"Circumcision fails to meet the commonly accepted criteria for the justification of preventive medical procedures in children," the doctors wrote.
A second flank of criticism came from the prominent British Journal of Medical Ethics, which dedicated a special issue to the ethics of infant and child circumcision.
An article in the ethics journal by Dr. Robert Van Howe, a Michigan medical school professor and pediatrician, and J. Steven Svoboda, head of the Berkeley-based Attorneys for the Rights of the Child, states: "Rather than objectively evaluating all available evidence, the AAP selectively quotes and references highly-contested and controversial studies to attempt to justify an entrenched, yet outmoded, cultural – not medical – practice."
These authors cite comments by Oxford University ethicist Brian D. Earp, who described last summer's AAP report as "replete with non-sequiturs, self-contradiction and blatant cherry-picking of essential evidence" in an attempt to justify a call for government-backed medical insurance to cover the surgery.The multi-authored international article published in the journal Pediatric systematically considered and rejected the variety of medical reasons the AAP task force attempted to use to justify its position.
- The AAP report claimed circumcision could cut down on cases of penile cancer, one of the rarest forms of cancer, but the international physicians' response noted that penile cancer linked to the human papillomaviruses is treatable if diagnosed early, and can be prevented through condom use or prophylactic vaccination. There is "no compelling reason" to remove healthy functioning tissue from the penis of a baby boy to prevent such a rare and treatable disease.
- The AAP report claimed circumcision can cut down on cases of urinary tract infection. The international physicians note that UTIs can be treated with means far less drastic and risky than the removal of healthy tissue.
- The AAP report claimed circumcision can cut down on cases of sexually-transmitted diseases, including HIV/AIDS. The international physicians point out that the AAP is relying on findings from disputed African studies of sexually active, adult heterosexual men – "findings … not in line with the fact that the United States combines a high prevalence of STDs and HIV infections with a high percentage of routine circumcisions." Further, "The situation in most European countries is precisely the reverse: low circumcision rates combined with low HIV and STD rates. Therefore, other factors seem to play a more important role … than circumcision status."