Monthly Archives: June 2015

INTERNATIONAL NURSES GROUP CONDEMNS MEDICALLY-UNNECESSARY CIRCUMCISION OF FOUR-YEAR OLD BOY, URGES NURSES TO CONSCIENTIOUSLY OBJECT

11 JUNE 2015

For immediate release: http://childrightsnurses.org/index.php/news/international-nurses-group-urges-nurses-to-conscientiously-object/

Nurses for the Rights of the Child supports the genital autonomy rights of Chase Hironimus, a healthy 4.5 year old boy from Florida, USA. Chase’s human rights are in jeopardy following a bitter family court dispute surrounding a parenting agreement which was drawn up after Chase was born. This parenting agreement included the option for a medically unnecessary circumcision desired by the father. The circumcision was not performed during Chase’s infancy. Later, his mother Heather researched circumcision and became aware that it was not medically recommended and that it had risks generally and specifically with regard to her son, who had reacted adversely to anesthetic in the past and who develops keloids. Heather was imprisoned until she agreed to sign a circumcision consent form, which she did while bound in handcuffs and crying. Nurses for the Rights of the Child condemns the actions of Judge Jeffrey Gillen on this matter and notes that this forced consent was done under duress, which is unacceptable and contrary to the principles of informed consent.

We call on nurses who may be asked to assist with the proposed circumcision of Chase to demonstrate moral courage by taking conscientious objector status.

The Association of Women’s Health Obstetric and Neonatal Nursing (AWHONN) supports nurses’ rights to conscientious objection and recommends that every institution have a written policy protecting these rights and making reasonable accommodations for nurses with such objections. It also says that taking a conscientious objector position “…should not jeopardize a nurse’s employment, nor should nurses be subjected to harassment due to such a refusal.”

The Code of Ethics for Registered Nurses in Canada states: “Ethical (or moral) courage is exercised when a nurse stands firm on a point of moral principle or a particular decision about something in the face of overwhelming fear or threat to himself or herself. [… T]he nurse should discuss with supervisors, [or] employers […] what types of care she or he finds contrary to his or her own beliefs and values (e.g., caring for individuals having an abortion, male circumcision, blood transfusion, organ transplantation) and request that his or her objections be accommodated, unless it is an emergency situation”.

According to the American Academy of Pediatrics, “Performing an action that violates one’s conscience undermines one’s sense of integrity and self-respect and produces guilt, remorse, or shame. Integrity is valuable, and harms associated with the loss of self-respect should be avoided.”

If you are a nurse in moral distress about assisting with Chase’s proposed circumcision or any non-therapeutic circumcision, please contact Nurses for the Rights of the Child via www.ChildRightsNurses.org. We can assist you with resources and support regarding conscientious objection and refer you to legal support if needed.

You are not alone.

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Nurses for the Rights of the Child is a non-profit organization dedicated to protecting the rights of infants and children to bodily integrity.  As health professionals, we specifically seek to protect non-consenting infants and children from surgical alteration of their healthy genitals.

Nurses for the Rights of the Child was founded in June of 1995 by a group of nurses who had become R.N. Conscientious Objectors to infant circumcision at St. Vincent Hospital in Santa Fe, New Mexico.

 

Is it or is it not, Joe DiMaggio?

In an interesting twist of events, the Joe DiMaggio Children’s Hospital tried to deny that the child at the center of the Nebus vs Hironimus dispute, “is or has been” a patient. Shortly afterwards, a copy of a pre-surgical assessment printed on Joe DiMaggio Children’s Hospital at Memorial letterhead, was posted.

Joe DiMaggio Children's Hospital denies that Chase is or has been a patient

Joe DiMaggio Children’s Hospital denies that Chase is or has been a patient

See the screenshot of the pre-surgical assessment, dated 6/4/2015 (first visit) at the bottom of this post.

On it, we can see the typical excuses for circumcision: “father reports frequent urine trapping and ballooning of foreskin. Also has noted mild erythema of distil[sic] foreskin

Ballooning is normal at that age, it’s one of the ways nature has to stretch the balanopreputial lamina to desquamate it. There can be several causes to redness (erythema), from too much soap or improper rinsing, to a mild irritation, to rubbing, to balanitis; all of those causes are usually easily treatable and don’t require circumcision.

The review mentions:

  • “penile pain” – do you cut parts of your body when you have pain, or do you find the cause of the pain?
  • “ballooning of foreskin” – again, not a cause for concern at this age, and
  • “foreskin not retractable”. Per Oster, less than 30% of boys can retract the foreskin at Chase’s age, so again, it’s not a cause for concern.

Down the paper, it reiterates:

  • “Foreskin reduces approximately 30 percent” – foreskin shouldn’t be retractable yet and nobody should be retracting it – indication that doctor was fondling his penis to see whether it would retract or not.
  • “Mild foreskin inflammation” – this is, again, the redness mentioned above; so, if you had inflammation in one ear, would you cut your ear? or treat it? how is this medicine?
  • “Urine noted under foreskin” – the foreskin traps moisture, it’s normal and more in children, every male in the world who has a foreskin maintains a certain moisture between the foreskin and the glans, it’s how mucosas work; to try to make this into a pathological situation is like saying that moisture inside the mouth is indication of improper hygiene, it simply makes no sense!

The paper does not mention the tendency to form hypertrophic scars, which has been noted on a previous surgery, and which could have negative results in a circumcision.

Then, the Assessment and plan continues:

Discussed pros and cons, RCA in detail with father and aunt as relatives to elective circumcision. They have asked that we proceed.

Here we can see that the doctor refers to the circumcision as “elective”. He is not recommending it, he is “discussing pros and cons”. In other words, the procedure is not medically necessary. The child has no condition requiring the procedure. Dr. Birken is clearly washing his hands over the procedure: he didn’t recommend it, the father elected it.

It’s clear from the form that the circumcision is not necessary, and the doctor wants it to be evident so he can dodge any blame later. That’s why he is calling it elective and reiterating that the father gave the go ahead.

The problem is also, if the father elected it (because it is not medically necessary), then Medicaid should not cover the procedure at all. But of course we know that this is where medical fraud is committed daily in this country. Should Medicaid cover this procedure, do not doubt there will be clear investigations.

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The court of public opinion speaks against the circumcision of 4 and 1/2 year old in Florida

Hironimus2
While the Joe DiMaggio Children’s Hospital keeps tight silence over the reported scheduled circumcision, activists and public from all over the world rush to the facebook page of the hospital to express their distaste for what a German commenter called a “middle-age procedure”.

Posts to the hospital, reviews, comments on the reviews, comments on the posts of the facebook page of the hospital. Allegedly the hospital started deleting comments yesterday (Tuesday) but gave up given the high numbers.

New Times Broward-Palm Beach, Palm Beach Post and ABC 25 WPBF were among the first news outlets to pick up the information, along with several bloggers and discussion forums.

What can you do? (1) Post on the hospital’s Facebook page, demanding that they refuse to circumcise a healthy child whose mother is vehemently opposed to the surgery, and telling them that if they do, there will be both public relations and legal consequences; (2) call the hospital 954-265-5933, and (similarly) tell the risk-management department that there will be both legal and reputational consequences if they circumcise the Hironimus (Nebus) boy; (3) call the physician’s office (954) 265-0072 and warn him that the mother of the child is vehemently opposed to the circumcision, and that to conduct medically unnecessary surgery under these circumstances is both unethical and legally risky. SPREAD THE WORD, PLEASE!!

The hospital wrote one post trying to “appease” the commenters. It had been shared 236 times and had over 1800 comments:

joed
While posts to the page can be easily deleted, that didn’t stop people from posting to the page anyway.

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Thousands of reviews clearly indicated the rejection:
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New Times Broward-Palm Beach: In Hironimus Case, Circumcision Scheduled for 4-Year-old; Protest Planned at Hospital,

Palm Beach Post: Protests planned at hospital where Boynton boy may be circumcised

ABC 25 WPBF: Circumcision scheduled for 4-year-old boy

Anonymous information about Nebus vs Hironimus, Joe DiMaggio Children’s Hospital, Dr. Gary A. Birken MD

The Chase’s Guardians page received this anonymous message:

“To the page administrators,

This is a throwaway account. I cannot give you any further information about me. This is NOT my real name. But I work at JDCH and due to my position and job I have gotten to see a lot of what has been going on surrounding Chase’s situation. I want to share what I know because I am so strongly against anyone so much as touching Chase with a ten foot pole. This is what I know – rumor or otherwise – and whether you share it with your followers or not is up to you.

-Chase’s father has not actually met with Dr Birken. From what I understand from his scheduling nurses, they are being ushered in without needing to establish a new patient relationship. Thursday will be their first meeting.

-Dr Birken will cut Chase no matter what Chase says or does in office. I have worked with Dr Birken in his office before and he is a very no nonsense doctor who will do whatever he has to in order to get done what he feels should be done. He has pressured patients and parents into unnecessary or excessive procedures in the past and I have no doubt he will have Chase forcibly restrained and put under anesthesia without regard to Chase’s medical history. Birken is NOT one of the more well loved doctors in our hospital system and that he has agreed to do this does not surprise me. You WILL NOT stop this by trying to reach out to Birken’s office – but you WILL make a big difference through the hospital itself. If you can convince them that their general image will be tarnished or that they may face lawsuits they may bar Birken from taking Chase as a patient.

-Hospital administration is threatening staff that chooses to participate in any sort of walk out, protest, or refusal to come in/work with the patient. Nobody in Birken’s office is allowed to call off sick on Thursday. They have said that they will place anyone who participates in any acknowledgement of Chase’s procedure on leave or will outright fire them for insubordination and violation of HIPPA (because by refusing to come in, protesting, or refusing to work with Birken or Chase they are acknowledging that he is a patient who will be in that day – it is a VERY fine line but the hospital believes they are within their rights).

-There is talk of secretly rescheduling the procedure to TOMORROW (Wednesday, June 10) or even to Friday. It’s said that one of the administrators is even considering having Birken be called to “emergency surgery” later today so that Chase can be circumcised, but I do not think this will happen.

-Regardless of when the procedure occurs the hospital will likely hire additional security detail and may also ask the police to be present all day on Thursday. This may mean additional risk for protesters, so those who do choose to protest should bring cameras and be prepared to be as open and obvious about being peaceful as possible.

-Currently the hospital is directing all questions about the case to the director of corporate communications, Kerting Baldwin – and that’s only because if it’s going to one person then all phone calls and emails can be systematically ignored if they are not “important”. I have been told that comments on the Facebook page will likely start being deleted soon (within 24 hours) and that they may shut down commenting entirely.

-Despite discussing taking precautions, hospital administration does NOT think that there will be much to worry about on Thursday. They are PREPARING for the worst but I have personally heard one of the upper level admins say that they would be shocked if there were “more than one or two of those crazy, smelly hippie moms with misspelled signs whose kids are homeschooled and unvaccinated”. That comment will probably stick with me forever. It was wrong on so many levels.”

Reflecting on Nebus vs. Hironimus

Nebus vs Hironimus – circumcision scheduled

According to Intact America and intactivist Brother K, there is a report “that Dr. Gary A. Birken, MD, 1150 N 35th Ave, Hollywood, FL phone: (954) 265-0072, has diagnosed Chase with a foreskin problem and that the circumcision is scheduled for June 11 at a Florida hospital.”

Dr. Gary Birken also writes fiction, with his name, and as Mason Lucas MD. As Mason Lucas MD he published “Error in Diagnosis”. Using his name he published “Error in Judgement”

Dr. Gary Birken will commit a terrible error in judgment if he proceeds to circumcise Chase based on a fraudulent diagnosis.

Physicians examining C.R.N.H. or performing surgery on him should be warned that they are being observed by thousands of activists, several intactivist organizations, the national and international media and the international community, and any fraudulent referral or procedure over “phimosis” will no doubt lead to reports of misconduct and ethics complaints.

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Richard Dawkins tweets Marilyn Milos’ video.

Richard  Dawkins tweeted:

11008517_823637881053422_7197394066429671049_n “What this woman says about circumcision has the ring of sense. If she’s right, I find it very depressing.”

What he is referring to is the video of Marilyn Milos about the sexual harm of circumcision, recorded by James Loewen.

https://www.youtube.com/watch?v=BgoTRMKrJo4