Complainant asked the Ombudsman to assess whether circumcision of boys (Circumcision) is the interference with the rights of the child, especially if it is done only for religious reasons and not justified on health grounds. The complainant considered that the interference is harmful to the Slovenian doctors but he do not know all the negative consequences of prejudice (subconscious trauma, impotence, infection, etc..).
Before preparing the opinion, we examined available scientific literature on the issues, specifically point out the article Damian Korošec, published in the magazine Lawyer, Volume 50 (1995) entitled Trim – unincorporated banality of surgery, inquiries were sent to the General Surgery for the College of Experts, the Commission of the Republic Slovenian National Medical Ethics and Health Insurance Institute of Slovenia.
According to the health care professional colleges have survived the highest academic body in a particular area of health, so we expanded the professional college of surgery applied for brief information about professional writers in this field and the available data on the annual number of such interventions on the basis of diagnosis have been made . We expected the data on the risks, complications and permanent consequences of this intervention, in particular, whether they may have in the past dealt with any of the questions related to cirkumcizijo (possibly also the question of conscientious objection). Expanded expert committee for surgery we did not answer any questions, send us the conclusion that the Circumcision of boys for non-medical reasons is not medically justified indications for professional intervention are listed in the professional urological literature.
Commission Office for Medical Ethics has sent us a long answer, which we summarize in its opinion of principle, “the ritual Circumcision of boys for religious reasons in our country due to legal and ethical reasons, is unacceptable and the doctors should not perform.” In addition to the unacceptability of Circumcision from an ethical point of view, the Commission also points out that it is unacceptable in that it has already passed the interference with the medical documentation falsely as medically indicated.
The Health Insurance Institute of Slovenia has asked for information concerning payment of Circumcision (annual number of interventions, the price of services) and how the issue of payment arranged, if medical intervention is not indicated, but is carried out only at the request of the individual or his legal representatives. Institute we have replied that no information on the annual number of interventions, the delivery price that society pays health care provider is € 34.88. When intervention is not medically indicated, service is not covered by the compulsory health insurance, so the intervention of the patient to pay or his agents.
The Ombudsman has not yet got the initiative, which would be directly working on Circumcision of the individual (specific) child. However, this possibility can not be excluded in the future, so we are on the basis of the above suggestions have decided to examine the situation with regard to some important issues of human rights and especially children’s rights. The United Nations Convention on the Rights of the Child obliges States Parties to take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury and abuse, while in the care of parents, legal guardians or any other person who care about him (article 19 CRC).
The Constitution of the Republic of Slovenia in the 56th Article child special protection and care during the 35 Article as everyone is guaranteed the inviolability of physical and mental integrity. From these provisions clearly show that any intervention in the physical integrity of children are limited and justifiable only for medical reasons. If there is a medical indication, that is to protect the health of the child cirkumcizijo be made, such intervention is a legitimate and legal, and a parent has responsibility for the child development permit required or allowed. If for any reason parents would not let Indicated medical intervention, the competent authorities to determine possible dereliction of duty caring for the child and take the necessary measures provided by law.
However, if the child has medical Circumcision is indicated, but the only result of his parents’ beliefs (religious or otherwise), such intervention is no legal basis. This even is not whether the child is explicitly opposed the intervention. Intervention in the physical integrity of a child solely because of the desire of his legal representatives or guardians, therefore, constitutes an inadmissible interference in his body and is in our opinion the evidence of criminal behavior.
Patients Rights Act (Official Gazette. 15/08) in 26 stipulates that a patient who is capable of making itself, without its prior free and informed consent is not permitted to perform medical procedure or medical care, except in cases provided by law. For children, the Patients’ Rights Act provides that, generally after 15 in the ability to consent, unless the physician, according to its maturity assessment that it does not fit. Child before 15 age but under the law generally is not able to consent, with the doctor in these cases, estimated to be in this position. The Act specifically provides that a child’s opinion regarding the treatment takes into account the extent possible, if it is able to express an opinion and if you understand the significance and consequences.
The Constitution recognizes the right of parents, in accordance with their beliefs provide their children with religious and moral education. Guiding children’s religious education and moral education shall be in accordance with their age and maturity, and with his freedom of conscience and religious and other beliefs or convictions (third paragraph of Article 41 of the Constitution). Guidance on religious education, in our opinion does not include the right of parents to mere religious belief choose to intervention in the child’s body. We therefore believe that the Circumcision, for reasons other than medical, is not permitted and constitutes unlawful interference with the child’s body and thus violates his rights.
Common ground for the development of children’s health and their parents are primarily responsible, but also they must in all cases take into account the child’s interest as a guide in decision making. Also, in deciding their rights are limited by the rights of others, in this case, therefore, their children, because children’s rights are subordinated to the rights of parents. The right to religious freedom does not justify interference with the right to physical integrity of another, so we believe that the Circumcision for non-medical reasons, may only be the child’s consent, subject to the conditions provided for by law on patients’ rights, therefore, usually after 15 year of her age. (11.0-66/2010)