, M.D., Family Medical Center,
Bismarck, in office visit conversations, 1993: “Routine infant
circumcisions are not done for medical reasons.”
Daniel Gruver, MD. in a letter to the Bismarck Tribune,
January 22, 1993: “I worked in Panama as a doctor for 20 years and saw
many, many complications of foreskins not being circumcised....All of
these [cancer, adhesions, urinary retention, phimosis and surgical
infections] are avoided by the simple process of circumcision. The
urologist [who?] informs me that AIDS is more likely to be transmitted
to and from non-circumcised men; and urinary tract infections are more
likely to occur also.” [Amputating part of one’s penis is not “simple,”
that is, insignificant, and does not decrease sexually transmitted
diseases. As for UTIs, even the questionable retrospective studies by
Thomas Wiswell show a hundred circumcisions would be required to prevent
one UTI, and still girls are four times more likely to get a UTI than
boys. What about the many “botched jobs,” even death, and the loss
of half the penis’ sensuous nerve endings?]
Thomas W. Mausbach,
M.D., former ND Chapter President, American Academy of Pediatrics, in a
letter to Rhonda Ketterling, Chair of the ND Board of Medical Examiners,
1/26/93: “...I think the important issue is that the total complete
scientific evidence is just not complete yet [it is for most people in the world, and this is the very reason for a
moratorium]....The key issue is that these individuals who are against
circumcisions have no significant scientific evidence to justify a
moratorium against circumcisions in our state. Personally I do not feel
they are going to go very far because of these public and social issues
regarding circumcisions in the United States. I guess it is better to
have them standing on the soapbox regarding this issue than something
that could be a more detrimental issue for medicine. Sorry I could not
help you any further but I think philosophically these people do not
have much ground to stand on.” [Even the national AAP does not
recommend routine infant circumcision. He confuses “medicine” with
“health.” Most MD’s do not agree with his view. Even Rhonda
Ketterling , to whom he is writing, does not think routine circumcision
is sound medical practice.]
Robert Pathroff, M.D.,
urologist, Bismarck, ND, verbally, June 1994: “Routine circumcisions
cannot be justified on medical grounds.”
Jon Rice, M.D., Former ND State
Health Officer: “This [routine infant circumcision] is not a medical
issue.” in a conversation with Jody McLaughlin, July 1993. He
elaborated that his reluctance to deal with the circumcision issue, was
due to the fact that he was mainly interested in medical issues, not
health issues, because even though he is the State Health Officer, he is
a physician first.
Wes Borowski, MD, Rugby in a letter to the Minot Daily
News, 1/14/95: “...To describe the foreskin as an essential [body]
part would be reaching beyond the boundaries of common sense. I agree
that infant circumcision cannot be strictly defined as medically
essential.” [What other healthy body parts are not essential? Is the
female prepuce, e.g., any more essential?]
Manuel Neto, MD, regarding
his opinion on surgery for hypospadias: Neto said a male infant did not
need corrective surgery to his urinary opening, but should be
circumcised so he "Doesn't get picked on by other boys because he
won't be urinating straight," because "He won't learn as well
in school if he doesn't get circumcised". Centennial Medical Center
in Minot, August 22, 1994, Complaint
to ND Board of Medical Examiners.
Joseph Cleary, MD, Medical Consultant for ND Medicaid
said Medicaid does not cover circumcision unless there is a medical
indication, which includes phimosis [prepuce is too tight] and balanitis
[an infection of the prepuce or glans penis]. He said these two
conditions can happen the first day after delivery. January 1996
[Phimosis is not a condition diagnosable in newborns or children, and
balanitis is a highly unlikely condition for neonates, according to Robert S.
Van Howe, M.D. FAAP, unless someone is forcing back the prepuce.]
M. F. Buscemi, MD, Urologist, Medcenter One, Bismarck,
when asked whether he did foreskin restorations, said he wouldn’t do
them even if he knew how. He went on to berate “those people” trying
to get nonconsensual circumcision outlawed. “Jews have to do it. You
can’t tell someone they can’t do this. Who do they think they are,
anyway? This is America, for chrissake.” He felt strongly enough to
return to the topic and basically repeat what he had said. May 1996.
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Insurance
Companies
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Medicaid’s present policy
statement for ND: “Effective for services provided on or after
November 1, 1986, the North Dakota Medical Assistance Program will
provide payment for circumcisions only when there is documented evidence
that the circumcision was performed due to medical necessity.
Routine circumcisions that are not medically indicated will no longer be
reimbursable through the Medical Assistance Program.” And further,
David Zentner, Medicaid Director, offered the following policy statement
from the ND Department of Humans Services: “Medicaid pays for
circumcisions only when they are medically necessary. Our medical
consultant [Joseph Cleary, MD] reviews all claims with circumcisions and
payment is allowed for the diagnoses phimosis
and balanitis. If other diagnoses are used, the medical necessity
must be documented and approved by the medical consultant. Routine
circumcision for newborns are not a covered service. Providers
should notify the family before the procedure is performed that Medicaid
will not cover routine circumcisions.” Emphasis added. [Phimosis
cannot be a diagnosis for a newborn or even an infant, since whether or
not the prepuce is too tight (phimosis) cannot be known until its tissue
physiologically differentiates from the glans, often not until teen
years; and very few babies, especially neonates, could have infection of
the glans or prepuce (balanitis or posthistis), and when they do, it
usually results from prematurely retracting the prepuce–against the
advice of all medical authorities–which damages the tissues leaving
them vulnerable to infection.]
Julie Weaver, former Vice President Planning, Development and
Benefit Administration, in a letter to Jody McLaughlin, 11/23/92: “Regarding
circumcisions–We [the Contract Administration Committee of BlueCross BlueShield of ND]
consulted with other Plans and The American Academy of Pediatrics. The
majority of these entities do not have an established policy regarding
circumcision.... There is recognition by these parties that this
[i.e., routine infant prepuce amputation] is an elective service.
Board action taken in 1987 in response to this issue provided that
payment should continue to be available for circumcisions, based on
individual choice [sic], in response to the market demand for this
covered service.” [Emphasis added. Letter to Jody McLaughlin,
11/23/92, from Julie Weaver. No infant ever chooses to be cut.]
Julie Weaver in a letter January 16, 1995: “I
admire your dedication to the issue you address....there will be no change
in our policy or benefit provisions...[based] on much the same criteria
noted in the letter from Dr. Fitzpatrick [namely to pay for some elective
surgeries requested by consenting patients, like tubal ligations
and vasectomies]. While we support efforts to educate the general public
on circumcision so that thoughtful and informed decisions may be made
regarding this elective procedure, we are not seeking a visible role in
that process at this time...[so we] request that any reference to Blue
Cross Blue Shield of North Dakota be deleted.” [Infant circumcision is
forced upon nonconsenting patients, and so does not fit the
analogies BlueCrossBlueShield gives to justify paying for it.]
Return to Insurance Issues
Page
ND Public Employees Retirement System Group
Health Plan (PERS), July 1, 1993, underwritten and administered by
BlueCross BlueShield of North Dakota: “You [North Dakota Public
Employees] are not covered for: nonmedically necessary circumcision for
newborns.”
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Nurses & Professors of Nursing
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Sister Mary Margaret Mooney, P.B.V.M, R.N., Professor and Chair,
Department of Nursing, University of Mary: “I used to work with a
physician who would ask a mother whether she wanted to mutilate her son.
He never did any circumcisions.”
She also said the practice continues [to a large extent] because
of the financial incentives. Conversation, 1992.
Connie Kalanek,
MSN, RNC, Associate Professor, Medcenter College of Nursing,: “I am
certainly supportive of efforts to try to stop routine circumcision. I
have always regarded this procedure as repulsive and a painful
experience for the neonate. I agree that the literature does not support
routine circumcision of the male. It truly represents an unnecessary
health care cost.” Letter, 10/22/92.
Arlene Mack ,
R.N., Vice President Medcenter One, Support Services. “We will inform
the parents of the risks [of circumcision].” Phone conversation,
10/3/94.
BSC student and Bismarck nurse:
“I find it very hard to believe that people, including the medical
profession, have been so blind to the fact that male infant circumcision
is child abuse. As a student nurse I was taught that these babies feel
no pain. How stupid! These doctors taught us this! These poor babies are
swaddled on a restraint board and the foreskin torn away and cut
off--for what? It makes me very angry to think that we as nurses,
parents and the general public have been so misled.”
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Government, Educational, Association
an Hospital Statements
(Also See Those Who Are Physicians and Professors)
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Gladys Cairns, Director
Child Protection Services
of North Dakota: “When one considers what is done to the child, it is
hard not to consider this child abuse,” verbally while extending an
invitation to Duane Voskuil in October 1992 to address, the Alliance for
Sexual Abuse Prevention and Treatment, ASAPT, a statewide group of
professionals from many areas concerned with sexual child abuse.
“I am already convinced that
it [circumcision] is not medically necessary, that it is culturally or
religiously driven....we [ASAPT] do not expect to cover the issue of
circumcision as an agenda item for our task force in the foreseeable
future.” Email to Jody McLaughlin, October 1998.
Susan Cordes Green, Director, Alliance for Sexual Abuse
Prevention and Treatment, Fargo: “My personal hope is that the
practice [infant circumcision] will be stopped.” Phone conversation
with Jody McLaughlin, September 12, 1998.
Susan Cordes Green,
Director, Alliance for Sexual Abuse Prevention and Treatment, Fargo, Linda
Rice, ASAPT, Adult Survivor Program, Fargo and Gladys Cairns,
Child Protection Services, Bismarck: “Gladys and Linda and I have
talked at length about the subject. WE are all concerned about the
issue, and believe that parents and physicians should receive better
information. Given the choice again, I would not readily agree to have
my sons circumcised. However, our major question is: Is circumcision
sexual abuse? I have read and re-read the accepted definitions, and it
does not meet the criteria. Sexual abuse most often involves the sexual
use of a child by an adult or a minor significantly older than the
child. This is done for the sexual gratification of the adult at the
expense of the child. Neither physicians nor parents derive any pleasure
from circumcision [Why is this assumed to be true?], and the child is
certainly not sexually stimulated by the procedure [But are some
cutters?]. Sexual abuse may [sic] also involve power and control linked
to sexual gratification. Although circumcision involves physical
restraint, the intent is not to control or punish. The intent, though
perhaps misguided, is the child's welfare. Because the result may [sic]
be physical and/or emotional damage, we join you in your concern....If
circumcision is to be considered abuse, the appropriate category is
physical abuse, not sexual abuse. For this reason, ASAPT will not be
acting on the issue, but will stay informed and will keep info[rmation]
available. We do commend you on your efforts, and hope that they will
effect a greater awareness and increased thoughtfulness regarding this
procedure.” Email to Duane Voskuil, September 10, 1998. [Physicians
insulate themselves from receiving
information because they
do not want to accept the fact that they have been harming children.
Many do receive pleasure from circumcision whether it is a prurient need
to do to the child what was done to them, financial compensation or the
desire to gain approval and appreciation for accommodating parents’
requests, or even the cultural comfort level that social conformity
provides them; the child is often stimulated to erection before the
cutting; and circumcision does cause physical and emotional damage.]
Janet Wentz, Republican State
Legislator, Minot: “If there is no compelling reason to do a
circumcision, that is a compelling reason not to do one,” verbally
November 1992, responding to Roger Allen’s KMOT TV comments of
November 1992 above: ("There is no compelling reason to do a
circumcision, but on the other hand, there is no compelling reason not
to.”).
“I
took my uncircumcised son to the pediatrician [T. Barry Brazelton] for
his first checkup. He ripped the foreskin back while my son screamed; I
felt sick. When we came back to the clinic for the next checkup, he
started crying. I took my son and left, and never went back.”
Sandra Holbrook, Ph.D., Director of Equal Opportunity,
NDSU in a letter to Duane Voskuil, August 2, 1993: “Thanks for your
letter and for sharing the information regarding various types of sexual
[genital] mutilation. This is obviously a significant gender issue....”
Mother and member of ND Board of Social Work Examiners:
“My doctor told me circumcision was necessary to be clean and prevent
infection, and besides, the military will do it anyway.”
State Representative Cathy Rydell, Executive Director,
ND Medical Association and ND Hospital Association: “When I first
worked at St. Alexius, my office was right next to the circ room. I can
still remember the babies’ screams.” Conversation, November 1992.
Spokeswoman for the ND Committee to Prevent Child Abuse,
appointed by the Governor: “It [circumcision] is an issue that is
being discussed, but the national level has not yet taken a position,
and we tend to follow them.” Conversation, 1994.
Russell Thane, Chair,
ND Senate Human Services Committee to Duane Voskuil after the committee
voted unanimously to recommend passage of SB2454: “Thank you for
bringing this issue [genital mutilation] to our attention. We needed to
deal with this, but it is hard for us to do it.”
North Dakota SB2454, initiated
by Jody McLaughlin and Duane Voskuil in a gender-neutral form (but
modified to include only females by Rae Ann Kelsh), sponsored by Senators
Scherber, Mathern and Watne and Representatives Kelsh and Maragos,
passed by the North Dakota Legislature, March 1995 unanimously with
backing from the AMA and the North Dakota Medical Association:
"North Dakota Century Code
12.1-36-01 FEMALE
GENITAL MUTILATION
AN ACT to prohibit female genital mutilation; and to provide a penalty.
Section 1. Surgical alternation of the genitals of females
minors - Penalty - Exception.
1. Except as provided in subsection
2, any person who knowingly separates or surgically alters normal,
healthy functioning genital tissue of a female minor is guilty of a
class C felony.
2. A surgical operation is not a
violation of this section if a licensed medical practitioner performs
the operation to correct an anatomical abnormality or to remove diseased
tissue that is an immediate threat to the health of the minor. In
applying this subsection, any belief that the operation is required as a
matter of custom, ritual, or standard of practice may not be taken into
consideration."
American Academy of
Pediatrics (AAP) Statement on Informed
Consent, Parental Permission, and Assent in Pediatric Practice: >http://www.aap.org/policy/00662.html
"...providers have legal and ethical duties to their child patients to
render competent medical care based on what
the patient needs, not what someone else expresses.
Although impasses regarding the interests of minors and the expressed
wishes of their parents or guardians are rare,
the
pediatrician's responsibilities to his or her patient exist independent
of parental desires or proxy consent ... A patient's
reluctance or refusal to assent should also carry considerable weight
when the proposed intervention is not essential to his or her welfare
and/or can be deferred without substantial risk." Pediatrics,
Volume 95, Number 2, February, 1995, pp. 314-317.
North
Dakota Board of Medical Examiners, indirectly responding to
requests to declare routine infant circumcisers are following a pattern
of inappropriate, and perhaps fraudulent, care, stated in their Winter
1996 issue of The Examiner: “During
the last few years, the Board of Medical Examiners has repeatedly been
approached by a small but committed group of individuals who would have
the Board declare the practice of routine infant circumcision to be “unnecessary
surgery” within the meaning of the Medical Practice Act. At this
point, the Board has neither embraced nor condemned this practice. The
Board’s research indicates that no other state medical board has any
rule, statute, or policy statement on this point either. Nevertheless,
it is a troubling and emotional issue. In the eyes of some people,
routine infant circumcision is nothing less than the wholesale,
unjustifiable mutilation of innocent infants by a violent society. Some
people see this question as being only a medical issue but to others it
is essentially a social issue and for some this practice has strong
religious significance. For all of these reasons, it is the conclusion
of the Board of Medical Examiners that this issue would be best debated
in the state legislature.” [Since when do physicians ask legislators
whether a surgical amputation is medically necessary, or even advisable?
Obviously, they understand that amputating healthy, functioning, normal
tissue is unnecessary, which it obviously is, since all males are born
intact and 95% of the world’s male infants remain that way.]
Reporting Child Abuse:
NDCC 50-25.1-03.
Persons required and permitted
to report - To whom reported.
1. Any physician, nurse, dentist, optometrist, medical examiner or
coroner, or any other medical or mental health professional, religious
practitioner of the healing arts, schoolteacher or administrator, school
counselor, addiction counselor, social worker, day care center or any
other child care worker, police or law enforcement officer, or member of
the clergy having knowledge of or reasonable cause to suspect that a child
is abused or neglected, or has died as a result of abuse or neglect, shall
report the circumstances to the department if the knowledge or suspicion
is derived from information received by that person in that person's
official or professional capacity. A member of the clergy, however, is not
required to report such circumstances if the knowledge or suspicion is
derived from information received in the capacity of spiritual adviser.
2. Any person having reasonable cause to suspect that a child is abused or
neglected, or has died as a result of abuse or neglect, may report such
circumstances to the department.
Edward T. Schafer, Governor of North
Dakota in letter to Jody McLaughlin, February 26, 1996: “It is my
understanding that no state medical board has concluded that routine
infant circumcision constitutes an inappropriate medical procedure or
unnecessary surgery. If it is your opinion that routine infant
circumcision is inappropriate, you may go to the Legislature and ask them
to specifically provide legislation to prohibit the procedure. North
Dakota law does not specifically provide that such surgery is unnecessary,
unethical, or inappropriate.” [The NDBME has not said amputating
healthy prepuces is an appropriate surgery. However, by saying it is
something that can be appropriately debated on nonmedical grounds they
have implicitly said circumcisers are not performing a necessary
healthcare procedure. The legislature has already given the NDBME
responsibility to determine whether procedures are medically “unnecessary,
unethical or inappropriate.” When will they fulfill this appointed
duty?]
MERITCARE HEALTH SYSTEM
PATIENT BILL OF RIGHTS
& RESPONSIBILITIES
from: >http://www.meritcare.com/guidebook/billofrights
It is
the policy of MeritCare Health System to support and care for all
patients in a manner and in an environment that promotes quality of life
with
emphasis placed on dignity, choice and self-determination. In
addition, MeritCare will strive to protect and promote patients' rights
and
responsibilities without interference, coercion or discrimination.
YOU HAVE
THE RIGHT TO:
* Receive kind and courteous care.
* Receive treatment and services consistent with acceptable
professional standards of practice.
* Have a family member or representative of your choice and your own
physician notified promptly of your admission to the hospital.
* Make informed decisions about your care by:
* being informed of your health status,
* being involved in care planning and treatment, and
* being able to request or refuse treatment.
* This right should not be used as a way to demand treatments or
services deemed medically unnecessary or inappropriate....
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Attorneys and Judges
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Roger J. Minch, Attorney, Fargo, letter, September 27,
1992: “The law does not allow one to mutilate another without consent,
and the law, on its face, cannot discriminate between the sexes.
However, the law often blindly follows custom and usage without much
reflection.” He was
responding in a to a question about the legalities of amputating a
healthy prepuce without consent and whether a parent or physicians could
do the same thing to a female.
Thomas A. Mayer, Assistant Attorney General of North
Dakota, January 12, 1993: “In connection with routine male infant
circumcisions, the criminal elements of assault are lacking. There is no
purpose to intentionally or knowingly cause bodily injury. Thus,
criminal culpability is absent [for the physician]. It is assumed there
is informed consent to the surgery.
“‘Parents, guardians, and custodians are authorized to
consent to health care on behalf of children.’ N.D.C.C. Sec.
23-11-13.”
“Circumcision
may also be performed for religious or cultural reasons. In this
respect, it may be more akin to elective plastic surgery for cosmetic
purposes. Arguably, such surgery does not in many instances serve any
medical [i.e. health care] need. This fact would not warrant
reporting elective cosmetic surgery under N.D.C.C. Sec. 43-17-41.
Presently in our culture a routine male infant circumcision does not
violate any North Dakota criminal statute.” Emphasis added. Mayer was
responding to questions (though not to “be considered as a formal
legal position of this office”) about culpability of physicians (and
others) who perform non-medically indicated surgery on non-consenting male or female children. [He
does not make clear how a surgery that does not “serve any medical
need,” and which is not elected by the patient, can be legally
forced on a nonconsenting individual. Is he also saying in the first
paragraph that a physician can remove or alter any body part on children
if a parent signs a consent form?]
Heidi Heitkamp, Attorney General, State of ND, after a
talk at the Unitarian Universalist fellowship, 1994, where she outlined
her work to prevent child abuse and violent children: “It won’t do
any good talking to me about it [routine infant circumcision].” [She was asked whether the
violence of circumcision could be one factor causing violence in
children, since it is common knowledge that those who are violated,
violate others.]
Rolf P. Sletten, Commission Secretary, responding to
Ramona Goheen’s formal complaint (see below) that Manuel Neto, M.D.,
injured her son’s genitals and wanted to circumcise him even thought
he had hypospadies, a textbook reason not to circumcise: “This is to
advise you that the Commission on Medical Competency has completed its
investigation regarding your experience with Dr. Neto....In this case
the Commission has determined that the circumstances do not give rise to
a disciplinary action under current North Dakota law.” Letter, October
3, 1994.
Patrick A. Conmy, District Judge, U.S. District Court,
upon dismissing a suit, based on the U.S. Constitutional equal
protection provisions, against the State of N.D. for passing a law that
protects females but not males: “Finally, the court notes that this
battle over routine male infant circumcision is one for the education of
new parents and for the legislatures of this country--not the courts.”
[What were the courts doing in all the other civil rights cases? The courts’ first duty must be
to speak for, and protect, those who are not powerful enough to enforce
equal protection for themselves.]
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Religious Leaders
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Robert Lynne, Former Bishop ELCA, in an interview fall
1992: “The Lutheran Church has no rite of circumcision.”
John F. Kinney,
former Bishop Bismarck Diocese, who chairs a national committee to
investigate sexual abuse by priests, said in a phone conversation, fall
1992: “The Roman Catholic Church has taken no stand on circumcision.”
Bismarck Lutheran minister: “People don’t ask
pastors about circumcision. The doctors have become society’s high
priests.” Conversation, 1992.
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Other Citizens
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Renee Bergstrom, psychologist and health educator now
living in Minnesota, speaking out publicly for the first time, and
videotaped, at the Third International Symposium on Circumcision,
University of Maryland, Washington DC, May 1994: “I was born and raised on a
farm in South Dakota (to very loving parents), and when I was three
years old, my mother who was concerned about the fact that I was
masturbating (she had read some place that it was the ultimate sin),
took me to a doctor in a clinic in [Wahpeton] North
Dakota, who took me to a hospital in [Breckenridge] Minnesota and removed
my clitoris. My mother was at the end of the table. I remember the
pain, and I also remember knowing that I couldn’t trust her any
more....” [Emphasis
added.] She went on to explain how the clitoridectomy has ruined much of
her life, and how clergy, counselors and physicians have been no
comfort. Please do not contact her for an interview without
conferring with Duane Voskuil
first.]
Ramona T. Goheen, in a letter, September 3, 1994, to the
North Dakota Board of Medical Examiners: “I brought my son in to get
Dr. Neto’s opinion on surgery regarding his hypospadias. He said that
my son did not need reconstructive surgery to the urinary hole, but
should be circumcised so he, ‘Doesn’t get picked on by other boys
because he won’t be urinating straight.’ He also stated that ‘He
won’t learn as well in school if he doesn’t get circumcised’....He
forcibly retracted the foreskin without my permission
causing it to redden, bleed, and swell, causing extreme pain to my son.
I said to him, ‘ I thought you were supposed to leave it (the
foreskin) alone,’ while he was doing this, but he still proceeded to
force it back even after I said this. He gave no explanation for
forcibly retracting the foreskin from the glans. If anyone else would
have done that to my son, I would have them arrested.” [See Rolf
Sletten’s NDBME’s reply
above under “Attorneys”.]
Female Minot High School student after watching
the suffering during three circumcisions in a local hospital as part of
a career orientation course in nursing: "There must be a very
important reason for doing this!"
A mother after learning routine circumcision is
not medically necessary: "I now know why my son who is 28, married,
in college in Utah asked me about why I did this to him. I couldn’t
understand why he even brought the topic up. Now I know...."
25-year-old Fargo business man when asked
whether he was circumcised: "I don’t know."
A North Dakotan raised as a Jew: "I don’t
think I would circumcise my sons." A year later he became the proud
father of an intact son.
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North Dakota College Students
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Mother and student: "I have to tell
you that I feel just awful for circumcising my son. I really did think
that I was doing him a big favor....This is really hard for me to
handle. I can’t imagine how other people feel, when they don’t even
know why they had them circumcised. I honestly thought I was doing him a
favor. I would now wait until he was old enough, to see if he even had a
problem with it....I feel I owe my son an apology when he gets
older."
"The film was the first time I
actually knew exactly what they do when a baby is circumcised. The
crying was so bad and just to know that doctors would do such things to
a little baby for no [medical] reason is so sick! Just watching and
listening to this film made my stomach turn!"
"The tape was an eye opener and a
stomach turner. I definitely would want both my husband and me to have
to be informed before making any decisions." "The film I
feel was rough to watch but it was worth seeing."
"I don’t see why such a big fuss
is made about circumcision. Women suffer all the time. Their hymen is
ripped; they have pain in birth; hot flashes in menopause, etc. Men
should have some pain too." Female BSC student who two months later
changed her mind when her girl friend had a baby boy.
Mother and student: "I didn’t have
my son circumcised and the doctor gave me a hard time for years....He
said the military will do it anyway."
Pre-med student: "My boy friend won’t
marry me unless I agree to circumcise our sons."
"The substitute doctor walked into
the room, said he had just mutilated my child and walked out. I wish he
had talked to me before he did it, if he felt that pained about
it."
"Do medical staff get into trouble
for trying to inform parents further about circumcision?" [Yes.]
Female BSC student: "I was so
ignorant that when the doctor asked me about doing the surgery, I had
never really understood what they even did. I would never have even
thought to ask for this surgery. She [the nurse with the consent form to
sign] came to me. I guess I had only seen circumcised males and didn’t
even recognized they were circumcised."
"No one has the right to do genital
mutilations on children. If you were born with it, then let be. I just
can’t understand why would any one want to torture someone that way
for no medical reason at all." Male student.
"I think hospitals should show this
film [on infant male circumcision] to parents before they perform the
circumcision."
"Have you ever suggested that it be
shown during Lamaze classes?"
"The videos were hard to watch but
very necessary to give informed consent for the procedures."
BSC ethics student, November 1994:
Watching the FGM was even worse the 2nd time...because I knew what was
coming. The MGM was bad. I couldn’t believe it. That baby goes through
hell. I can’t believe what I put my son through. No wonder he was
crying so hard when they brought him to me. He went through hell. I’m
glad you made this video available for us to watch...."
“I was too shocked after watching
the video [on infant male circumcision] to be able to write anything
coherent on my [daily 3x5] card. But that night, at home, I told my
husband about the videos and asked him, ‘Why do you still see fit to
perform circumcision?’ (He is a doctor, and that is [one thing] he
does for a living.) Our own two boys are not circumcised....
But when I asked him that night after watching the video, ‘What good
do you as a person and doctor see in this procedure,’ he told me, ‘The
good I see is that it does reduce sensitivity, [and] the full force of
sexual drive. Man is not [meant] to be subjected to the full force of
his sexual drives, but instead to God.’ What he was talking about is
Paul and his advices about sexuality (being sinful, of course).
Well, then I asked him, ‘What is wrong with being sexual? We are
supposed to be, otherwise, God would not have seen fit to give us such a
drive.’ He insisted that it is the purpose [for sex] that matters. As
‘Godly’ beings we are called to transform it into something higher.
Sexuality for him is ‘lower’ and ‘lesser,’ and that the purpose
of it is just offspring, not on its own a joy.
I guess what I am sharing is this: I’ve discovered, through this topic
of yours in class, a can of worms. In a few years I might not remember
Anaximenes, but I will my husband’s remarks...!’ Thanks.” [This
quotation shows the close tie that can exist between personal religious
beliefs and the use of medical facilities for ritual purposes.
"I was shocked at how cruel
circumcision is."
Male student, 1995: "When I first
found out about circumcision, I heard that is was done as part of a
religious practice. I didn’t really understand this at that time. When
I got older I found it is still a very common practice. I asked my
mother about it, and she said it is something little boys have done [to
them] when they are born. I found this extremely disturbing. She said it
was for hygiene. The thoughts I had about this [comment on cleanliness]
was: What happened before anyone thought of circumcision? Did every male’s
organ just get diseased and fall off? I found this absurd. It couldn’t
just happen. I felt very angry for a long time about this misjustice:
Feeling that you can be violated as a child in a way you couldn’t even
imagine was possible, until you learn about it." [Is it already too
late to save the medical profession’s prestige and legal culpability?]
Female pre-med student to Dr. Voskuil:
"I would like to know something, O.K. Now I understand the concern,
but if it has been going on for so many years, and it is so bad, then
why has it gone on? I mean how can you know so much when our own
doctors don’t know that much? How can you say this has to be stopped?
You can’t know everything, yes?! Now, I’m not questioning your IQ.
It just seems weird that if this was so painful & and hurtful that
it would have gone on for so long. Plus, where do you think the doctors
get their information? If not from medical school, then where? It
is hard to believe doctors hurting patients for $200 or so. They are
suppose to know how to heal--that’s what they are taught." [When
will the North Dakota Board of Medical Examiners answer this woman’s
questions?]
"I think, as a mother of two boys
and a wife, [circumcision] is a good thing to discuss. I found out
things today I as a mother was never told. There are harms that last the
child’s whole life. I have to truly say I’m pissed off I didn’t
hear these things from my doctor. Maybe, I would have not have had it
done to my baby boys, if I would have known half of this!" [Perhaps
the reason she didn’t hear these things has to do with the silence of
our watchdog boards. Are they legally negligent because she did not
hear?]
Female student, 1996: "When I was
entering puberty and seeing what "normal" [i.e., cut] penises
look like, I thought something was seriously wrong with my dad (who is not
circumcised) whom I had often seen nude as a child. I was also afraid
something was wrong with me because of this. Years later, when I found
out why my dad was different, and that he was normal, I was quite
relieved for him and myself—but didn’t understand why these other
boys had this done—and I probably never fully will
understand....Circumcision is a subject I feel very strongly
about."
Dear Mr. Voskuil. You recently came to our college to educate us
on circumcisions, male and female, and why they should be stopped.
I am behind you 100% because I had this cruel surgery performed on my
two sons. Both were done for "'hygienic" reasons and my second
son's circ. was not performed "'properly" and had to be
medically corrected after he turned one year of age. He is permanently
scarred. Both my babies screamed and cried from the pain in an IHS
[Indian Health Service] hospital. I pray they will lead healthy and
productive lives as they grow older.
What I want to know is where the hell was all this information nine
years ago when my first son was born?!! I am so sorry my first two
babies went through this unnecessary procedure but never will my future
babies experience this torture.
Thank you for educating me when no other would.
Signed:
Mother of three, 2 boys and 1 girl
, and
United Tribes Technical College
, Criminal Justice Student. April 6, 1996
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Our Thanks
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We want to express our appreciation to the many people who have
written or talked to us about the need to stop unnecessary male and
female genital surgeries even though the present taboo around the
subject makes it difficult for them to speak out.
If you find yourself quoted above and do not believe the
quotation is accurate, or if you have changed your mind on what you
believe regarding this issue, please contact us so we can correct and
update the list. If you want to be added to the list, please give us
your comments in writing: NoCircND/Genital Integrity, P.O. Box 3154,
Minot ND 58602-3154 or by email,
Duane Voskuil or
Jody McLaughlin.
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