Cutting Risk: The Ethics of Male Circumcision, HIV Prevention, and Wellness

Abstract

The question of ethics has accompanied all discussion of male circumcision and HIV: How can trials be run ethically? How could circumcision be promoted and provided ethically? Is it ethical to provide medical circumcision and payment to under-resourced test subjects? Would it be ethical to not do so? Two comprehensive and widely read papers (“Circumcision and HIV prevention research: An ethical analysis,” Lancet, 2006, and “The first randomised trial of male circumcision for preventing HIV: What were the ethical issues?,” PLoS Medicine, 2005) addressed the ethical issues of these investigations from the perspective of scientific liability, and many of the opponents of male circumcision, for this or other reasons, call their viewpoint a human rights matter. In this paper, I draw from social science and from the harm reduction movement to propose an ethic of wellness, built on causing the least harm and contributing to the most knowledge. This approach to the ethical question is linked to, but distinct from and sometimes at odds with, the traditional canon of medical ethics or bioethics.

Citation

Mukherjea, A. (2007), "Cutting Risk: The Ethics of Male Circumcision, HIV Prevention, and Wellness", Katz Rothman, B., Mitchell Armstrong, E. and Tiger, R. (Ed.) Bioethical Issues, Sociological Perspectives (Advances in Medical Sociology, Vol. 9), Emerald Group Publishing Limited, Leeds, pp. 225-243. https://doi.org/10.1016/S1057-6290(07)09009-2