This month, the AMA Journal of Ethics published a special issue on Iatrogenesis

[injury or illness caused by a physician] in Pediatrics, containing two articles relating to circumcision, each with important implications for health care professionals.

Svoboda JS. Nontherapeutic circumcision of minors as an ethically problematic form of iatrogenic injury. AMA J Ethics. 2017;19(8):815-24.

The author, Executive Director of Attorneys for the Rights of the Child, shows how non-therapeutic circumcision (NTC) violates widely accepted norms of medical ethics, and argues that, as a structure with significant erogenous, protective, and immunological properties, the loss of the foreskin itself should be counted, clinically and morally, as an iatrogenic harm of NTC regardless of any other complications. The article concludes:

“The vast majority of medical practitioners have the best interests of their patients at
heart; if they recommend or agree to circumcision, it is usually in the belief that it does
more good than harm. As more physicians are coming to realize, however, this belief is
misguided: many physicians to whom I speak these days now say that they would prefer
not to circumcise and only do it because the parents ask for it. At the same time, it is
often the case that the only reason parents ask for it is because they believe circumcision
is medically beneficial, recommended by health authorities, or the normal thing to do. It
is time for this vicious circle to be broken. Who better to take the initiative than the
community that introduced NTC in the first place—the American medical profession?”

Reis-Dennis S, Reis E. Are physicians blameworthy for iatrogenic harm resulting from unnecessary genital surgeries? AMA J Ethics. 2017;19(8):825-33.

ABSTRACT: We argue that physicians should, in certain cases, be held accountable by patients and their families for harm caused by “successful” genital surgeries performed for social and aesthetic reasons. We explore the question of physicians’ blameworthiness for three types of genital surgeries common in the United States. First, we consider surgeries performed on newborns and toddlers with atypical sex development, or intersex. Second, we discuss routine neonatal male circumcision. Finally, we consider cosmetic vaginal surgery. It is important for physicians not just to know when and why to perform genital surgery, but also to understand how their patients might react to wrongful performance of these procedures. Equally, physicians should know how to respond to their own blameworthiness in socially productive and morally restorative ways.