舊瓶新酒：包皮環切術的演進與新貌

New Wine in an Old Bottle: Evolution of and a New Look at Male Circumcision

許振東(Chen-Tong Hsu) ； 丁志音(Chih-Yin Lew-Ting)

《台灣公共衛生雜誌》 29卷5期 (2010/10) Pp. 401-409

https://doi.org/10.6288/TJPH2010-29-05-03

摘要

包皮環切術是已知最古老也是執行最多的手術，在人類的發展歷史中，它已經變換許多面貌，呈現在不同時代不同社會的不同族羣人面前。傳統儀式性的包皮環切術，在近代醫學的加持下，曾經蔚為主流，但也因缺乏臨床效益而逐漸褪去光彩；然而近年來，越來越多流行病學及臨床試驗的研究結果，顯示它確實可以減少許多疾病的發生，特別是HIV/AIDS的預防。但如同其他的公共衛生計畫一樣，這項介入措施也涉及倫理的爭議。國內學界與相關單位並未對此議題有共識與建議，亦未提供民眾參考與指示，因此本文的目的除了對此議題作一綜合性的歷史回顧與論述其新的公共衛生意義外，更希望拋磚引玉引起學界與相關單位的重視與討論。

關鍵字

包皮環切術 ； 人類免疫缺乏病毒 ； 致癌性人類乳突病毒 ； 子宮頸癌 ； 人權

並列摘要

Male Circumcision is the oldest known surgical procedure in the world, and it continues to be one of the most commonly performed operations today. Because of its diversified ritual features and multiple functions throughout human history, the value of this cultural practice cannot be overlooked. It was once very popular in the medical community but later faded away due to a lack of clinical effectiveness; however, recent findings have shown it to be effective in disease control, especially in the prevention of HIV/AIDS. The practice of male circumcision, however, evokes ethical concerns just as other public health measures do. Currently there is a lack of consensus about the practice of male circumcision in Taiwan and recommendations are not available for the general public. This article provides a comprehensive review of the origin, development, and emerging public health implications of this practice. The medical and public health communities in Taiwan should raise concern about this issue.

並列關鍵字

circumcision ； human immunodeficiency virus ； oncogenic human papillomavirus ； cervical cancer ； human rights

參考文獻

Doctors Opposing Circumcision. Genital integrity policy statement. Available at: http://www.doctorso pposingcircumcision.org/. Accessed September 30,2009.

Morris B. Circumcision: an evidence-based appraisal.Available at: http://www.circinfo.net/. Accessed September 30, 2009.

The Royal College of Surgeons of England. Statement on male circumcision. Available at: http://www.rcseng.ac.uk/media/press-releases-new-system/2001/ statement-on-male-circumcision/. Accessed September 30, 2009.

American Academy of Pediatrics. Parenting corner Q&A: circumcision. Available at: http://www.aap.org/publiced/BR_Circumcision.htm. Accessed September 30, 2009.

(2003).(Siegfried N, Muller M, Volmink J, et al. Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev 2003;3:CD003362).