ABSTRACT: A review of literature from the fields of nursing, medicine, sociology, law and psychology from the late 1980's to the present reveals extensive discussion and debate of male circumcision. This investigation was an attempt to determine factors which may influence parental decision making regarding routine newborn circumcision and to determine parental attitudes toward circumcision. The issue has been debated for decades; with proponents and opponents alike arguing their position with passion. In 1999 the American Academy of Pediatrics (APA) updated their current policy on routine newborn circumcision. The APA does not recommend routine newborn circumcision, instead declares circumcision to be a decision best left to parents. The policy further states the decision regarding circumcision should be made after parents receive accurate and impartial information from their healthcare provider. Using a questionnaire asking both demographic and nondemographic questions a sample of parents of male children aged birth to thirty-six months were invited to participate in the research. One hundred-one participants returned the completed questionnaire. Data collected shows that although not statistically significant, there does seem to be a trend between decision making regarding circumcision and advice from healthcare providers. This is reflected by the fact that of the participants who had their son circumcised 58% did so without advice from any healthcare provider with an increase to nearly 80% after discussion with a healthcare provider. Data was unable to show any significant effect by demographic variables on parental decision making regarding circumcision.

The labor and delivery nurse is knowledgeable to a point about the medical aspects of circumcision, they may or may not be knowledgeable about the procedural, emotional, or religious aspects. It is proposed that labor and delivery nurses be educated in these areas so that they can be ready to explain all the aspects of circumcision to the parents of newborn males when the time comes to make this most important and necessary decision. This quality review of literature shows that supporting the parents with making the informed decision of circumcision will provide for more patient autonomy. The research shows "Parents want to make the best decision for the health of the children, but not all...medical bodies are equally forthcoming with information for parents on the risks of circumcision" (Williams, 2009). It is the responsibility of the said institution and caregivers to ensure the parents are able to excise their rights and make this decision. This project will explore the theory of educating medical staff on circumcision procedures, religious views, cultural views, emotional aspects, benefits of circumcision and risks of circumcision that it will improve patient education and care. Improving the education of the patient on the topic of circumcision will thus improve the ability of the parent to make an informed decision and practice their right of autonomy. Improving this aspect of care should theoretically improve patient satisfaction and should improve institutional reimbursement for care. This being part of a patient safety indicator from the Centers for Medicaid and Medicare as a quality of care measure influences reimbursement for such a procedure if complications occur and parents were not educated on the procedure (AHRQ, 2003).