Informed consent. Doctors must respect a patient's autonomy.36 Consent must be obtained for a surgical procedure prior to its performance or the procedure is classified as battery.24 Valid consent may only be given by a fully informed person.25 36 49 The person must possess the capacity to make the decision.27 36 Consent must be voluntary and not coerced.28 36 Medical ethics requires doctors provide all material information to patients or their proxy representatives prior to obtaining consent for a surgical procedure.1925 29 Information must also be provided for alternative treatments, including the choice of no treatment.19 29 36 41 Non-circumcision is a viable and reasonable alternative, so the attending physician must also provide full information regarding non-circumcision.48 When the patient is legally incompetent, a proxy representative must be found to grant permission for investigation and treatment on his/her behalf.19 27 36 Consent for Children. Children are separate persons from their parents and possess a separate set of legal rights.27 Parent's rights cannot override child's rights.53 54 Children are legally incompetent persons so parents usually grant informed permission for diagnosis and treatment on behalf of children.19 35 48 When parents bring a child to a doctor, it is the child who is the patient and not the parents.18 19 30 The doctor's responsibilities are to his child-patient and to no one else.4 18 19 52 The doctor's responsibility to the child-patient is paramount.42 52 When parents decide about treatment for a child, that decision must be made in the child's best interests.19 30 34 35 38 52 53 Children must be involved in the decision.15 18 19 23 30 52 Non-essential procedures should be delayed until the the child is mature enough to decide.19 52 Moreover, parental power to grant permission for treatment is less extensive than if the parent was granting permission for his or her own treatment.19 52 Parents may only grant permission for diagnosis and treatment of disease.1935
Consent for child circumcision. The current practice of the medical community is to obtain permission from a parent for circumcision of a child. (In the United Kingdom and British Columbia the permission of both parents is required.)52 53
The medical community has long based this protocol for obtaining consent on the assumption that a parent may legitimately give consent to the non-therapeutic circumcision of a child. There is, however, no basis in law to support this assumption. A male neonatal circumcision is neither a diagnostic procedure nor a treatment of a disease.19 36 Thus non-therapeutic circumcision is, in effect, an act of battery. No parent can grant consent for an act of battery. By this reasoning, "parental consent" for a non-therapeutic, non-diagnostic circumcision operation on a child appears to be invalid. However, a court decision would be necessary to resolve the question.
Further, it is not clear how medically unnecessary non-therapeutic circumcision can be in the best interest of any particular child. A court ruling in the United Kingdom held that a circumcision was not in the best interest of a particular child.52