Neonatal circumcision in the United States: Authoritative knowledge and social justice

Neonatal male circumcision is available from physicians on request in the United States and parents are authorized to use non-medical sources of knowledge in electing circumcision. This situation resembles Brigitte Jordan's (1997) prediction that authority over producing knowledge in birth environments will become more equally distributed between the participants. Circumcision provides an opportunity to evaluate this possibility, with the conclusion that it does not represent the sort of shift that Jordan described. Analysis of the American Academy of Pediatrics (AAP) Policy Statement on Circumcision and its associated commentaries and response, and of ethnographic interviews and surveys of parents show how' the AAP uses traditional claims to biomedical authority to bolster its claim that parents must make a determination about circumcision's advisability. The dissertation also offers a critique of circumcision on two levels: first in terms of the bioethical contradictions inherent in the practice, and second in terms of the relationship between individual experiences and the overall structure of the practice itself. Alternatives derived from classical theories of social justice are proposed to resolve the ethical issues in a manner consistent with U.S. values.