Discussion and Conclusion

Circumcision, being a very old practice, has been paradoxically faced with heated arguments and political debates, with medical arguments being sought to be widespread, especially in the African countries and on the other hand, especially after the 1980’s. Discussions on the subject of circum-cision have blazed up with the legislative arrangements and practices in the western countries of immigrant communities where different cultures lived together. In this sense, the prohibition of cir-cumcision by the Cologne Court, on June 26, 2012 stating that the child’s circir-cumcision performed for reasons other than medical reasons is within the scope of “injury” or “mutilation” on grounds that the right to save his own body is greater than the freedom of religion is worthy of noting [29]. It is also important to note the opinion stated in the technical report published by the American Aca-demy of Pediatrics/AAP that the potential benefit of circumcision is more prevalent than its risks and cost [9]. However, the assertion by Jennifer Bossio as well as other scholars that there are not enough studies in North America to confirm this view is of importance [45].

Regulations and practices on circumcision may have economic and political consequences on the social level. Especially the use of circumcision as a political material in different forms is quite

common. As valid in all other controversies, opposition to these regulations and practices is also a political decision to support and corresponds to a political stance. This stance depends on the purpose for which the decision is made concerning the organization and application of circumcision and on whom or for whom the benefit of the circumcision will be observed. Of course, it is important to practice circumcision in healthy and hygienic environments and under the supervision of speci-alist physicians. However, when it comes to realizing this, it is important to make arrangements so as not to cause major problems.

It is important to consider the country conditions in the regulation. For example, in Turkey, where the authority to perform circumcision procedures is granted only to authorized physicians, an issue arises with regard to the performance of the circumcision procedure in the regions where health services cannot be accessed easily. For families who want to have their children circumcised with the reason that circumcision is a prevalent tradition, this implies that circumcision is actually for-bidden. In this sense, precautions should be taken not to abuse this profession, especially the aut-horization granted to the physicians or not to gain profits by creating a sector out of this problem.

Regulations in this sense should not be in the form of serving the interests of doctors in order to bring extra burden to the country’s economy. If this is done, “under the counter” applications may increase further. The decision to be taken regarding the process of the legal regulation granting the authorization to perform circumcision procedure in Turkey in the year 2014 is also a political decision. It is also dependent on a political decision to consider circumcision as a susceptible prac-tice instead of seeing it as an “illness” that will cause to be considered as an extra burden on either the country or the family’s economy. This is because, when it is considered as a serious “illness”, precautions should be taken to avoid misuse of the person in different platforms and by different people. Taking a non-illness procedure into the scope of health insurance and leaving the discre-tion to private hospitals may also cause economic problems to arise. Therefore, in the reguladiscre-tions related to the practice commercialization of circumcision should not be encouraged and this aspect should be considered. This will issue problems for every segment as well as the poor segment by causing the service of circumcision to be less accessible. Furthermore, it is also explicit that legal arrangements and practices may contradict the attitudes of maintaining this tradition with existing traditions, which in turn will lead to negative consequences. In this sense, the regulations on cir-cumcision should be susceptible towards tradition and it is important that circir-cumcision cannot be ignored with a “top-down” mentality of tradition under the name “medicalization”.

In conclusion;

1. Prohibition of circumcision is problematic and will bring many problems in its wake. In this sense, Johnson’s opinion about circumcision that even though he is against all kinds of circumcision, prohibition will not prevent it and bring adverse outcomes is important [29].

In societies keeping the circumcision tradition, prohibiting the circumcision may cause the sector turn into an “under the counter” sector and increase the problems. Also, prohibiting the circumcision will cause ignoring different traditions and cultures which will naturally lead to new conflicts. In this sense, it is also problematic as it is against a social concept which cares and respects the differences.

2. Regulations and implementations to make the circumcision obligatory or encourage it are as problematic as prohibiting it. Generalization of the traditional circumcision for

“medi-calization” poses the risk of commercialization by turning the circumcision into a profit-o-riented sector and the new problems which will come along with this commercialization.

In this regard, Douglas and Hongoro’s conclusion about the circumcision turning into a profit-oriented sector and being commercialized in South Africa is important and worth pondering [46]. As the negative economic determinants such as poverty, unemployment, commercialization and profit making in addition to social determinants of circumcision will reduce the access to the commercialized circumcision, they may play role in keeping the traditional circumcision which causes higher complication and mortality rates. In this sense, making regulations about circumcision considering the social and socio-economic determinants is inevitable.

As is seen, circumcision is a social phenomenon with multiple variables that is being discussed from various aspects. However, one thing is certain, while the circumcision rates are dropping, steps are being taken towards the medicalization of non-therapeutic circumcision and the present research on the steps to be taken are inadequate and short-coming. Then, the main point is to make regulations based on the objective research data rather than financial goals without giving any change to commercialization. The current literature indicates that it is crucial to make proper decisions on the regulations about circumcision which is a controversial social phenomenon by recognizing the presence of societies with different economic, social and cultural characteristics, and making these regulations on a non-patronizing sense based on “human welfare” instead of an

“out-of-the-blue” sense which looks after some people’s interests knowingly or unknowingly.