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Helsinkin Sanomat
Prosecutor General defers move on Kuopio botched circumcision case
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seattlepi.com Anti-circumcision activists march
By CAROL SMITH That was the question anti-circumcision activists posed to passers-by and convention-goers outside the Pediatric Academic Societies' convention meeting yesterday in Seattle. The protesters, buoyed by the settlement last month of a landmark New York case by a man who sued the physician who circumcised him as an infant, buttonholed anyone who would listen to get them to reconsider their positions on circumcision. "Most parents do it out of misinformation and ignorance," said John Mark, founder of Seattle-based Doctors Opposing Circumcision, as he handed out leaflets that asked: "Does being born a healthy male require surgical correction?" Many doctors attending the convention walked on by, apparently uninterested in a street-corner debate. "There are more important social issues," said one doctor, shaking his head. "This is a waste of paper." Some pedestrians heckled the protesters. And a few seemed befuddled. "It's done for health reasons, right?" said one man. Although, originally touted as necessary for "hygiene" and to prevent certain cancers, the procedure has become a rite of birth in the United States. In recent years, however, the American Academy of Pediatrics, has backed away from routine circumcisions. "Circumcision is not essential to a child's wellbeing at birth, even though it does have some potential medical benefits," the AAP said in a policy statement posted on its Web site. The AAP did acknowledge that cultural, religious and ethnic traditions also play a role in making circumcision decisions. "I've never pushed it," said Dr. Sheldon Korones, a neonatologist from Memphis who was attending the meeting. "But if the parents want it, I don't oppose it either." [How many babies have asked him for it?] At Seattle's Swedish Medical Center, about 60 percent of newborn boys are circumcised at their parents' request, said spokesman Ed Boyle. John Geisheker, a Seattle attorney who specializes in botched circumcision cases, is hoping for a new wave of cases based on the success of the New York case. In December, 2000, then 18-year-old William Stowell filed suit against the hospital where he was circumcised and the doctor who did it. His attorneys sued for fraud and battery, arguing that he didn't consent to the procedure, which was done for "non-therapeutic reasons." Terms of the settlement two weeks ago were not disclosed, but other attorneys viewed it as validation that such claims would be considered seriously In Washington men have a three-year window beginning at age 18 during which they can sue for what Geisheker calls a "prophylactic amputation." No such suits have been filed yet. The graphic posters of infants being circumcised and other protest literature did make an impression on some men. "What they need to do is wait until you're 13 and let them make the choice themselves," said Charles McAteer, 44, who was walking by and said he hadn't given the issue much consideration before. But Adam Kriston, 35, wasn't so sure circumcision was all bad. "I've been told by women the appearance is better without it," he said. P-I reporter Carol Smith can be reached at 206-448-8070 or Reprinted in Good Housekeeping. |
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( Reuters Health) Last Updated: 2003-04-29 10:32:15 -0400
Another study fails to find Circumcision does not dull sensitivity: study
NEW YORK (Reuters Health) - Circumcised men appear to have the same degree of penis sensitivity as men who are uncircumcised, a new study suggests -- in a finding that will probably just add fuel to the fire of a
controversial subject debated for years.
The findings are to be presented Tuesday by Dr. Arnold Melman at a meeting of the American Urological Association in Chicago.
"We demonstrated that there are no significant differences in penile
sensation between circumcised and uncircumcised men in both patients with
and without erectile dysfunction," said Melman in a prepared statement.
"This study does not address whether or not patients should be
circumcised, however, it merely served to test sensitivity," added Melman,
who is with Montefiore Medical Center in New York City.
[Then why the next three paragraphs?]
The current policy of the American Academy of Pediatrics is that the
potential medical benefits of male circumcision are not substantial enough
to recommend that all boys become circumcised.
Around three-quarters of American-born men in the U.S. are circumcised, although that number appears to be declining rapidly in some regions of the country.
Male circumcision is common in North America [no, only the US] and elsewhere for religious and cultural reasons and is known to help prevent urinary tract
infections, sexually transmitted diseases and penile cancer, a rare
condition. In the minor surgical operation, the foreskin is removed, which
can help prevent bacteria from growing under the fold of skin.
On the other hand, many parents feel it inflicts unnecessary pain, and in
many countries circumcision is rarely performed. In recent years, the
issue has been highly controversial with vocal opponents to the procedure
likening it to mutilation.
Still, few studies have aimed to investigate the differences in penile
sensitivity, if any, between the two groups.
In the current investigation, Melman's team evaluated the penile
sensitivity among 43 uncircumcised men and 36 circumcised men through a
variety of methods, including vibration, pressure, spatial perception and
warm and cold thermal thresholds. Both groups contained men with and
without erectile dysfunction.
[This is already a very small sample. All but 20 of the men had erectile dysfunction, leaving far too few fully-functioning men to draw any meaningful conclusions.]
In uncircumcised men, the foreskin was pulled back during the sensitivity
testing procedures.
[It is hard to see what they could compare the sensitivity of the intact men's foreskins with, that would make any comparison meaningful. They seem to have measured sensitivity per unit area for one or two small areas of the penis, regardless of
The investigators found no statistically significant differences in
sensitivity between the two groups of men, regardless of whether they had
erectile dysfunction.
In other findings, the researchers found that white men were 25 times as
likely and African-American men were eight times as likely as Hispanics to
be circumcised.
[The sample is far too small to draw any statistical conclusions - it appears to depend on one Hispanic man in the sample happening to have been circumcised. While it is irrelevant, its innumeracy casts grave doubt on the rest of the research.]
To the abstract |
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PO Box 2512, San Anselmo, California 94979 www.nocirc.org Tel: 415-488-9883 Fax: 415-488-9660 Attorneys for the Rights of the Child 2961 Ashby Avenue, Berkeley, California 94705 www.arclaw.org Fax/Phone 510-595-5550 FOR IMMEDIATE RELEASE: April 25, 2003 Stage Set for Men to Sue for Being Circumcised as Infants SUFFOLK COUNTY, New York – After a two-and-a-half year legal battle with Plaintiff William G. Stowell, the doctor and hospital have settled the landmark circumcision case brought against them. The terms of the settlements have not been publicly disclosed. Twenty-one-year old Stowell filed suit December 19, 2000, in the U. S. District Court for the Eastern District of New York, against the hospital where he was circumcised and the physician who circumcised him as a newborn. Stowell, born on December 22, 1981, in West Islip, NY, was circumcised the following day by his mother's obstetrician. This case presented the issue of the legal validity of consent for circumcision obtained by a nurse from a mother who was debilitated by the effects of a Caesarian section and painkillers. It also questioned whether a physician could legally and ethically remove healthy, normal tissue from a non-consenting minor for non-therapeutic reasons. David J. Llewellyn, one of Plaintiff Stowell's attorneys, said, "William and I are very happy that we were able to resolve this case with both the hospital and the doctor. While a settlement is never an admission of liability, I believe it shows that our allegations were taken seriously. Never again can someone say that a young man who is dissatisfied with his circumcision as an infant is being frivolous when he objects to his mutilation and brings suit to obtain justice. This case should send a message to doctors that they run the risk of a lawsuit each time they circumcise an infant for non-therapeutic reasons, particularly when they rely on the hospital to obtain consent the day after birth. Social or cosmetic concerns provide no justification for harmful surgery. I would expect that this is just the first of many cases that will be brought by angry circumcised young men against their circumcisers." The American Academy of Pediatrics (AAP) first acknowledged that there was no medical justification for routine circumcision in 1971. Last year, the AAP reaffirmed that it does not recommend routine circumcision. The American Medical Association concurred this year, calling routine circumcision "non-therapeutic." No national or international medical organization recommends routine circumcision. The case has received national attention from Good Morning America, Newsweek, The New York Post, and other prominent media sources. John L. Juliano of East Northport, New York, and David J. Llewellyn of Conyers, Georgia, represented Mr. Stowell. Mr. Llewellyn, who regularly represents the victims of circumcision throughout the country, can be reached at 1-770-918-1911. |
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USAID to push circumcision
Circumcision shown to deter HIV spread [So this campaign is based on a literature search. A well-known fault of such studies is the "lab drawer effect": studies that fail to show an effect are less likely to be published than studies that seem to show one.
All these studies assume that the primary mode of transmission of HIV is sexual. Recent work suggests it is not.] "A sub analysis of 10 African studies found a 71 percent reduction among higher risk men," said the report obtained by The Washington Times. [No studies have demonstrated any reduction, only difference between populations. (Correlation is not causation.) By what criteria were these ten studies selected? Other studies might have given a very different result.] "There is really an incredible preponderance of evidence. There is really a strong association," between circumcision and HIV protection, Dr. Anne Peterson, assistant administrator for global health at USAID, said yesterday in an interview. ["HIV protection" begs the question. There is only an association with HIV non-infection.] According to the scientific studies, the skin on the inside of the male foreskin is "mucosal," similar to the skin found on the inside of the mouth or nose [or the vulva or vagina]. This mucosal skin has a high number of Langerhan cells, which are HIV target cells, or doorway cells for HIV. [Langerhans cells are part of the immune system. Cutaneous (ordinary) skin also has a high number.] The rest of the skin on the penis is more like the outer skin on the rest of the body, a barrier that protects against germs. "HIV looks for target cells, like the Langerhans; it's a lock and key," said Edward G. Green, senior researcher at Harvard University, who has been looking at circumcision and HIV in Africa for 10 years. "The rest of the skin on the penis is armorlike." [Suspicion of such exaggerated language is in order.] He said that it is better to be circumcised as a baby, rather than as a teenager in "rite-of-passage" ceremony, because many teenage boys in Africa are already sexually active. [If infant circumcision ever has any effect, it will only begin 15 years from now. By then, a vaccine may well have been found, and in the meantime, many more adults will have contracted HIV. But it's easier to circumcise babies, who can't object.] Mr. Green said that if all males in Africa were circumcised, the HIV/AIDS prevalence rate could be reduced from 20 percent in some regions to below 5 percent. [It would be interesting to see how he reaches that figure. One study, much quoted by circumcisionists, found one-third of the circumcised men had HIV before it began.
N.B. This proposal protects women only indirectly, by protecting men - if it does. Circumcised HIV-positive men are just as likely to pass the virus on as intact men - more so if they think circumcision has made them safe. Women have every right to be outraged at the greater risk this campaign is going to expose them to. It will do nothing to reduce same-sex transmission.
] In addition, circumcision reduces the transmission of other sexually transmitted diseases, is more hygienic, reduces infections associated with poor hygiene and makes it easier to use a condom, Mr. Green said. [Mr Green seems to like circumcision, doesn't he?] "This is something the tribal healers, the herbalists, faith healers and witch doctors have known for years," he said. [Witch-doctors also "know" about the benefits of FGM...] The 60-page USAID report is based on presentations given at a USAID conference in September, and will be available on the USAID Web site "soon," Dr. Peterson said. She said that while the information "looks profound and wonderful," she cautioned there may be other factors that reduce HIV transmission in circumcised men. [...such as culture and religion, and hence sexual behaviour, alcohol/drug usage, age of onset of sex, and any number of other things unconnected with the foreskin but connected with HIV.] She said clinical trials in Kenya and Uganda, under the auspices of the National Institutes of Health (NIH), Johns Hopkins University and the Gates Foundation, would give a clearer picture. Until then, she said USAID would move cautiously to educate and promote male circumcision. ["No, no!" said the Queen. "Sentence first - verdict afterwards." - Lewis Carroll] Dr. Peterson said there is no evidence the female circumcision, sometimes called genital mutilation, offers any benefit whatsoever. [...because nobody has looked for any. If they looked as hard as they have for benefits from circumcision, they might very well find some.] In fact, the scarring produced in the procedure may enhance the transmission of disease, she said. "We are adamantly opposed to female circumcision." [Male circumcision also causes scarring, of course.] Another concern is that by promoting circumcision, circumcised men may mistakenly believe they are invulnerable to HIV. They are not, said Dr. Peterson. "It reduces your risk. [Maybe] It does not protect you outright," said Dr. Peterson. "People who are circumcised still get HIV. It is still better to abstain, be faithful in marriage," or use condoms, she said. [Indeed, but how many men undergoing a painful procedure in the hope of protection - in a culture where sex with a virgin is believed to protect against HIV - are going to listen to these half-hearted and confusing warnings? This campaign is a recipe for disaster.] |
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Philippine Doctors Making a Stand Against Male Circumcision
Mon, 21 Apr 2003
Stand of the Ospital ng Maynila Medical Center 2003 Gist of letters (March 4, 2003) of Hospital Director Dr. Christia S. Padolina to Mayor Atienza, Secretary to the Mayor, City Administrator, City Council, and SK Federation "OMMC will not do circumcision inside and outside the hospital." March 13, 2003, in an Executive Medical Board meeting, all chairpersons of the clinical departments of OMMC supported the stand of the Department of Surgery (NO to Routine Circumcision; NO to Operation Tule). No department will do circumcision in the hospital starting March 13, 2003. |
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Helsinkin Sanomat
Prosecutor General defers move on Kuopio botched circumcision case
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Japan Times THE ZEIT GIST Society fiddles as young get burned By MARK SCHREIBER The vernacular media frequently goes tsk-tsk over crimes by juveniles. These days, people's concerns tend to be reflected through two terms: "kyoaku-ka" and "teinenrei-ka," which refer, respectively, to more violent crimes by increasingly younger perpetrators Unfortunately, the media and the public tend to dwell a bit too much on the bad kids and not enough on finding more ways to insulate kids from the bad adults who prey on kids at every turn. ... Another outrageous racket involves urologists, whose ads can be found in nearly every men's magazine. They convince naive youths that they will be rejected by girls unless they undergo circumcision, promising a "cure" as if they suffered from some sort of birth defect. A responsible physician would almost certainly dissuade a patient from such surgery. ... The Japan Times: April 8, 2003 (C) All rights reserved |
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salon.com West Hollywood bans declawing of cats
By Louinn Lota
'We would just encourage our neighboring cities to follow our lead,' Councilman John Duran said Monday night after the council's 5-0 vote. West Hollywood, a city of 3,500 people surrounded by Los Angeles and Beverly Hills, already has a law on the books designating its residents as pet guardians rather than pet owners. Although cat declawing is banned in several European nations, animal advocates said they know of no such restrictions in the United States. ... The procedure, known as onychectomy, costs $100 to $300 and removes the first joint of each toe in a cat's paw. It's normally done to keep cats from scratching people and furniture. ... "I was abhorred [sic] at what I had done to lovely Fluffy," Duran said earlier. "It's the equivalent of removing a knuckle off of a human finger. Had I known that, I would have sought alternatives." |
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The Maitland Mercury
Neonatal procedure suspended
Hunter Health has ceased routine neonatal circumcision within its hospitals following a Royal Australasian College of Physicians recommendation.
In its position statement on circumcision, the college stated that it had revised its policy following 'critical literature analysis' by a working party of representatives from a number of professional organisations including paediatricians, paediatric surgeons, general surgeons and urologists from Australia and New Zealand.
The Royal Australasian College of Physicians' division of paediatrics and child health has concluded that where no medical indication for circumcision exists, the procedure is best performed under general anaesthetic after the age of six months to reduce the risks and the discomfort for the child. [Where no medical indications exist, it's best not performed.]
Until recently, circumcision of newborn baby boys was available at Cessnock and Belmont hospitals.
Hunter Health Area director of child health services professor Trish Davidson said about 250 babies were circumcised in the Hunter each year and the majority of these babies were aged under six months and were performed for social rather than medical reasons.
"Following the College of Physicians' declaration, we have acted quickly and prudently to stop newborn circumcisions in Hunter public hospitals," professor Davidson said.
"There are some individuals and cultures who favour the circumcision of male babies and the procedure is still available for babies more than six months old. Parents need to ask their GP for a referral to an appropriate surgeon."
While some health benefits have been claimed for circumcision, this review of the literature shows no evidence of benefits outweighing harm for circumcision as a routine procedure.
The complication rate of neonatal circumcision is reported to be about one per cent to five per cent and ranges from minor bleeding and infection to damage to the genitalia or, rarely, septicaemia or even death.
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UK Doctors Advised on [This summary is rather more pro-circumcision than the actual guidelines, mainly by omission.] LONDON (Reuters Health) - The British Medical Association (BMA) issued new circumcision guidelines on Friday in an effort to help doctors negotiate the ethics of what it calls an increasingly controversial area.
The guidance says there is significant disagreement about whether circumcision is beneficial, harmful or neutral when it comes to boys' health, and that parents have the right to make choices about what is in their child's best interest. [But it also says "parental preference alone is not sufficient justification for performing a surgical procedure on a child."]
Circumcision for medical purposes is rarely controversial, the BMA says, but it points out that the British Association of Pediatric Surgeons advises that there is rarely a clinical need for the procedure.
In the case of non-therapeutic circumcision for religious or cultural reasons, the ethical situation is less straightforward.
"Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA's membership," the document says.
"The medical harms or benefits have not been unequivocally proven except to the extent that there are clear risks of harm if the procedure is done inexpertly."
It is legal to perform non-therapeutic circumcision so long as it is done competently, is thought to be in the child's best interests and valid consent has been obtained, the BMA says. [It also says "The responsibility to demonstrate that non-therapeutic circumcision is in a particular child's best interests falls to his parents."]
Boys old enough to express a view should be involved in the decision about being circumcised, but if they are not old enough, then both parents should agree.
"If a child presents with only one parent, the doctor must make every effort to contact the other parent in order to seek consent," the guidelines say. [It says if parents disagree, a court order is required, but warns against circumcising when one parent refuses.]
Doctors who have a conscientious objection are under no obligation to comply with a request to circumcise a child. They should explain this to the child and his parents, the BMA concludes. [It actually concludes after that, that they are arguably under no obligation to refer the parents on, either.]
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Genital Integrity Awareness Week, April 2003 at Washington DC  |
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