The death of David Flynn during a non-therapeutic circumcision has reignited debate over Medicare funding and the risks of elective procedures on children, writes Dr Chris Coughran.
THE SAME WEEK that Education Minister Jason Clare announced the “most significant” child safety reforms in Australia’s history, the Coroner’s Court of Western Australia handed down its findings into the death of two-year-old David Kalunda Flynn.
The official cause of death was ‘cardiorespiratory arrest in a young child with opioid (morphine) toxicity’. As Coroner Robyn Hartley’s report explains, David was ‘a happy, healthy child with no pre-existing medical conditions who never woke from the deep sedation administered for the circumcision’ he underwent at a Perth clinic in December 2021. ‘Procedural sedation’ in the Coroner’s view – but not, apparently, infant circumcision per se – ‘comes with significant known risks’.
Meanwhile, David’s nine-month-old brother, Joseph, circumcised that same day, in that same Gosnells Clinic by the same doctor, but deemed too young for general anaesthesia, was rushed to Perth Children’s Hospital, where he underwent emergency surgery to control bleeding from his frenular artery’.
Compounding the tragedy, there was no medical indication for either David’s or Joseph’s circumcision.
In fact, according to the Australasian Institute for Genital Ausonomy:
‘Australian health authorities have firmly and consistently recommended against [routine circumcision] since 1971.’
In lieu of medical necessity, David and Joseph Flynn were circumcised in accordance with the cultural and/or religious expectations of their parents.
The proportion of Australian doctors willing to perform non-therapeutic circumcisions on children is vanishingly small, around a quarter of 1%.
But there are, at least in principle, constitutional and statutory impediments to Commonwealth funding for surgical procedures that are not “clinically relevant” for the purposes of the Health Insurance Act 1973.
In practice, Medicare – under reactionary pressure from religious lobbyists – has turned a blind eye when it comes to non-therapeutic male circumcision, such that most circumcision providers, including purveyors of botched circumcision procedures, such as in this case, openly flaunt the Medicare rebate on websites and billboards.
This sordid state of affairs does a disservice to both public health and our democracy, as the late medical historian Robert Darby observed:
‘In May 2012 a poll in the Sydney Morning Herald found that 67% of respondents were in favour of dropping circumcision from the [Medicare Benefits Schedule], and in August a survey in Australian Doctor showed that 51% believed that circumcision was child abuse and should not be done at all, while a further 23% believed that it... should neither be available in public hospitals nor funded by Medicare.’
Far from promoting child safety, Medicare funding for routine circumcision appears to imply:
‘... tacit Australian government endorsement and encourages private health insurers to fund the practice. The removal of Medicare funding would send a positive signal to parents, insurers and the relatively few doctors who participate... that the community does not support unnecessary genital harm to children unable to consent, to protest or to refuse.’
David Flynn’s death will never be chalked up, in any public health database, as (yet another) “botched circumcision”. Accepting the judgment of two expert witnesses, Coroner Hartley seems satisfied that male circumcision has been safely 'practised for thousands of years for cultural, religious and health reasons'.
Likewise, Noor Blumer, who represented the Flynn family throughout the inquest proceedings, told ABC News:
“It’s really important that circumcision is something that is available to people that want to do it for whatever reasons... for their children.”
The amputation of any healthy, functional body part is inherently harmful and, especially for young children, fraught with unnecessary risk. Botched or otherwise, anaesthesia or none, non-therapeutic male circumcision is scarcely to be reckoned in the child’s best interests. It violates, among others, his rights to bodily integrity and the best possible healthcare, not to mention his own freedom of religious thought and belief. In extreme cases, male circumcision negates the child’s right to life.
David Flynn never woke up. When will we, as a nation, stir from our collective circumcision coma? Wake up, Australia: routine circumcision is ‘an idea whose time has gone’. Our public health system is in sore need of something better than the fig leaf – cum olive branch – of a pretended multiculturalism. The safety of Australian children depends on it.
As Coroner Hartley concluded:
‘To honour David’s memory, we must ensure that the lessons learnt from his death are shared and acted upon in the hope that no other family has to endure a loss like the one the Flynns must live with.’
Dr Chris Coughran is an independent researcher. Schooled in English and the humanities, he is the survivor of a botched neonatal circumcision.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia License
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