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Unfortunately, in an issue where support exists for both sides, the nurse must often make a difficult decision as to how to present information on the decision of whether to circumcise or not to circumcise to the parents. The current body of information provided to patients, if any information is provided at all, does not present a balanced view of the issue, the rather reflects the cultural opinions of physicians of in the United States.
Recommended Actions However, it is their place to provide parents with sufficient information and a balanced approach to the topic so that parents can make their own decisions based on research and their own cultural preferences. Many nurses, currently disagree that circumcision is the best choice for newborns. The stance of the AAP on the issue is based on research that suggests that the practice of circumcision is not necessary and that it has no medical basis. However, new research is beginning to come into light that suggests that prophylactic circumcision can have a positive effect on preventing certain serious diseases such as HIV and other sexually transmitted diseases. For parents who choose not to circumcise, nurses need to be prepared to provide the information on how to care for the foreskin and penis so that UTIs do not occur in the future.
It is not the role of the nurse to make cultural decisions for patients. Yet, the nurses have an obligation to help of patients make informed medical decisions about the care of their newborn. Therefore, it is recommended that nurses implement plans to help provide parents with valid information on both the for and against side of the circumcision issue. The information should include empirical evidence that supports both sides of the issue.
This recommendation suggests that the hospitals prepare informational packets for parents that include evidence to support both sides the issue, at least until sufficient evidence is found to definitively support one side or the other. Hospitals need to develop a stance that is neutral and that is culturally sensitive. Hospitals that present a one-sided approach to the circumcision issue are not demonstrating that they are culturally diverse, but rather that they are reflecting the views of the dominant society.
Unlike research found during this literature review, it is recommended that evidence-based policy guidelines be developed that do not take a stance on the circumcision issue, but rather that present information on both sides. A hospital needs to develop policy guidelines that are based on solid evidence, rather than personal opinion. This guideline recommends that hospitals develop information that can be provided to parents that reflects the most current views on circumcision. According to the literature found during this exploration of the topic, the information contained in these materials should be neutral and present evidence on both sides of the issue. Only in rare medical cases, does the information favor circumcision.
References
Dickerman, J. (2007)in . Circumcision in the Time of HIV: When Is There Enough Evidence to Revise the American Academy of Pediatrics' Policy on Circumcision? Pediatrics. 119 (5): 1006-1007.
Fortier, S. (2009). Debating Circumcision. RN. April 2009.
Jia, L., Hawley, S., & Paschal, a. et al. (2009). Immigrants vs. Non-Immigrants: Attitudes Toward and Practices of Non-Therapeutic Male Circumcision in the United States of America. Journal of Cultural Diversity. 16 (3): 92-98.
Provencio-Vasquez & Rodriguez, a. (2009). Circumcision Revisited. Journal for Specialists in Pediatric Nursing. 14 (4): 295-297.
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