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One reason GMC has lost our respect

·Dr John Fitton (Soapbox, February 5) and his fellow travellers in the anti-circumcision brigade forcefully impose on the public their unscientific and emotional opinions disguised as facts.

The characterisation that the baby was 'rather miserable' due to 'a grazed glans penis, chafing on its nappy', is simply speculation.

In fact, this child will have the benefits of a markedly lowered incidence of urinary infections leading to lowered

rates of severe renal disease and virtually no chance of ever getting cancer of the penis which has a lifetime incidence of up to one in a 1,000 for an uncircumcised man.

In addition, he will never have phimosis which occurs to some degree in up to 10 per cent of adult men, no painful and frightening tearing of the frenulum during sexual activity, nor any foreskin-related infections. Indeed, he will have no penile maintenance to contend with at all.

Perhaps Dr Fitton should himself be reported to the GMC for patient harassment and improper counselling. One can only hope that the unfortunate lady in this story has the ability to change to a physician with more professionalism and respect.

Readers who would prefer factually-based material to the tripe dished out by anti-circumcision proponents should visit www.circs.org/index.html

Dr R Willcourt

Adelaide

·It amazed me to read such an emotive Soapbox by Dr Fitton. Perhaps he hates the religions and not the practice of circumcision.

The act of circumcision is not barbaric but it is dangerous and should be made illegal for untrained hands to peform.

Dr Fitton talks about rights, but no one mentions our duties as human beings. Why does he not raise his voice against the thousands of killings that take place every year under the name of medical termination?

Which is worse: taking a life or removal of a piece of skin?

I see no harm in circumcision as long as it is carried out as a 'recognised surgical procedure'.

Dr BM Dodhy

Hayes, Middlesex

·Further to Dr Fitton's Soapbox, any mother would soon learn that 'a grazed glans penis, chafing on its nappy' could be due to prolonged wet or fecal contact in the infant's perineal area.

Proper diaper etiquette and knowledge, with or without being circumcised, is soon learned and is in

the advisory instructions for medical students.

Dr Gerald Weiss

Fort Collins

Colorado

·I read with interest and some concern the views of Dr Fitton. In reporting his colleague for misconduct he is making a very bold step.

Once I had cause, as a GP in the UK, to be very upset about something I regarded as negligence in a local colleague.

The correct action ­ in consultation with my partners ­ was to inform the medical director at the hospital concerned and leave the dispassionate investigation and remedy to him.

Things go wrong postoperatively in the best institutions and I am sure that a seasoned doctor such as Dr Fitton has seen this often enough. In my decade of work as a children's physician in The Gambia, Ghana and Cameroon I have seen hundreds of infants and children circumcised.

True I have seen postoperative complications, and some of them are horrific. We all learn from such instances, and are better doctors as a result.

We should all avoid emotive language unbecoming of our profession. It seems to me there are more serious matters by far for Dr Fitton to address in his GP work in the UK than an occasional 'grazed glans penis'.

Dr Peter McCormick

Banso Baptist Hospital

Cameroon

·I am appalled that Pulse has given such prominence to Dr Fitton's tirade against male circumcision. His attitude reflects both prejudice and medical ignorance.

Male circumcision has long been acknowledged as the safest off all

surgical procedures undertaken on humans and remains one of the commonest.

There is something surprising and worrying about somebody claiming to have practised medicine for three decades in three continents not to have come across male circumcision or referred poor miserable children with phimosis/ paraphimosis/recurrent balanitis for circumcision.

Wasting the GMC's time and resources on complaints arising from jaundiced views of how other cultures lead their life is not a good reflection on Dr Fitton's personal and professional integrity.

Pulse should be careful in giving too much space to such confused rantings.

Dr S Rahman

Colchester

Essex

·I was alarmed to read Dr Fitton's Soapbox. It is clear that he is not speaking as an unconcerned bystander but as a positive objector.

If he were to have his way, no doctor in the UK would be able to perform this simple operation.

Families would be forced to seek the services of unqualified backstreet 'physicians'. As it is, so few GPs are prepared to provide this simple service that many families have to travel hundreds of miles to find a qualified doctor prepared to operate.

At the Circumcision Agency we receive hundreds of inquiries each month from families looking for GPs to perform circumcisions. They don't know where to turn: the NHS doesn't want to know, private urologists charge thousands of pounds for the simplest operation, and patients should not be forced to risk the backstreet operators.

It is a shame that more doctors do not see the benefits of providing this straightforward service. Any GP, with the proper training, can perform a circumcision.

If managed well, it can provide the GP with much needed extra income, while providing the community with a much-needed service.

Simon Clarke

Circumcision Agency

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