Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909655
James M. DuBois, Ana S. Iltis, Heidi A. Walsh
Editors' Note James M. DuBois, Ana S. Iltis, and Heidi A. Walsh Dionne Deschenne was 30 weeks pregnant with her son when she contracted a serious case of pneumonia, requiring her to have an emergency C-section. Her son spent weeks in the NICU after his premature birth. Deschenne writes, "Under the conditions, I relied on the hospital staff to help me understand the risks, benefits, and necessities of each procedure or test they recommended. We formed a relationship of mutual respect." One day when Deschenne's doctor was making rounds, a nurse asked if she wanted to have her son circumcised while the doctor had time and was available. "The nurse bringing up circumcision was one with whom I had built a relationship of trust over the previous days. I considered her a trusted advisor. I asked her what the benefits would be? What would the risks be? Would my son experience pain? Was operating on such a tiny and ill baby safe?" Authors in this issue of "Narrative Inquiry in Bioethics" pondered similar questions. In the symposium, "Newborn Male Circumcision," we aimed to explore the decision making process of parents when choosing whether to have their infant male children circumcised. Through the symposium, we hoped to gain insights about what information or resources parents lack or would find helpful as they decide. "Overall, even though it was a very difficult decision, I think it was the right one for my son and our family," says Anonymous Two, one of 14 authors who contributed a story. "I don't think it's right for others to judge parents that make the choice to circumcise their sons. I don't think it's an easy choice for most of them—it certainly wasn't an easy choice for me." Twelve stories are included in the symposium; two additional narratives are published in the online supplement. Nine of the 12 parent authors opted to circumcise their infant sons, though the reasons they stated for doing so varied. Most of the parent authors relied on cultural or social beliefs, religious guidance, or a desire for sameness with the infant's father. Parents who didn't circumcise their male infants discuss their convictions about autonomy, bodily rights, and the medical benefits of circumcision versus the harm or pain caused by the procedure. The symposium editor, Heidi A. Walsh, makes the observation that "while shared decision making is not an overarching theme in the stories, the authors demonstrate that circumcision decisions are not straightforward for many parents and discussion with a trusted healthcare provider could have been helpful." The four commentary articles by Lauren L. Baker, Laura M. Carpenter, Shawn D. O'Connor and Claudio J. Kogan offer important insights into the authors' stories. Comatose survivors of cardiac arrest often die after life-sustaining therapy is withdrawn. Family members, acting as surrogate decision makers, are frequently asked to decide whether their loved one should continue to receive ongoing mechanical ventilation or o
迪翁·德谢尼(Dionne Deschenne)在怀孕30周时感染了严重的肺炎,需要紧急剖腹产。她的儿子早产后在新生儿重症监护室呆了几个星期。Deschenne写道:“在这种情况下,我依靠医院的工作人员来帮助我了解他们推荐的每项手术或检查的风险、益处和必要性。我们建立了一种相互尊重的关系。”一天,当德尚的医生在查房时,一位护士问她是否想趁医生有时间和有空的时候给她的儿子做包皮环切手术。“那位提出包皮环切的护士是我在前几天建立起信任关系的人。我认为她是一个值得信赖的顾问。我问她有什么好处?风险是什么?我的儿子会感到痛苦吗?给这么一个生病的小婴儿做手术安全吗?”本期《生命伦理学的叙事探究》的作者也思考了类似的问题。在“新生儿男性包皮环切术”研讨会中,我们旨在探讨父母在选择是否为男婴进行包皮环切手术时的决策过程。通过这次研讨会,我们希望深入了解家长在做决定时缺乏哪些信息或资源,以及哪些信息或资源对他们有帮助。“总的来说,尽管这是一个非常艰难的决定,但我认为这对我的儿子和我们的家庭来说是正确的,”匿名者2说,他是14位为这篇文章撰稿的作者之一。“我认为别人评判那些选择给儿子行割礼的父母是不对的。我认为这对他们中的大多数人来说不是一个容易的选择,对我来说当然也不是一个容易的选择。”专题论文集收录了12个故事;在线增刊中还发表了另外两篇叙述。12位父母作者中有9位选择对他们的婴儿进行割礼,尽管他们这样做的原因各不相同。大多数父母的作者都依赖于文化或社会信仰、宗教指导或与婴儿父亲相同的愿望。没有给男婴做包皮环切手术的父母会讨论他们对自主、身体权利的信念,以及包皮环切手术的医疗益处与手术造成的伤害或痛苦。研讨会编辑海蒂·a·沃尔什(Heidi a . Walsh)观察到,“虽然共同决策不是故事中的首要主题,但作者证明,对于许多父母来说,割礼的决定并不简单,与值得信赖的医疗服务提供者讨论可能会有所帮助。”劳伦·l·贝克、劳拉·m·卡彭特、肖恩·d·奥康纳和克劳迪奥·j·科根的四篇评论文章对作者的故事提供了重要的见解。心脏骤停的昏迷幸存者经常在停止生命维持治疗后死亡。作为替代决策者的家庭成员经常被要求决定他们的亲人是否应该继续接受持续的机械通气或其他维持生命的治疗,考虑到一旦这种治疗被撤销后死亡的高风险。有时,医生和家庭成员不同意什么是在病人的最佳利益,这给家庭和医疗保健提供者造成痛苦。由Rachel Caplan等人撰写的“心脏骤停后的医生家庭冲突:一项定性研究”,检查了24名心脏骤停患者的医疗记录中的主题,这些患者的家人表示,尽管医生建议撤回维持生命的治疗,但他们希望继续为其家庭成员寻求生命支持。在记录在案的家庭成员和医疗服务提供者之间的对话中,家庭成员提到的不想撤销生命支持的四个突出主题出现了,包括对奇迹的信仰,“扮演上帝”的不恰当,与患者共度更多时间的价值,以及医疗服务提供者和家庭成员对患者状况的不同看法。作者总结说,通过仔细倾听、提问和参与谈话,临床医生可以帮助减少冲突、改善沟通,并帮助家属为患者做出最好的决定。本期的案例研究由Leenoy Hendizadeh等人撰写,并作为我们与凯撒医疗机构合作案例研究的一部分提交。
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Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909677
{"title":"Full Collection of Personal Narratives","authors":"","doi":"10.1353/nib.2023.a909677","DOIUrl":"https://doi.org/10.1353/nib.2023.a909677","url":null,"abstract":"","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135194439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909657
Anonymous One
Surprised Divide Anonymous One Anonymous One Not long after our daughter was born, my wife and I were expecting a son. We were busy new parents, so her pregnancy with our second child went by quickly and without a lot of the fuss that a first pregnancy brings. To our surprise, our son was born a few weeks early but aside from a little jaundice he was a happy, healthy baby. My parents were caring for our daughter while we were at the hospital. After my son's birth, we were excited for them to bring our daughter up to the hospital to visit her new baby brother. The hospital photographer came by and took photos of our two kids together and photos of our son swaddled and sleeping soundly in a basket. Other family members stopped by to meet the new baby as well. It was a happy time. Little did we know that a couple of hours later we would be faced with a communication breakdown. My wife and I usually pride ourselves on how well we are able to communicate and plan our future. I grew up heavily Catholic, attending parochial schools through high school graduation. Meanwhile, my wife's family are Unitarian Universalists. You could not have two more polar opposite religions! We are used to having different points of view. We have always talked through many of life's choices and have both had to make compromises in order to have a successful relationship. It was on that happy day of my son's birth that we discovered we forgot to discuss one important topic. As our family was gathered in my wife's hospital room, joyfully celebrating the newest addition, the doctor entered the room to check on my wife and said it was time to do the circumcision if we wanted. Without hesitation, I responded in the affirmative, then the doctor and I looked over at my wife, who was staring at us with saddened, conflicted eyes. I was confused. Didn't she want the same thing for our son that I did? Surprisingly we never discussed this decision, at least not that I remember. I don't recall her ever telling me she was against it. My wife stated that she wasn't prepared to make a decision because she didn't know what our son would want and she was worried about him experiencing pain. She worked hard for 9 months to grow this baby boy, and he was so little. I understood her anguish in the thought of letting someone alter his tiny body. I am circumcised myself. My background provided me guidance and an expectation that this would be happening, so it was a nonissue for me. I never considered a scenario in which my son would not be circumcised. In truth, it felt ridiculous to even contemplate not circumcising him. My words of reassurance that it would be fine and my explanation to my wife that this was just one of the many decisions we would need to make for him and our other child did little to settle her. It was clear that no one (including me) had discussed this with my wife prior to this point, which was unfortunate. The doctor described the process and tried to reassure my wife that
{"title":"Surprised Divide","authors":"Anonymous One","doi":"10.1353/nib.2023.a909657","DOIUrl":"https://doi.org/10.1353/nib.2023.a909657","url":null,"abstract":"Surprised Divide Anonymous One Anonymous One Not long after our daughter was born, my wife and I were expecting a son. We were busy new parents, so her pregnancy with our second child went by quickly and without a lot of the fuss that a first pregnancy brings. To our surprise, our son was born a few weeks early but aside from a little jaundice he was a happy, healthy baby. My parents were caring for our daughter while we were at the hospital. After my son's birth, we were excited for them to bring our daughter up to the hospital to visit her new baby brother. The hospital photographer came by and took photos of our two kids together and photos of our son swaddled and sleeping soundly in a basket. Other family members stopped by to meet the new baby as well. It was a happy time. Little did we know that a couple of hours later we would be faced with a communication breakdown. My wife and I usually pride ourselves on how well we are able to communicate and plan our future. I grew up heavily Catholic, attending parochial schools through high school graduation. Meanwhile, my wife's family are Unitarian Universalists. You could not have two more polar opposite religions! We are used to having different points of view. We have always talked through many of life's choices and have both had to make compromises in order to have a successful relationship. It was on that happy day of my son's birth that we discovered we forgot to discuss one important topic. As our family was gathered in my wife's hospital room, joyfully celebrating the newest addition, the doctor entered the room to check on my wife and said it was time to do the circumcision if we wanted. Without hesitation, I responded in the affirmative, then the doctor and I looked over at my wife, who was staring at us with saddened, conflicted eyes. I was confused. Didn't she want the same thing for our son that I did? Surprisingly we never discussed this decision, at least not that I remember. I don't recall her ever telling me she was against it. My wife stated that she wasn't prepared to make a decision because she didn't know what our son would want and she was worried about him experiencing pain. She worked hard for 9 months to grow this baby boy, and he was so little. I understood her anguish in the thought of letting someone alter his tiny body. I am circumcised myself. My background provided me guidance and an expectation that this would be happening, so it was a nonissue for me. I never considered a scenario in which my son would not be circumcised. In truth, it felt ridiculous to even contemplate not circumcising him. My words of reassurance that it would be fine and my explanation to my wife that this was just one of the many decisions we would need to make for him and our other child did little to settle her. It was clear that no one (including me) had discussed this with my wife prior to this point, which was unfortunate. The doctor described the process and tried to reassure my wife that","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909671
Shawn D. O'Connor
Abstract: Newborn male circumcision has potential benefits and advantages as well as disadvantages and risks. Families will at times have medical questions regarding newborn male circumcision that clinicians must be prepared to answer.
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Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909668
Molly Sinderbrand
A Brit Milah for Eliezer Herschel ben Yonatan Aryeh Molly Sinderbrand For observant Jews, the choice to circumcise one's son is not a choice. Technically, it is a contractual obligation; the belief is that male circumcision is part of a holy covenant with God. The word for ritual circumcision, brit milah or bris, literally means "covenant [of circumcision]." Circumcision is a physical symbol of a relationship with the divine. It is the commandment that encompasses all other commandments. It is, thankfully, only required of men (women, they say, are naturally closer to divinity). Circumcision is when a baby boy enters the Jewish community, eight days after birth, and when he gets his name. He becomes somebody. To choose otherwise— and some may choose otherwise—is to choose not to be part of the contract, and by extension, not be part of the Jewish community. And a community is one of the most valuable things a person can have. I was not always an observant Jew, though I was raised in a Jewish household. I essentially fell into observance over a period of 10 years, starting with studying ancient Hebrew with a language-loving rabbi in high school and eventually leading to weekly attendance at an orthodox shul, which I joined shortly after first tasting the vegan cholent at kiddush. It was much easier to make friends in [End Page 91] the Jewish community than in my competitive and mildly misogynist graduate program, and frankly, I liked them better. I received kindness and support when I needed it, and gave it back equally, especially around having children. Having children is difficult under any circumstance, but it is especially difficult in social settings where it is seen as abnormal, strange, or even selfish. The Jewish community normalized having children and created a respite from the judgment of the secular world. When I was pregnant at work, I got comments like "It looks like you're having twins!" and "Are you sure you don't have pre-eclampsia? You look awfully large"; at shul, I got pep talks, encouragement, and the traditional "b'sha'a tova"—"may it happen at a good time." Eventually, after having two kids in a two-bedroom rowhome, my husband and I moved to a mostly-Jewish suburb just outside the city. It is the kind of place where everyone says "Gut Shabbes" (a good Sabbath) to each other on Saturdays, but not one in which all the men wear black hats and study Torah all day (though some do). That is, folks live Jewish lives, but interact with the outside world as well. After a few months, it felt like home. This was the context in which I decided—or rather, did not have to decide—to circumcise my son. It was the natural result of the decision to be part of a community that places value (and even membership) on the ritual of circumcision. I made that decision years earlier and have been continuously reaffirming it since. Every day I wake up is a day I decide to be an observant Jew, and I decide to do so in order to be a member of an observ
{"title":"A Brit Milah for Eliezer Herschel ben Yonatan Aryeh","authors":"Molly Sinderbrand","doi":"10.1353/nib.2023.a909668","DOIUrl":"https://doi.org/10.1353/nib.2023.a909668","url":null,"abstract":"A Brit Milah for Eliezer Herschel ben Yonatan Aryeh Molly Sinderbrand For observant Jews, the choice to circumcise one's son is not a choice. Technically, it is a contractual obligation; the belief is that male circumcision is part of a holy covenant with God. The word for ritual circumcision, brit milah or bris, literally means \"covenant [of circumcision].\" Circumcision is a physical symbol of a relationship with the divine. It is the commandment that encompasses all other commandments. It is, thankfully, only required of men (women, they say, are naturally closer to divinity). Circumcision is when a baby boy enters the Jewish community, eight days after birth, and when he gets his name. He becomes somebody. To choose otherwise— and some may choose otherwise—is to choose not to be part of the contract, and by extension, not be part of the Jewish community. And a community is one of the most valuable things a person can have. I was not always an observant Jew, though I was raised in a Jewish household. I essentially fell into observance over a period of 10 years, starting with studying ancient Hebrew with a language-loving rabbi in high school and eventually leading to weekly attendance at an orthodox shul, which I joined shortly after first tasting the vegan cholent at kiddush. It was much easier to make friends in [End Page 91] the Jewish community than in my competitive and mildly misogynist graduate program, and frankly, I liked them better. I received kindness and support when I needed it, and gave it back equally, especially around having children. Having children is difficult under any circumstance, but it is especially difficult in social settings where it is seen as abnormal, strange, or even selfish. The Jewish community normalized having children and created a respite from the judgment of the secular world. When I was pregnant at work, I got comments like \"It looks like you're having twins!\" and \"Are you sure you don't have pre-eclampsia? You look awfully large\"; at shul, I got pep talks, encouragement, and the traditional \"b'sha'a tova\"—\"may it happen at a good time.\" Eventually, after having two kids in a two-bedroom rowhome, my husband and I moved to a mostly-Jewish suburb just outside the city. It is the kind of place where everyone says \"Gut Shabbes\" (a good Sabbath) to each other on Saturdays, but not one in which all the men wear black hats and study Torah all day (though some do). That is, folks live Jewish lives, but interact with the outside world as well. After a few months, it felt like home. This was the context in which I decided—or rather, did not have to decide—to circumcise my son. It was the natural result of the decision to be part of a community that places value (and even membership) on the ritual of circumcision. I made that decision years earlier and have been continuously reaffirming it since. Every day I wake up is a day I decide to be an observant Jew, and I decide to do so in order to be a member of an observ","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135194192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909656
Heidi A. Walsh
Abstract: This symposium includes twelve personal narratives from parents about making the decision whether to circumcise their infant male children. The authors of the narratives include five fathers and seven mothers. Nine of the 12 parent authors opted to circumcise their infant sons, though the reasons they stated for doing so varied. Most of the parent authors relied on cultural or social beliefs, religious guidance, or a desire for sameness with the infant's father. Parents who didn't circumcise their male infants discuss their convictions about autonomy, bodily rights, and the medical benefits of circumcision versus the harm or pain caused by the procedure. The symposium includes four expert commentaries on the narratives that are informed and enriched by the commentators' expertise in pediatric bioethics, healthcare ethics, gender studies, Jewish law and tradition, and the medical and surgical techniques of circumcision.
{"title":"Newborn Male Circumcision","authors":"Heidi A. Walsh","doi":"10.1353/nib.2023.a909656","DOIUrl":"https://doi.org/10.1353/nib.2023.a909656","url":null,"abstract":"Abstract: This symposium includes twelve personal narratives from parents about making the decision whether to circumcise their infant male children. The authors of the narratives include five fathers and seven mothers. Nine of the 12 parent authors opted to circumcise their infant sons, though the reasons they stated for doing so varied. Most of the parent authors relied on cultural or social beliefs, religious guidance, or a desire for sameness with the infant's father. Parents who didn't circumcise their male infants discuss their convictions about autonomy, bodily rights, and the medical benefits of circumcision versus the harm or pain caused by the procedure. The symposium includes four expert commentaries on the narratives that are informed and enriched by the commentators' expertise in pediatric bioethics, healthcare ethics, gender studies, Jewish law and tradition, and the medical and surgical techniques of circumcision.","PeriodicalId":37978,"journal":{"name":"Narrative inquiry in bioethics","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909667
Dionne Deschenne
Declining Circumcision for My Premature Newborn Dionne Deschenne In 1993, I was pregnant with my first of three sons and was busy preparing for his arrival. Unlike most parents, who focus much of their time on decorating the nursery and buying supplies, I was researching the medical decisions that I would need to make in the moments and weeks following his birth. Having worked in a hospital while a pre-medicine student, I had heard the cries of babies undergoing tests and procedures shortly after birth and knew I needed to be clear on the necessity of those tests and procedures if I was going to consent to them for my baby. My husband was in the Navy and out to sea for six months, so I took a few college courses to pass the time. One was a philosophy course on ethics, and I chose the bioethics of infant male circumcision as the focal point of my coursework that quarter. This allowed me to work through my findings in a racially, religiously, and age-diverse classroom under the guidance of a skilled professor. I was shocked to learn that even the American Academy of Pediatrics (AAP) at that time acknowledged that there were no known medical benefits that resulted from circumcision. How, I wondered, could parents allow their newborns to undergo such a harrowing experience for no reason? As the months passed and the birth of our first son grew nearer, I had everything ready—all of the decisions made, the doctors prepared, and the hospital selected. All of that preparation went out the proverbial window when I contracted pneumonia at 30 weeks. I was admitted to the Naval Hospital and treated for a week before being airlifted to a nearby Army Hospital when my condition worsened. After a few days there, the doctor came in very early one morning to wake me. Our son's heart rate was slowing, and we were at risk of losing him. They needed to immediately perform an emergency Cesarean section to preserve his life. I was terrified, knowing the potential myriad adverse effects his pre-term birth could cause. We were rushed into the OR and within seconds I had an epidural in my back. Moments later, my perfect, tiny but silent baby was whisked from the room to be attended to by a highly skilled and immensely respected NICU team. My husband followed to keep a watchful eye on our son while I was taken to Recovery. A few hours later, I was allowed to join my husband and son in the NICU. Our baby was beautiful, but so tiny that my husband could hold him in one hand. He weighed four pounds and had an enormous needle in the top of his head. The nurse explained to me that the IV needle was in the best location for administering the IV fluids and medications that our baby needed. His pre-term birth had introduced the need for several tests and treatments I had not anticipated. This was immensely distressing for me as someone who wanted to research and understand so that I could make well-informed and ethical decisions. Keep in mind that this was in the days before smart
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Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909666
Lisa Braver Moss
Proudly Jewish—and Averse to Circumcision Lisa Braver Moss I've always had a strong sense of my Jewish identity—and I've always had grave misgivings about circumcision. It used to seem that these [End Page 86] statements were at odds with one another. Now I'm on a mission to integrate the two. I'm married to a man who's also Jewish. In the late 1980s, we had two sons, whose circumcisions I agreed to. Brit milah (the covenant of circumcision) is intended as a spiritually meaningful act symbolizing the agreement between God and the Jewish people. But for me, the experience was so upsetting that I didn't feel God's presence. In spite of all the arguments in favor—the weight of tradition, wanting my boys to be accepted in the Jewish world, and so on—I came to regret my acquiescence. I began to explore reasons to question circumcision from a Jewish point of view, publishing articles in Jewish magazines and speaking at conferences. Rather than focusing on the medical pros and cons, I wrote about Jewish law and ethics, and spoke with many rabbis. I was hoping to deepen Jewish dialogue on this topic, which was oddly off-limits in a culture that values intellectual inquiry. Besides helping me understand more about Judaism, my research and writing was a way of living with my guilt. I had succumbed to—and put my boys through—a tradition that went completely against my maternal instincts. This schism had made me doubt myself as a new mother. What kind of parent was I if I couldn't be a fierce protector of my newborn baby? It was not a positive or welcoming way for me to enter into motherhood. I blamed myself. I hadn't done medical research before my boys were born, trusting instead in the longevity of the tradition and the claim that circumcision is more hygienic. I bought into the medical justifications for circumcision—all of which, I later learned, fail to acknowledge the erogenous nature of foreskin tissue and its physiological function. If I'd known more; if I'd thought more deeply about infant trauma; if I'd taken my own spirituality more seriously—I would have fought for a different outcome, despite the pressure I felt as a Jewish person. Years went by. I wrote a novel about Jewish circumcision, then co-wrote a book of alternative bris ceremonies for families opting out of circumcision. Slowly, I came to understand that blaming myself for agreeing to circumcise my sons was not only a waste of time, but also missed the larger point. I'm not alone in my objections to this ancient tradition. Indeed, many Jewish parents get through the event with white knuckles, emotional detachment, alcohol, or sedatives rather than with genuine religious feeling. Shouldn't their spiritual authenticity matter? Shouldn't mine have mattered? In Judaism, every commandment (of which circumcision is one) should be approached with kavanah, or spiritual intent. Thus, my non-spiritual feelings about the circumcision tradition are problematic from a Jewish point of view. I should
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Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909676
Laurie Evans
My Circumcision Decision:A Journey of Inquiry, Courage and Discovery Laurie Evans Before becoming a mother, I was teaching parents to massage their babies and offering trainings for professionals. To promote my work, in 1984, I exhibited at the Whole Life Expo in New York City. When I returned to my booth after a break, I noticed someone had left a pamphlet by Edward Wallerstein, who wrote "Circumcision: An American Health Fallacy." Since I am naturally curious, I read it. Disturbed, I thought of tossing it. But, how could I be teaching a nurturing technique for newborns and avoid this topic? As a Jewish woman, how would I make the decision for my own future sons? Little did I know this one piece of paper would lead me on a path of inquiry that would change my life. One of the presenters at this conference was Dr. Robert Mendelsohn, an Orthodox pediatrician. Although Dr. Mendelsohn realized some parents would allow circumcision for religious reasons, he was honest enough to dispel every medical myth and explain the harm of removing normal functioning tissue. He also described possible complications from removing the foreskin, including infection, hemorrhage, and although rare, death. To learn more, I read whatever I could find on the topic. I attended midwifery and childbirth conferences to promote my work and prepare for when I became pregnant. I decided to ask about circumcision, but the conversations were awkward and I received little helpful information. I found that circumcision was a taboo topic; few people wanted to talk about it. Why? Doctors who perform circumcisions, nurses who recommend it, and parents who consent to it do not want to face the reality of the harm they cause. Instead of facing the pain, they avoid the topic, and the procedure continues. Most men do not want to discuss or think about their own circumcisions. I learned that we need to have compassion during these conversations. A Jewish ritual ceremony (bris) is performed on the eighth day after the boy's birth, and includes circumcision and prayers. At a bris, friends and relatives are invited to observe and celebrate. It is part of my heritage. I tried to talk to my relatives about the information I had found, but everyone refused to discuss it. This avoidance made my decision very difficult. Then, for the first time, I was invited to a bris; I didn't want to attend. However, I had been at the boy's birth, so I decided to go to offer support. During the circumcision, my reaction was intense: I wanted to take the baby and run. I felt like an accomplice. I wanted to grab people by the [End Page E2] shoulders and scream, "How dare you?" I vowed I would never attend another bris, and I made the decision to write publicly instead of anonymously. I still had doubts, because I didn't know one intact adult male. What if I were to have a son, keep him intact, and he developed a complication later in life? I have learned that doctors are not taught non-invasive solutions, so most
劳里·埃文斯(Laurie Evans)在成为母亲之前,我教父母给婴儿按摩,并为专业人士提供培训。为了推广我的作品,1984年,我在纽约的终身博览会上展出了我的作品。当我休息后回到我的摊位时,我注意到有人留下了一本爱德华·沃勒斯坦(Edward Wallerstein)的小册子,他写的是《割礼:美国健康谬论》(Circumcision: An American Health Fallacy)。因为我天生好奇,所以我读了它。我很不安,想把它扔了。但是,我怎么能在教授新生儿养育技巧的同时避免这个话题呢?作为一名犹太妇女,我该如何为自己未来的儿子做决定?我一点也不知道这张纸会引导我走上一条改变我一生的探索之路。这次会议的演讲者之一是罗伯特·门德尔松(Robert Mendelsohn)医生,他是一位东正教儿科医生。尽管门德尔松医生意识到有些父母出于宗教原因会允许包皮环切,但他足够诚实地消除了所有医学上的神话,并解释了切除正常功能组织的危害。他还描述了切除包皮可能出现的并发症,包括感染、出血,以及尽管罕见的死亡。为了了解更多,我读了所有我能找到的关于这个话题的书。我参加了助产和分娩会议,以促进我的工作,并为怀孕做准备。我决定询问包皮环切术,但谈话很尴尬,我没有得到什么有用的信息。我发现割礼是一个禁忌话题;很少有人愿意谈论这件事。为什么?实施包皮环切术的医生、推荐包皮环切术的护士和同意包皮环切术的父母都不愿面对自己造成伤害的现实。他们不去面对痛苦,而是回避这个话题,然后这个过程继续下去。大多数男性不愿讨论或考虑自己的包皮环切手术。在这些谈话中,我学到了我们需要有同情心。犹太仪式(bris)在男孩出生后的第八天举行,包括割礼和祈祷。在布里斯,朋友和亲戚被邀请观察和庆祝。这是我遗产的一部分。我试着和我的亲戚们谈谈我发现的信息,但每个人都拒绝讨论它。这种回避使我很难作出决定。然后,我第一次被邀请参加割礼;我不想参加。然而,我参加了这个男孩的出生,所以我决定去支持他。在割礼过程中,我的反应非常强烈:我想带着孩子跑掉。我觉得自己像个帮凶。我想抓住人们的肩膀大喊:“你怎么敢?”我发誓我再也不参加割礼了,我决定公开写作,而不是匿名。我仍然心存疑虑,因为我不认识一个完整的成年男性。如果我生了个儿子,让他完好无损,而他后来出现了并发症怎么办?我了解到,医生没有被教导非侵入性的解决方案,所以大多数在婴儿期后进行的包皮环切是不必要的。一位犹太医生建议一位79岁的老人做包皮环切术,因为他长了持续的皮疹,治疗无效。我们组织建议他局部使用嗜酸乳杆菌。他照着建议去做之后,疹子就消失了,所以他取消了割礼。1985年,我怀孕了。和我交谈过的许多女性一样,我不想面对割礼的决定,所以我祈祷生个女孩。我们的分娩教育老师分享了关于男性包皮环切术的知识,这让我和丈夫聊了起来。这些紧张的互动以僵局告终。我想知道这个决定会对我的婚姻产生怎样的影响。我的长子是个女孩,这让我如释重负。时间站在我这一边。有一天,我在纽约散步时,偶然遇到了我的分娩老师。她要去联合国反对女性割礼。我30多岁,有一个教学硕士学位。我学过按摩和解剖学。然而,我从未听说过这种部落仪式。我有……
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Pub Date : 2023-06-01DOI: 10.1353/nib.2023.a909663
Petrina Fadel
My Personal Experience with Circumcision Petrina Fadel On October 2, 1981, I sat down to watch "NBC Magazine" on television, with a segment about infant circumcision called "The Casual Cut," by Douglas Kiker. (To watch, see youtube.com/watch?v=vm6Y0HJo034) I listened to doctors say there were no valid medical reasons for performing circumcisions on baby boys. One doctor said that circumcisions were done mainly for parental preference. In horror, I saw a newborn baby boy being circumcised without anesthesia. Edward Wallerstein, author of the book "CIRCUMCISION: An American Health Fallacy," told how circumcision is not practiced in most other countries. He called it a "cop out" that American doctors do not stop performing infant circumcisions, but instead take a neutral position by saying they'll let the parents decide. I was stunned. Why had most parents never heard this before? I did not know this when my first daughter was born in 1972, a year after the American Academy of Pediatrics wrote that "there are no valid medical indications for circumcision in the neonatal period." Before my second daughter was born in 1977, I was asked during my hospital admission if I wanted my baby circumcised if I had a boy. No doctor had ever mentioned the word circumcision, but now a woman in admissions was soliciting me for this surgery, despite "No Solicitation" signs posted on their doors. When I thought back to being questioned this way, I got angry. I did not understand why doctors would do such a ghastly thing to baby boys, something no national medical association in the world recommends. I know now that the driving force in medicine is money. I read Wallerstein's book to educate myself, and spoke with my friend who was a La Leche League leader. Together we signed a letter to the editor that I wrote and mailed to local newspapers, telling people the facts about circumcision. I was reluctant to put my name alone on this letter, since people in the United States do not talk openly about circumcision. For me, this was the first step in a long journey. I learned of a childbirth group fighting against infant circumcision and contacted them. I arranged for a speaker to come speak about circumcision to two local childbirth classes. I learned that genital cutting is practiced not only on baby boys in the United States, but also on females in Africa and the Middle East. I inwardly wept as I read about the inhumane things done to girls there. I thought of my own daughters. No child, male or female, should ever be subjected to genital mutilation. In 1982, my third daughter was born. When I questioned my doctor during my prenatal care, he told me that circumcisions were medically unnecessary, that he had seen infants die from them in medical school, but he circumcises babies anyway if parents want that done. He called himself "the reluctant rabbi." I told my doctor to write "No Circumcision" on my chart if I had a boy. While he delivered my daughter by Cesarean sectio
1981年10月2日,我坐下来看《NBC杂志》的电视节目,里面有一个关于婴儿割礼的片段,名叫“随意切割”,由道格拉斯·基克尔(Douglas Kiker)主持。(观看,见youtube.com/watch?v=vm6Y0HJo034)我听医生说,对男婴进行包皮环切手术没有正当的医学理由。一位医生说,做包皮环切手术主要是出于父母的意愿。我惊恐地看到一个刚出生的男婴在没有麻醉的情况下接受割礼。爱德华·沃勒斯坦是《包皮环切术:美国人的健康谬论》一书的作者,他讲述了包皮环切术在大多数其他国家是如何不实行的。他称这是“逃避责任”,美国医生没有停止为婴儿做包皮环切手术,而是采取中立立场,说他们会让父母来决定。我惊呆了。为什么大多数父母以前从未听说过这个?1972年,当我的第一个女儿出生时,我还不知道这一点。一年前,美国儿科学会(American Academy of Pediatrics)写道,“在新生儿时期,没有有效的医学指征需要包皮环切术。”在1977年我的第二个女儿出生之前,我在住院期间被问到,如果我生的是男孩,我是否要给我的孩子做包皮环切手术。以前没有医生提过包皮环切这个词,但现在有个住院的女人在招揽我做这个手术,尽管她们的门上贴着“禁止招揽”的牌子。当我回想起被这样盘问时,我很生气。我不明白为什么医生会对男婴做出如此可怕的事情,世界上没有任何国家医学协会建议这样做。我现在知道医学的驱动力是金钱。我读了沃勒斯坦的书来教育自己,并与我的朋友交谈,他是国际母乳会的领导人。我们一起签署了一封给编辑的信,我把信寄给了当地的报纸,告诉人们关于割礼的事实。我不愿意在这封信上单独署名,因为美国人不公开谈论割礼。对我来说,这是漫长旅程的第一步。我了解到一个反对婴儿割礼的分娩组织,并联系了他们。我安排了一位演讲者来给当地的两个分娩班讲割礼。我了解到,切割生殖器的做法不仅适用于美国的男婴,也适用于非洲和中东的女性。当我读到那里对女孩所做的不人道的事情时,我在心里哭了。我想到了自己的女儿们。任何儿童,无论男女,都不应遭受外阴残割。1982年,我的第三个女儿出生了。当我在产前护理期间询问我的医生时,他告诉我,从医学上讲,包皮环切术是不必要的,他在医学院看到过婴儿死于包皮环切术,但如果父母想要,他还是会给婴儿包皮环切术。他称自己为“不情愿的拉比”。我告诉我的医生,如果我生的是男孩,在我的病历上写上“不包皮环切”。当他给我女儿剖腹产时,他对我说的第一件事就是:“现在你不用担心割礼了。”他的话听起来像是在无视我的感受。因为我不支持伤害儿童的医生,我后来给他写了一封信,告诉他为什么他失去了我这个病人。我相信“第一,不伤害”,尽管有些医生不这么认为。手术后休养期间,我在医院的走廊里散步。突然,我听到婴儿撕心裂肺的尖叫声,从婴儿室紧闭的窗帘后面传来。我无意中听到别人说这个男婴正在接受割礼,我看到婴儿的父亲站在大厅里开玩笑。我无法忍受这个可怜的孩子被迫忍受的痛苦。我冲回自己的房间,关上门,用手指堵住耳朵,试图挡住他那可怜的哭声。我不能。婴儿的尖叫声如此之大,如此绝望,以至于他们传到了……
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