Ritual Circumcision and Abuse of Profession: The Court of Cassation Clarifies with Ruling No. 23215/2025

The Court of Cassation, with ruling no. 23215 filed on June 20, 2025 (Hearing 04/17/2025), has issued an important decision addressing the delicate balance between cultural-ethnic practices and the need for public health protection. The central issue concerns "ritual" male circumcision and its legal classification when performed by individuals not licensed to practice medicine, constituting the crime of abusive practice of a profession. This decision, which saw the partial annulment with referral of a previous ruling by the Court of Assizes of Appeal of Rome (10/08/2024), offers a fundamental interpretative beacon in an area of great social and legal sensitivity.

The Legal Classification of Circumcision: Medical Act or Ritual Practice?

Male circumcision, although rooted in age-old traditions and practiced for religious or cultural reasons, is an intervention that affects physical integrity. Italian jurisprudence, with this ruling by the Fifth Criminal Section (President Dr. G. R. A. Miccoli, Rapporteur Dr. M. T. Belmonte), has firmly reiterated its nature as a medical act. This implies that, regardless of the underlying motivation, it must be performed by qualified and legally authorized healthcare professionals.

The Supreme Court addressed the case of the defendant I. P.M. L., whose actions were questioned precisely due to the lack of necessary qualifications. The ruling focuses on the protection of individual well-being and public trust in the integrity of healthcare professions.

The crime of abusive practice of a profession is constituted by the conduct of anyone who, without being licensed to practice medicine, performs a "ritual" or cultural-ethnic male circumcision, given that the latter, while constituting an act of disposition of one's body not expressly prohibited and not incompatible with art. 5 of the Civil Code, must be classified as a medical act.

The maxim crystallizes an essential principle: circumcision, while it may be considered an act of disposition of one's body not prohibited by art. 5 of the Civil Code (which allows such acts provided they do not result in permanent physical impairment and are not contrary to law, public order, or good morals), is intrinsically a "medical act." Consequently, its performance by someone who does not possess the special qualification required for the medical profession constitutes the crime of abusive practice of a profession, pursuant to art. 348 of the Penal Code. This interpretation aims to safeguard the health and safety of those undergoing such a practice, ensuring it is performed with the necessary skills and precautions.

Article 348 of the Penal Code and the Protection of Public Health

Article 348 of the Penal Code penalizes anyone who abusively practices a profession for which state licensing is required. The rationale behind this provision lies in the protection of fundamental public interests, such as citizens' health and the integrity of professional bodies. When an intervention like circumcision is carried out by unqualified personnel, individuals are exposed to high risks.

The dangers associated with a circumcision not performed by a licensed physician include:

• Risk of serious infections due to non-sterile instruments or unsuitable environments.
• Hemorrhagic complications due to lack of anatomical knowledge and adequate surgical techniques.
• Permanent injuries or disfiguring scars due to procedural errors.
• Absence of appropriate pain management (anesthesia).
• Lack of capacity to intervene in case of emergencies or adverse reactions.

The Court, referring to a consolidated jurisprudential trend (see previous conforming maxims such as no. 43646 of 2011 and others cited, such as no. 16566 of 2017, no. 12539 of 2020, no. 5319 of 2024, no. 17164 of 2024), has therefore reiterated that the invasive nature and potential consequences of a circumcision intervention necessitate medical professionalism, in line with the right to health guaranteed by Article 32 of the Constitution.

Conclusions: A Warning for Safety and Legality

Ruling no. 23215/2025 of the Court of Cassation serves as a clear warning for the protection of public health and for compliance with regulations governing the practice of professions. This is not about limiting freedom of worship or cultural traditions, but about ensuring that any practice affecting physical integrity is carried out under conditions of maximum safety and professionalism. The Court has skillfully balanced the right to self-determination with the imperative of health protection, establishing that, even in the presence of cultural or religious motivations, the medical act must remain the exclusive domain of those legally authorized. This is a fundamental principle for the protection of every individual and for the safeguarding of the healthcare system.