Bioethics Discussion Blog: Male Circumcision: Should It Now Be A Crime?

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Wednesday, July 05, 2006

Male Circumcision: Should It Now Be A Crime?

Male circumcision is without doubt one of the more controversial issues along with abortion within the cultures within the United States. There are ethical, legal, medical, cultural and religious as well as, I presume, political aspects to the issue. This topic was brought up on my blog posting "I Hate Doctors" but I felt it was an important topic to be discussed on a posting more specific to the circumcision issue. Other constructive discussions of "hateful" concerns and experiences about physician behavior can continue to be discussed there but I would like circumcision issues discussed here. I would also appreciate comments and arguments here from those visitors who see some good or value in circumcision or would find defects, legal or ethical, in the law requested below. ..Maurice.



The MGMBill.org, is attempting to get a bill passed in Congress to make male genital circumcision a crime in addition to what many feel to be mutilation acts on females. Below is the proposed congressional bill which the group hopes will become law. According to their website, "the MGM Bill proposal has been submitted to every member of Congress three times: on February 23, 2004, February 28, 2005, and February 6, 2006. In 2006, our state offices also submitted state level MGM Bill proposals to every member in 15 U.S. state legislatures."

Genital Mutilation Prohibition Act

IN THE HOUSE AND SENATE OF THE UNITED STATES

---------------------------------------------------------------

A Bill

Submitted to Congress on February 6, 2006

Entitled the "Federal Prohibition of Genital Mutilation Act of 2006"

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, to amend the Female Genital Mutilation Act of 1996 (a) so that boys, intersex individuals, and nonconsenting adults may also be protected from genital mutilation; (b) to increase the maximum punishment of offense to 14 years imprisonment, (c) to include assistance or facilitation of genital mutilation of children or nonconsenting adults as an offense, and (d) to prohibit persons in the U.S. from arranging or facilitating genital mutilation of children and nonconsenting adults in foreign countries.

SECTION 1. SHORT TITLE
This Act may be cited as the "Federal Prohibition of Genital Mutilation Act of 2006".

SECTION 2. TITLE 18 AMENDMENT
(A) IN GENERAL.--Title 18, Part I, Chapter 7, Section 116 of the United States Code is amended by revising the text to read as follows:

"116. GENITAL MUTILATION
"(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, cuts, or mutilates the whole or any part of the labia majora, labia minora, clitoris, vulva, breasts, nipples, foreskin, glans, testicles, penis, ambiguous genitalia, hermaphroditic genitalia, or genital organs of another person who has not attained the age of 18 years or on any nonconsenting adult; whoever prematurely and forcibly retracts the penile or clitoral prepuce of another person who has not attained the age of 18 years or on any nonconsenting adult, except to the extent that the prepuce has already separated from the glans; whoever knowingly assists with or facilitates any of these acts; or whoever arranges, plans, aids, abets, counsels, facilitates, or procures a genital mutilation operation on another person outside the United States who has not attained the age of 18 years or on any nonconsenting adult outside the United States shall be fined under this title or imprisoned not more than 14 years, or both.

"(b) A surgical operation is not a violation of this section if the operation is (1) performed on a person who has not attained the age of 18 years and is necessary to the physical health of the person on whom it is performed because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place of its performance as a medical practitioner; (2) performed on an adult who is physically unable to give consent and there is a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place of its performance as a medical practitioner; or (3) performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.

"(c) In applying subsection (b), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that or any other person that the operation is required as a matter of custom or ritual.

(B) CLERICAL AMENDMENT.--The table of sections at the beginning of Chapter 7 of Title 18, Part I, of the United States Code, is amended by revising Section 116 to read "116. Genital mutilation."

SECTION 3.INFORMATION AND EDUCATION REGARDING GENITAL MUTILATION
(A) IN GENERAL. -- The Secretary of Health and Human Services shall carry out the following activities:

(1) Compile data on the number of persons of all sexes living in the United States who have been subjected to genital mutilation (whether in the United States or in their countries of origin), including a specification of the number of children under the age of 18 who have been subjected to such mutilation.

(2) Identify communities in the United States that practice genital mutilation, and design and carry out outreach activities to educate individuals in the communities on the physical and psychological effects of such practice. Such outreach activities shall be designed and implemented in collaboration with representatives of the ethnic groups practicing such mutilation and with representatives of organizations with expertise in preventing such practice.

(3) Develop recommendations for the education of students of schools of medicine and osteopathic medicine regarding genital mutilation and complications arising from such mutilation, as well as complications arising from premature forcible retraction of the prepuce. Such recommendations shall be disseminated to such schools.

(B) IN GENERAL. -- The President shall carry out the following activities:

(1) Seek to end the practice of genital mutilation worldwide through the active cooperation and participation of governments in countries where genital mutilation takes place.

(2) Steps to end the practice of genital mutilation should include--

(a) encouraging nations to establish clear policies against genital mutilation and enforcing existing laws which prohibit it;

(b) assisting nations in creating culturally appropriate outreach programs that include education and counseling about the dangers of genital mutilation to people of all ages; and

(c) ensuring that all appropriate programs in which the United States participates include a component pertaining to genital mutilation, so as to ensure consistency across the spectrum of health and child related programs conducted in any country in which genital mutilation is known to be a problem.

(C) DEFINITIONS. -- For purpose of this Act, the term "genital mutilation" means the removal or cutting (or both) of the whole or part of the clitoris, labia minora, labia majora, vulva, breasts, nipples, foreskin, glans, testicles, penis, ambiguous genitalia, hermaphroditic genitalia, or genital organs. The term "premature forcible retraction of the penile or clitoral prepuce" means forced retraction of the prepuce from the glans, except to the extent that the prepuce has already separated from the glans. The term "prepuce" means foreskin. The term "adult" means a person who has attained the age of 18 years. The term "nonconsenting" means not wishing to undergo genital mutilation.

SECTION 4. EFFECTIVE DATES
Section 2 of this Act shall take effect immediately after the date of the enactment of this Act. Section 3 of this Act shall take effect immediately after the date of the enactment of this Act, and the Secretary of Health and Human Services and the President shall commence carrying it out not later than 90 days after the date of the enactment of this Act.


IMPORTANT NOTICE: NO FURTHER POSTINGS HAVE BEEN ALLOWED ON THIS THREAD SINCE 2006. HOWEVER, YOU CAN CONTINUE WRITING ON THIS TOPIC BY GOING TO THE "INFANT MALE CIRCUMCISION: CHAPTER 3" THREAD.

448 Comments:

At Wednesday, July 05, 2006 4:11:00 PM, Blogger Maurice Bernstein, M.D. said...

I am curious what political resistance is there for those in congress to acting on the proposal? Are they concerned about how the Jewish voters would respond to such an act? ..Maurice.

 
At Wednesday, July 05, 2006 6:24:00 PM, Anonymous Anonymous said...

I assume someone will write this, but there is good evidence to suggest that a circumcision substantially lowers the risk of transmission of HPV and HIV and substantially lower the number of UTI's that a newborn experiences in the first year of life.

obgyn physician- who does circumcisions with local

 
At Thursday, July 06, 2006 8:32:00 AM, Blogger Aggravated DocSurg said...

This. Is. Absolute. Insanity.

 
At Thursday, July 06, 2006 2:48:00 PM, Blogger Maurice Bernstein, M.D. said...

Aggravated Docsurg, I realize you.are.totally."agrravated" by what you have just read but since this is a bioethics discussion and, going to your blog,you appear to be a great writer, perhaps you can document here the specifics of your concerns and what you understand and what you would believe could represent instead a sane response to the issue of male circumcision. . ..Maurice.

 
At Friday, July 07, 2006 10:25:00 AM, Anonymous Anonymous said...

I watched the circumcision film. Not pleasant. I have no idea why pain relief is not provided. The medical community can be strange at times. Perhaps you could find a film of a woman left in obstructed labour for a day/ baby’s head welded into the pelvic bones, given no help with the pain and the doctor making jokes and laughing because a blister has formed on her throat due to dehydration. The laugher turns to a high pitch giggle when she’s finally offer pain relief, in the form of gas, and she chokes on it because it’s like breathing in chalk dust. The message to the woman is that the baby’s wellbeing has no value to the doctor. Or, perhaps a film of a 13 year old girl fainting, throwing-up all over herself and suffering the public humiliation of diarrhea due to menstrual cramps and the doctor, rather than testing to see why the cramps are so painful or simply providing pain relief, explaining to her that she needs to grow up and learn to deal with the pain. Even a 13 year old knows the doctor would not be able to function in his job if he was fainting and throwing-up all over himself in front of patients, so would find a solution to his problem. Of course 13 year olds don’t verbalize their thoughts. They simply think “What’s the point in going to a doctor? They treat people like garbage.” I’m sure there are many moments of needless suffering that should be filmed and shown to the public.

My dad had himself circumcised at the age of 45 because not being circumcised had caused him grief all his life. I’m sure he was given pain relief.

 
At Friday, July 07, 2006 11:40:00 AM, Anonymous Anonymous said...

Hi Dr. B.

You will "cut-off" all communication on the other thread about circ?
Funny-Ha-Ha.


http://morphmaster.com/chester.htm

ANY promotion of infant genital cutting by US doctors for HIV/Aids which is based on VERY QUESTIONABLE studies from a 3rd world country is just bizarre!

You doctors are playing on the fears of the American public to keep yourselves out of jail from the mass ripping-off of infant baby skins that make you a TON of money! YOU will sink to new lows to continue robbing the largely trusting American public of their childrens God-Given body parts! Can I vomit now? With all 'due respect' i don't even want to discuss this issue with you in particular Dr. B. You are, I assume Jewish. By the way, it is NOT possible for me to be Anti-Semitic...my Mother's side is Jewish. The conflict of interest when a Jewish doctor wants to promote, endorse, advocate, recommend, OR PERFORM infant genital cutting on non-jewish babies (aka BRIS) is CLEARLY obvious here!

 
At Friday, July 07, 2006 11:53:00 AM, Anonymous Anonymous said...

Thank God for there are some OB's and Peds in the US with a conscious about infant genital cutting/robbery!


www.doctorsopposingcircumcision.org

If "God" intended men to have foreskins...they would have been born with them.

 
At Friday, July 07, 2006 11:59:00 AM, Anonymous Anonymous said...

What is your religious faith Sir? After you answer, we can discuss why ALL Jewish Physicians feel genital cutting is Good. Here's a BIG & BIASED clue to your readers:

It has everything to do with being Jewish.

"I would also appreciate comments and arguments here from those visitors who see some good or value in circumcision or would find defects, legal or ethical, in the law requested below. ..Maurice."

 
At Friday, July 07, 2006 12:16:00 PM, Anonymous Anonymous said...

I wouldn't recommend circumcision or any other form of genital cutting to anybody. But I'm definitely opposed to any law that would outright ban a practice with deep religious roots. On the other hand, I don't think there is any defense for not taking steps to minimize suffering. In other words, I'm ambivalent about ritual mutilation which, in context, is a form of ritual sacrifice.

BTW, cicumcision doesn't have "everything to do with being Jewish." Just ask an orthodox muslim, if you don't believe me.

 
At Friday, July 07, 2006 12:17:00 PM, Anonymous Anonymous said...

Poll:

Doctors don't use a local on neonates when they amputate part of their penis because....

A They don't have too!
B. They are desensitied to human pain and suffering.
C. They are taught in medical school how think of us as robots.
D. all of the above

 
At Friday, July 07, 2006 12:24:00 PM, Anonymous Anonymous said...

I am curious what political resistance is there for those in congress to acting on the proposal? Are they concerned about how the Jewish voters would respond to such an act? ..Maurice.

There aren't enough Jewish voters in this country for THAT to be a threat. The threat is this Sir: Congress would have to WAKE UP and THINK about what they are doing to their OWN CHILDREN. Too threatening I suspect. But the times are a changin!!!! The circ rates in US are almost 50/50 now (& less than 35% in the Western States), down dramatically from nearly 20 years ago, when they were at 90% nationally.

The word is getting out! Genital cutting of helpless, non-consenting infants is a a human rights crime if there ever was one.

 
At Friday, July 07, 2006 12:33:00 PM, Anonymous Anonymous said...

BTW, cicumcision doesn't have "everything to do with being Jewish." Just ask an orthodox muslim, if you don't believe me.

Yes you are right Muslim OB's and PEDS who endorse genital cutting also have an agenda all their own.

KEEP your RELIGIONS off our bodies!!!

 
At Friday, July 07, 2006 12:41:00 PM, Anonymous Anonymous said...

BTW, cicumcision doesn't have "everything to do with being Jewish." Just ask an orthodox muslim, if you don't believe me.

Yes you are right Sir-- Muslim OB's and PED's have their agenda's too! Damn! Can you all just keep your religions off of people's bodies? Non-muslim and Non-Jewish Americans are going to be pretty pissed-off when they learn about this! Watch out for the anti-semetic * anti-Islam backlash!

 
At Friday, July 07, 2006 3:29:00 PM, Blogger Maurice Bernstein, M.D. said...

Let's keep this a civil discussion with the relaying from one visitor to another factual details, legal aspects and ethical considerations. I had to delete the previous comment since it was a "rah, rah" and contributed nothing of value for a bioethics discussion blog.

FACTS: Does anyone have specific references or links to sources that show, as statistically significant, that male circumcision is or is not beneficial to prevent sexually transmitted organisms or make penile cancer less likely or improve orgasim? ETHICS: What about the ethics of a mother facilitating her daughter, with no capacity to make a decision on her own, to have her ear lobes pierced for earrings, if not for other piercings? LAW: Can male circumcision be really considered as intentional child abuse? What are the criteria for establishing child abuse and does male circumcision fit with the criteria? These ae some of the questions that I think would be interesting to follow up on, rather than a "rah, rah" to a previous comment. ..Maurice.

 
At Friday, July 07, 2006 3:49:00 PM, Anonymous Anonymous said...

Can you start a new thread Dr. b on censorship? Thanks.

 
At Friday, July 07, 2006 4:12:00 PM, Anonymous Anonymous said...

Detailed Guide: Penile Cancer
Can Penile Cancer Be Prevented?

The large variations in penile cancer rates throughout the world strongly suggest that penile cancer is a preventable disease. The best way to reduce the risk of penile cancer is to avoid known risk factors whenever possible. In the past, circumcision has been suggested as a way to prevent penile cancer. This suggestion was based on studies that reported much lower penile cancer rates among circumcised men than among uncircumcised men. However, most researchers now believe those studies were flawed because they failed to consider other factors that are now known to affect penile cancer risk. For example, some recent studies suggest that circumcised men tend to have certain other lifestyle factors associated with lower penile cancer risk: they are less likely to have many sexual partners, less likely to smoke, and more likely to have better personal hygiene habits. Most public health researchers believe that the penile cancer risk among uncircumcised men without known risk factors living in the United States is extremely low. The current consensus of most experts is that circumcision should not be recommended as a prevention strategy for penile cancer. Perhaps the most important factor in preventing penile cancer in uncircumcised men is good genital hygiene. Most public health experts recommend that uncircumcised men practice good genital hygiene by retracting the foreskin and cleaning the entire penis. If the foreskin is constricted and difficult to retract, a doctor may be able to cut the skin to make retraction easier. Avoiding sexual practices likely to result in HPV infection might lower penile cancer risk. In addition, these practices are likely to have an even more significant impact on cervical cancer risk. Until recently, it was thought that the use of condoms ("rubbers") could prevent HPV infection. But recent research shows that condoms poorly protect against infection with HPV. This is because HPV can be passed from person to person by skin-to-skin contact with any HPV-infected area of the body, such as skin of the genital or anal area not covered by the condom. It is still important, though, to use condoms to protect against AIDS and other sexually transmitted diseases that are passed on through some body fluids. The absence of visible warts cannot be used to decide whether caution is needed because HPV can be passed on to another person even when warts or other symptoms are not visible. HPV can be present for years with no symptoms, so it can be difficult or impossible to know whether a person with whom you might have sex might be infected with HPV. The longer a person remains infected with any type of HPV that can cause cancer, the greater the risk that infection will lead to cancer. For these reasons, postponing the beginning of sexual activity and limiting the number of sexual partners are two ways to reduce the chances of developing penile cancer. Smoking, another factor associated with increased penile cancer risk, is even more strongly associated with several other very common and often fatal cancers, as well as non-cancerous conditions such as heart disease and stroke. Quitting smoking or never starting in the first place is an excellent recommendation for preventing many diseases, including penile cancer. Some men with penile cancer have no known risk factors, so it is not possible to completely prevent this disease.

 
At Friday, July 07, 2006 4:41:00 PM, Anonymous Anonymous said...

Penile cancer risk among uncircumcised men is so rare that you are more likely to be killed by a bolt of lightning than be diagnosed with it.

When doctors (esp. Jewish OB’s and Ped’s) suggest that you sould amputate part your child’s penis on the rare chance that he will get penile cancer…ask this:

For the sake of consistency in medical advice, do you advocate that every American woman cut off her breasts to protect against one of the LEADING causes of death, breast cancer?

Does circ prevent STD's? Are you kidding me? Are they now going to go on record and try to suggest that Circ prevents Aids and other STD’s too? This is surreal. To suggest that in any shape or form, that condoms are less effective at preventing STD's & AIDS is gross medical misconduct that will result in many more deaths and continued growth of anti-doctor sentiments.

Re: Orgasism. Let's use some good old common sense here. If you are a man and you have half of the sexual equipment of the man who is Intact...who do you think is 'operating' closer to maximun capacity? Here’s something to chew on: The amputated penis has far less nerve-endings than the Intact penis. i have heard from adults who have circ’d at an age of consent, that post-circ sex is like sight without the benefits of color.

FACTS: Does anyone have specific references or links to sources that show, as statistically significant, that male circumcision is or is not beneficial to prevent sexually transmitted organisms or make penile cancer less likely or improve orgasim

 
At Friday, July 07, 2006 5:15:00 PM, Anonymous Anonymous said...

Is neonatal circumcision child-abue? Hmmmm. Well. Let’s sit down and think about this really REALLY hard America. Have you ever heard about the “cycle-of-abuse” theory? That means that acts of violence against people (and I would say that the sexual assault of an infant is an act of violence) tends to be passed down from generation to generation. Circ is no different. Circ is multi-generational child abuse “in mass” sanctioned by the state.

Criteria for establishing child abuse:

Child abuse is physical and sexual maltreatment of a minor. Is non-therapeutic surgery on healthy body tissue without someone’s consent and with no use of pain control, a form of child maltreatment? Most certainlly YES. Physical abuse is characterized by physical injury. The penis is physically injured by the doctor who claims that it is medically justifiable. And for doctors that don’t claim it is justifiable and do it anyway, per parental request...They are GROSSLY abusing their power! Circ is NOT medically justifiable as something theraputic. Sexual abuse includes molestation, incest, rape, prostitution, or use of a child for pornographic purposes. Circumcision of a neonate is equivalent to a sexual rape, and thus a form of sexual abuse.

In practice, there are borderline areas where what constitutes child abuse is not clear. For example, the U.S. Supreme Court has ruled (1944) that parents do not have an absolute right to deny life-saving medical treatment to their children, but devout members of the Church of Christ, Scientist, and other churches believe in the healing power of prayer and do not always seek medical help. Most U.S. states, however, permit parents to use religious beliefs as a defense against prosecution (Again, this is state-sanctioned child abuse…just like Bris Milah) for the withholding of medical treatment from their sick children, even in cases where the lack of treatment results in a child's death.

 
At Friday, July 07, 2006 5:43:00 PM, Anonymous Anonymous said...

“Can male circumcision be really considered as intentional child abuse?”
Wikipedia provides some information on the law and child abuse: http://en.wikipedia.org/wiki/Child_abuse
My thought would be that pain relief and circumcision have to be looked at as two issues. Neglecting to protect a child from ‘serious’ physical or emotional harm is the definition of child abuse in law that would pertain to this question. Is not providing pain relief going to cause serious physical or emotional harm to an infant? Does the physical change cause serious physical or emotional harm? On the surface, and in a very general view, circumcision does not seem to meet this definition of child abuse. However, simply looking at the issue of pain relief…what possible reason could anyone have for not providing pain relief? It might not be against the law to inflict short term pain but that doesn’t mean it’s the right thing to do.

 
At Friday, July 07, 2006 6:44:00 PM, Blogger Maurice Bernstein, M.D. said...

To the Anonymous of today July 7th who wrote "Can you start a new thread Dr. b on censorship? Thanks." I would say absolutely! The new thread, however, would have to deal with a specific censorship: censolship on a bioethics discussion blog where the intent of the blog as set by the moderator-blogger is to provide a resource for productive, educational, rational and civil communication on ethical issues about medicine and other areas of bioethics. This means that in order to attempt to satisfy the intent which I think is reasonably attainable, some general criteria regarding communication needs to be agreed upon,understood and followed. Otherwise, without these criteria, the communication can turn into chaos rather than education. So to this Anonymous or others, write me e-mail (doktormo@aol.com) about the criteria and the role, if any, of censorship on a bioethics discussion blog. I will then start the new thread with that e-mail.

There are some other suggestions I can make now to make the reading of posts easier to follow. Although the use of
"Anonymous" description of the writer is certainly permissable on blogs, including this one, I really think it is less productive than if the writer uses a specific pseudonym of some sort or,to me more rational, would be for the writer to use his or her real name. I always wonder why folks who have some important view to express to others find a problem to use their own real name. Shouldn't under most conditions, the writer would want to take credit for the important views which are being broadcast here? I would hope no person would be personally penalized for taking a stance, for example, for or against male circumcision.

By the way, as a physician and NOT as a Jew and not one to perform circumcisions, as I noted previously, I think the controversy is very important and my mind is open on the issue though I am not prepared to send the physician or others who perform the procedure away to prison for years. I think infants do suffer pain and I would want to treat infants as we do those much older by using medical techniques to minimize or eliminate pain.

OK, that is your moderator's comments on what has been written so far. I await your e-mail regarding the role or no role of censorship on a blog devoted to public discussion. I will start a new thread. Anonymous (whichever one you are), thanks for the suggestion! ..Maurice.

 
At Friday, July 07, 2006 10:38:00 PM, Anonymous Anonymous said...

Does the physical change cause serious physical or emotional harm? On the surface, and in a very general view, circumcision does not seem to meet this definition of child abuse.
******************
Cow manure! In my line of work I have spoken to hundreds of men (not counting all of those who keep silent) about how emotionally devastated they are to learn what has been stolen from them. You may think that you speak for all men...but I know for a fact that there are many men, and many more to come who are furious to learn the truth about the theft of their body parts by profit driven doctors. They are the motion behind the great 'Intactivist' haven't figured that out yet.

You may also casually dismiss the physical trauma of neonatal genital cutting, but I am here to tell you that every expierence you have as a human being (esp. those in childhood) go down on your 'emotional life canvass'. They ALL make you who you are. You can pretend that the sheer primal fear and terror that you expierenced in infancy when someone took a knife to your penis, isn't really emotionally harmful, but you would be wrong.

Dr. B. Why have you not addressed any of the comments posted on this thread except for the one of censorship? That has to be the least important post on this thread and that is what you chose to devote your response too? I think this is far from the "discussion" that you said we'd have.

PS. It's easier to post as Anonymous. It is quicker, requires no log-in. i will look into it now.

 
At Friday, July 07, 2006 10:40:00 PM, Blogger Maurice Bernstein, M.D. said...

Here is another example of a cultural practice that has been going on for years, like male circumcision, called "breast-ironing" It is written up in an article in Reuters today. An excerpt is pasted below. Go to the link to read the entire article. My question would be whether jailing the mothers for years, such as the current bill offered to Congress regarding male circumcision to jail the doctors, rabbis or those who contributed to the act, is really the wisest and best way to eliminate an age-old accepted practice in a culture or religion. ..Maurice.


YAOUNDE, Cameroon (Reuters) - Worried that her daughters' budding breasts would expose them to the risk of sexual harassment and even rape, their mother Philomene Moungang started 'ironing' the girls' bosoms with a heated stone.

"I did it to my two girls when they were eight years old. I would take the grinding stone, heat it in the fire and press it hard on the breasts," Moungang said.

"They cried and said it was painful. But I explained that it was for their own good."


"Breast ironing" -- the use of hard or heated objects or other substances to try to stunt breast growth in girls -- is a traditional practice in West Africa, experts say.

A new survey has revealed it is shockingly widespread in Cameroon, where one in four teen-agers are subjected to the traumatic process by relatives, often hoping to lessen their sexual attractiveness.

"Breast ironing is an age-old practice in Cameroon, as well as in many other countries in West and Central Africa, including Chad, Togo, Benin, Guinea-Conakry, just to name a few," said Flavien Ndonko, an anthropologist and local representative of German development agency GTZ, which sponsored the survey.

 
At Friday, July 07, 2006 10:40:00 PM, Anonymous Anonymous said...

revision:

They are the motion behind the great 'Intactivist' movement if you haven't figured that out yet.

(wish we could edit in here)

 
At Friday, July 07, 2006 10:52:00 PM, Anonymous Anonymous said...

Ok. You seem like you have a real interest in discussing our MGM bill. That's a good start!
********************
My question would be whether jailing the mothers for years, such as the current bill offered to Congress regarding male circumcision to jail the doctors, rabbis or those who contributed to the act, is really the wisest and best way to eliminate an age-old accepted practice in a culture or religion. ..Maurice.
***********************

You would be correct sir...jailing is not the wisest and best way to eliminate male genital mutilation (MGM). A massive educational effort is underway in this country. As evidence...look at the plummeting circ rates since 1980. Intactivists are using a multilateral approach. MGM is one aspect.

Jailing African mom's for the abusive act of breast ironing? They sound misguided. Perhaps they just need deprogramming...like we do regarding MGM.

 
At Friday, July 07, 2006 11:20:00 PM, Anonymous Anonymous said...

revision:
mgmbill is one aspect.

As for changing ancient customs. I am sure that the Jews will be most resistent to keeping their jewish son's intact. But there is a significant number of us now that are open to the theories being put forward. Being Jewish is in your mind and your heart...not your penis.

Humans have many ancient & bizarre 'traditions' that they cling too. I have researced some of them in the past that have also lasted for centuries and faded away. i will find some of them and post.

"Right and wrong, good and evil, are not determined by power, or by
adherence to this or that interest group. The struggle to know how to act
for the best is a struggle that never ceases. Don't follow leaders:
look out, instead, for the oddballs who insist on marching out of step"

-Salman Rushdie

 
At Saturday, July 08, 2006 6:20:00 AM, Anonymous Anonymous said...

Dr. Bernstein, your blog is a wonderful forum for the civilized and thoughtful discussion of many difficult subjects. Frankly, I'm shocked at the tone of this particular thread, and I can see that the aggressiveness and arrogance has come from far fewer people than the number of comments would indicate.

I've never understood how a person can say: "This is what I think is right, and you're going to do it!" ... and not understand that they themselves are doing exactly what they feel has been done to them. Forcing your will, your opinions, on other people is wrong - no matter what side of the fence you're sitting on.

One of your commenters said: "KEEP your RELIGIONS off our bodies!!!" ... doesn't he see that what he's doing is exactly the same thing: trying to force his opinion on other people? Perhaps he should consider keeping his opinions "off" other people's faiths?

It would be far more helpful to try to press for legislating the use of "locals." It would then seem a bit more like concern for the well being and comfort of little children, rather than raw anti-semitism.

I am not Semitic, and have no Semitic roots that I'm aware of. I chose to have my 3 sons circumcised when they were newborns for sanitary reasons, and to prevent their having to have it done later in life, like many who are uncircumcised end up doing. I've been told by those who know that it's very painful when performed on an older person. Also, it's usually done after there's already been a lot of pain from various infections and strictures, each of those potentially incurring even more medical problems. I see no good reason to chance putting a person through that.

None of my sons, who are now all adults,
have complained about my choice for them, although they've demonstrated that they feel free to be honest with me about such subjects.

I'm grateful that when my children were born, I lived in a free America ... and was allowed to make my own informed decision about which course of action would be the best for my own children. It saddens and frightens me to see these rights being eroded by people who can't possibly have any idea of how they themselves are "just another brick in the wall."

Please forgive me for the harsh tone of my comment, but this strikes at the very heart of a person's freedom of choice, freedom of religion, and bullies its way into the sacrosanct relationship between a parent and child.

 
At Saturday, July 08, 2006 7:45:00 AM, Anonymous Anonymous said...

"this strikes at the very heart of a person's freedom of choice"

Holy cow, it sure does! You are complaining that it strikes at YOUR parental freedom of choice, and you aren't even the owner of that penis! Who has to live with the consequences of your imposed cutting decision??? You??? how about the person who owns the darn penis? what about HIS freedom of choice??? Cutting a kid's genitals is a RADICAL now! People 'get it' and that is precisely why it is less popular now than it was 20-30 or years ago. 80% of the planet is intact. All of non-muslim Asia, South America, most of Canada, Europe, and 50% of the US! If all these Intact men were 'suffering' so badly, why haven't all these countries embraced the genital cutting that is so 'trendy' in the US? Hmmmmm. Could it be that you are arrogant enough to believe that only your country know's best?

Your post is full of half-truths and outright misinformation. I will adress each point in my next post to you.

 
At Saturday, July 08, 2006 8:36:00 AM, Anonymous Anonymous said...

Forcing your will, your opinions, on other people is wrong - no matter what side of the fence you're sitting on.
******************************
Aren’t you forcing ‘your will’ on your son when you consent to have him strapped down and have part of his penis amputated without a local? According to you, this should be wrong too??
************************************


One of your commenters said: "KEEP your RELIGIONS off our bodies!!!" ... doesn't he see that what he's doing is exactly the same thing: trying to force his opinion on other people? Perhaps he should consider keeping his opinions "off" other people's faiths?

Keep my opinions of of other people’s faiths? Excuse me. What???
I take it you are referring to the mgmbill. As for me, I am entittled to speak here just like you are. My opinion about the Jewish Faith is this: if you want to modify your kids genitals so that it connects you to God, so-be-it. But when a Jewish MD’s faith starts to spill over (in the context of jewish OB’s and PEDS ‘recommending’ bris for every non Jew) I get a little ticked off. You can play your ‘anti-semetisism card’ if you want but this is rightfully an outrageous abuse of power by a Jewish MD’s who ‘recommend’ circumcise to all gentiles. Almost a ‘mark’ of ownership if you think about it…like the ancient slaves who were circumcised by their masters. If you don’t see the blatant bias & psycho-political subversion there….I can’t help you anymore lady.

It would be far more helpful to try to press for legislating the use of "locals." It would then seem a bit more like concern for the well being and comfort of little children, rather than raw anti-semitism.


I agree with legislation for doctors…but how on earth could you enforce that? Again, you play the anti-semitism card here, but it wins you no extra points. Remember, my mom’s side is jewish. I would say that Intactivists are DEEPLY concerened for the welfare US children. Who else do you see exposing the private torture of US neonates? Is it your pro-circ camp??? No.
**************************************

I am not Semitic, and have no Semitic roots that I'm aware of. I chose to have my 3 sons circumcised when they were newborns for sanitary reasons,

How old are your kids? You are obviously out of the loop here. Today’s parents say NO to circumcision. Do some research and you’ll see. Nearly half of the US is INTACT now. Down dramatically from 30 years ago! The western US is at less than 35% now. The number is falling by the day too. Check it out for yourself if you don’t believe me.

MODERN WOMEN WITH DOUBLE-STANDARDS
Did you know that Routine Infant Circumcision (RIC) got its start in
the USA as a way to curb males from touching themselves? 'Masturbation'
was thought to be an illness in the 1800's. Two prominent Jewish
Pediatricians theorized that Jewish children 'touch themselves' much less,
due-to-the-fact that they have no foreskins to manipulate.
This made sense to most American Doctors and they all began recommending ritual "Bris" for all American males as a method for 'curing' male masturbation (aka, childhood genital touching). The purtanical US public was generally feeling "masturbation-hysteria", and they were especially uneasy when their kids fondled their genitals. The word caught on quickly, and to this very day 57% of our culture still routinely requests this 'partial penis amputation' surgery for
their sons. Almost none of them know that it was specifically recommended by Victorian doctors as an effective method to cure/curb their son's future masturbation (touching) habits.
It has no medical validity what so ever and it is not recommended by one national or international medical organization in the world. Two notable PEDS that opposed it were Dr. Spock and Dr Jonas Sauk. Not even the grand old AAP recommends it anymore for “hygenic” reasons. That is because they too are aware that RIC was a method recommended for good ‘moral hygiene’. There was NEVER any other evidence that it promoted ‘personal’ hygienne. Only soap and water will do that.
Every human being has an inherent right to a whole & uncensored body. Every human being has an inherent right to genital integrity. Every human being has the RIGHT to decline this surgery for themselves.... but that is certainly NOT possible when it is forced upon them as a neonate! Every human being is entitled to CHOICE (listen up "Pro-Choice" America!) in THIS matter too! How can modern American women expect CHOICE over their own bodies when they still deny men a CHOICE over 'their bodies'? It appears that their are 2 different standards here. One for women and one for men. Last I checked…that was called sexism. Reverse sexism!





and to prevent their having to have it done later in life, like many who are uncircumcised end up doing.
************************************************
a generalization designed to make you feel better about your choice.
***************************************************
I've been told by those who know that it's very painful when performed on an older person.

Hmmmm. The age old “It’s more painful as an adult” lie. Well let’s get back to common sense here ok? The ADULT gets the local…the neonate doesn’t. Which person do you think is in more pain now? Or are you referring to the old “babies don’t feel pain” lie that so many MD’s fed to US parents for decades? That was disproven a long time ago by our very own government!
http://www.nichd.nih.gov/cochrane/BradyFryer/BRADYFRYER.HTM


Also, it's usually done after there's already been a lot of pain from various infections and strictures, each of those potentially incurring even more medical problems. I see no good reason to chance putting a person through that.
***************************************************
Are you an MD? You sure know a lot about these alleged infections and such…what are the stats? If you teach your son good personal hygienge habbits there should be no infections. This is an outright lie by old-school MD’s who used it to promote genital cutting. That advice is outdated. The PEDS don’t give that advice out anymore, that is, unless they are Jewish. My son is 5 and he has never had 1 infection in his life on his penis. I have many friends with Intact kids….and the same is true for theie son’s.

None of my sons, who are now all adults,
have complained about my choice for them, although they've demonstrated that they feel free to be honest with me about such subjects.

Congrats. I hope that makes you feel better about yourself. I don’t blam you persay, you were dupped by MD’s and you don’t even know it yet.
*********************************************************

I'm grateful that when my children were born, I lived in a free America .
Funny….you want your freedoms…but you aren’t willing to give it to your male children. That’s sad.

 
At Saturday, July 08, 2006 8:55:00 AM, Anonymous Anonymous said...

"Hisbodyhisrightz" ... I've been doing a bit of research on your organization, and I think I begin to see what your real agenda is.

You can make any addresses you'd like. The fact of the matter is that I believe in freedom of choice, and freedom of religion ... and none of your "in your face" reactions are going to change that. In fact, the research you've caused me to undertake is reinforcing my beliefs. I imagine that I'm not the only one who's going to have that experience.

You accuse me of half truths and misinformation, and then you put words into my mouth. Perhaps you should re-read what I've actually written ... and perhaps you should also review your own statistics.

Comparing female circumcision to male circumcision is transparently disingenuous. They're not at all the same - medically, in purpose, or in outcome.

Here's a quote I found during some of my research this morning:

"Again, I don't know these people, but this Hess guy seems to be a bit of an extremist on this thing. I haven't heard that circumcision damages male sexual function, have you? I do know that studies on adults getting the procedure have busted that myth."

http://www.rightwinged.com/2006/02/support_grows_for_ban_on_male.html

If this were such an issue, why have you lost on 3 submissions ... and why are you having such a hard time finding supporters? I would think that there would be a huge number of angry circumcised men of all orientations (and religions) advocating your bill if what you say is true.

"Hisbodyhisrightz" ... you would do well to fight your battles on a different front. Ranting and raging with embarrassing lack of self control on a Bioethics Blog isn't going to further your cause.

Your apparent attitude says quite a bit about you, and it could well cause you to lose your case.

Dr. Bernstein, please forgive me. I probably should not have come back to answer this fellow. I don't mean to keep this less than civil thread going on your blog. I've had my say, and have nothing more to add.

Thank you for your kindness in allowing us to be guests on your blog.

 
At Saturday, July 08, 2006 8:55:00 AM, Blogger Maurice Bernstein, M.D. said...

I think this discussion is great BUT please allow me as moderator to make a suggestion to hisbodyhisrightz and any other contributers. If you are going to comment on specific statements of other visitors, please identify the other party and put what they say in quotes, if the actual words are repeated. I was trying to follow hisbodyhisrightz's argument but I got confused where one comment began and ended. Didn't others have the same problem? If a commentator wants to make a point, clarity in the argument is essential but also essential is the format in which it is written. Thanks. ..Maurice.

 
At Saturday, July 08, 2006 9:24:00 AM, Anonymous Anonymous said...

I really wish i could edit it so if you delete the post, I will resubmit it in a form that is easier to understand.

 
At Saturday, July 08, 2006 9:31:00 AM, Anonymous Anonymous said...

Moot--

the "RIGHT-wing" link just made me nauseous. This progressive leftie has to take a break now. Be back later.

 
At Saturday, July 08, 2006 10:21:00 AM, Anonymous Anonymous said...

Here's something to chew on while I am away today.

Some other wacky ancient traditions that human have embraced:

Asian Foot-binding
http://www.kidzworld.com/site/p2142.htm

Slavery

Child labor and child marriage

Female genital cutting

 
At Saturday, July 08, 2006 10:24:00 AM, Anonymous Anonymous said...

oh and i couldn't resist sharing this too:

FGM vs. MGM

http://www.circumstitions.com/FGMvsMGM.html

 
At Saturday, July 08, 2006 11:34:00 AM, Blogger Maurice Bernstein, M.D. said...

OK gang, here is what we ought to be presenting in discussion instead of inflammatory guesses or "I read that..." or "this link reports..". If one argument to continue or discontinue the practice of male circumcision is based on medical benefit or lack of benefit, then we should be presenting data which is evidence-based.

An example of such a presentation is that of "The Cochrane Database of Systematic Reviews" where the literature is searched, reviewed and a careful analysis is made of the statistical studies which has been performed to date and a conclusion regarding the validity of the studies and their significance is given. One such Cochrane review regarding the relationship between male circucision and HIV infection was produced in 2003. I will paste the abstract of the review below. It shows that as of 2003, until random controlled studies, underway, were completed, absolute proof that male circumcision prevented HIV infection was not as yet available.

I am not saying that visitors here should not express their own philosophical views on the subject. I only want to emphasize the importance too of factual details as obtained in as non-biased manner as possible. ..Maurice.

AU: Siegfried N, Muller M, Volmink J, Deeks J, Egger M, Low N, Weiss H, Walker S, Williamson P
TI: Male circumcision for prevention of heterosexual acquisition of HIV in men
SO: Siegfried N, Muller M, Volmink J, Deeks J, Egger M, Low N, Weiss H, Walker S, Williamson P. Male circumcision for prevention of heterosexual acquisition of HIV in men. The Cochrane Database of Systematic Reviews: Reviews 2003 Issue 3 John Wiley & Sons, Ltd Chichester, UK DOI: 10.1002/14651858.CD003362
YR: 2003
NO: 3
PB: John Wiley & Sons, Ltd
US: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003362/frame.html
KY: Humans [checkword]; Male [checkword]; Circumcision; Heterosexuality; HIV-1; HIV-2; HIV Infections [prevention & control]
CC: HM-HIV
DOI: 10.1002/14651858.CD003362
AB: BACKGROUND: The findings from observational studies, reviews and meta-analyses, supported by biological theories, that circumcised men appear less likely to acquire human immunodeficiency virus (HIV) has contributed to the recent ground swell of support for considering male circumcision as a strategy for preventing sexually acquired infection. We sought to elucidate and appraise the global evidence from published and unpublished studies that circumcision can be used as an intervention to prevent HIV infection.

OBJECTIVES: 1) To assess the evidence of an interventional effect of male circumcision for preventing acquisition of HIV-1 and HIV-2 by men through heterosexual intercourse 2) To examine the feasibility and value of performing individual person data (IPD) meta-analysis

SEARCH STRATEGY: We searched online for published and unpublished studies in The Cochrane Library (issue 2, 2002), MEDLINE (April 2002), EMBASE (February 2002) and AIDSLINE (August 2001). We also searched databases listing conference abstracts, scanned reference lists of articles and contacted authors of included studies.

SELECTION CRITERIA: We searched for randomized and quasi-randomized controlled trials of male circumcision or, in their absence, observational studies that compare acquisition rates of HIV-1 and HIV-2 infection in circumcised and uncircumcised heterosexual men.

DATA COLLECTION AND ANALYSIS: Independent reviewers selected studies, assessed study quality and extracted data. We stratified studies based on study design and on whether they included participants from the general population or high-risk groups (such as patients treated for sexually transmitted infections). We expressed findings as crude and adjusted odds ratios (OR) together with their 95% confidence intervals (CI) and conducted a sensitivity analysis to explore the effect of adjustment on study results. We investigated whether the method of circumcision ascertainment influenced study outcomes.

MAIN RESULTS: We identified no completed randomized controlled trials. Three randomized controlled trials are currently underway or commencing shortly. We found 35 observational studies: 16 conducted in the general population and 19 in high-risk populations. It seems unlikely that potential confounding factors were completely accounted for in any of the included studies. In particular, important risk factors, such as religion and sexual practices, were not adequately accounted for in many of the included studies.General population study results:The single cohort study (N = 5516) showed a significant difference in HIV transmission rates between circumcised and uncircumcised men [OR = 0.58; 95% CI: 0.36 to 0.96]. Results for the 14 cross-sectional studies were inconsistent, with point estimates for unadjusted odds ratios varying between 0.28 and 1.73. Six studies had statistically significant results, four in the direction of benefit and two in the direction of harm. The test for heterogeneity between the cross-sectional studies was highly significant (chi-square = 77.59; df = 13; P-value < 0.00001). Nine studies reported adjusted odds ratios with eight in the direction of benefit, ranging from 0.26 to 0.80. Use of adjusted results tended to show stronger evidence of an association although they remained heterogenous (chi-square = 75.2; df = 13; P-value < 0.00001). Only one case-control study was found (N = 51) which had a non-significant result [OR = 1.90; 95% CI: 0.50 to 7.20].High-risk group study results:The four cohort studies identified found a protective effect from circumcision with point estimates for unadjusted odds ratios varying from 0.10 to 0.39. Two of these studies had statistically significant results. Two studies reported adjusted odds ratios, both protective with one being significant. The chi-square test for between-study heterogeneity was not significant (chi-square = 5.21; df = 3; P-value = 0.16). All eleven cross-sectional studies reporting unadjusted results found benefit from circumcision, eight of which had statistically significant results. Estimates of effect varied from an unadjusted odds ratio of 0.10 to 0.66. Between-study heterogeneity was significant with the chi-square = 29.77; df = 10; P-value = 0.0009. Four of these studies reported adjusted odds ratios ranging from 0.20 to 0.59 and all were significant. One additional cross-sectional study only reported an adjusted odds ratio in the direction of benefit which was statistically significant. All three case-control studies found a protective effect of circumcision on HIV status, two being statistically significant. Point estimates varied from unadjusted odds ratios of 0.37 to 0.88. One reported an adjusted odds ratio showing a significant protective effect.Adverse effects:No studies reported on the adverse effects of circumcision. In most studies, circumcision had taken place during childhood or adolescence before the studies commenced.

AUTHORS' CONCLUSIONS: We found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men. The results from existing observational studies show a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups. However, observational studies are inherently limited by confounding which is unlikely to be fully adjusted for. In the light of forthcoming results from RCTs, the value of IPD analysis of the included studies is doubtful. The results of these trials will need to be carefully considered before circumcision is implemented as a public health intervention for prevention of sexually transmitted HIV.


PLAIN LANGUAGE SUMMARY: Male circumcision for prevention of heterosexual acquisition of HIV in menCircumcision in heterosexual men is associated with lower rates of HIV infection. This association is strongest in groups at high-risk of HIV infection. However there are no trials to show whether male circumcision as an intervention reduces HIV infection.Male circumcision is the surgical removal of the foreskin of the penis. It is a common religious or traditional ritual, and is sometimes done for medical reasons. It is not known if the foreskin affects sexual transmission of infection. Circumcision may be an indicator of men affected by other religious or traditional practices which lower the risk of HIV. The review found that men who have already been circumcised have lower rates of HIV infection than uncircumcised men. However, there is no strong evidence of the effects of male circumcision to try to reduce the spread of HIV/AIDS. Trials are underway.

 
At Saturday, July 08, 2006 2:38:00 PM, Anonymous Anonymous said...

Dr. Bernstein, I have to admit that I'm a bit skeptical about the prevention of HIV through circumcision, however there does seem to be a correlation between the two. Whether it's due to medical reasons is still anyone's guess, until further studies are done.

However, I did come across some very interesting information regarding circumcision and infection. If you don't mind, I'll like to post my findings here. I will, of course, include links.

Before I do, I want to make a note that what I found was that the medical web sites I came across were overwhelmingly in favor of circumcision, and those sites which were not in favor of circumcision were other than medical sites; many of those not in favor were trying to make exclusive associations between circumcision and religion. The repeated positive correlations between decreased infections and circumcision indicate that there's more to circumcision than its link to particular religions.

The following cut/pastes will show that there appears to be enough of a correlation between an outcome of decreased infection and circumcision, to warrant encouraging parents to continue to choose circumcision for their male neonates.

----------------------------------------

Effect of circumcision on incidence of urinary tract infection in preschool boys

Craig JC; Knight JF; Sureshkumar P; Mantz E; Roy LP
Department of Nephrology, Royal Alexandra Hospital for Children, Sydney, Australia.

OBJECTIVE: To determine whether circumcision decreases the risk of symptomatic urinary tract infection (UTI) in boys less than 5 years of age. STUDY DESIGN: A case-control study (1993 to 1995) in the setting of a large ambulatory pediatric service. Case subjects and control subjects were drawn from the same population. One hundred forty-four boys less than 5 years of age (median age, 5.8 months) who had a microbiologically proven symptomatic UTI (case subjects), were compared with 742 boys (median age, 21.0 months) who did not have a UTI (control subjects). The proportion of case and control subjects who were circumcised in each group was compared with the use of the chi-square test, with the strength of association between circumcision and UTI expressed in terms of an odds ratio. To determine whether age was a confounder or an effect-modifier, we stratified the groups by age (< 1 year; > or = 1 year) and analyzed by the method of Mantel-Haenszel. RESULTS: Of the 144 preschool boys with UTI, 2 (1.4%) were circumcised, compared with 47 (6.3%) of the 742 control subjects (chi-square value = 5.6; p = 0.02; odds ratio, 0.21; 95% confidence intervals, 0.06 to 0.76). There was no evidence that age was a confounder or modified the protective effect of circumcision on the development of UTI (Mantel-Haenszel chi-square value = 6.0; p = 0.01; combined odds ratio, 0.18; 95% confidence intervals, 0.05 to 0.71; Breslow-Day test of homogeneity chi-square value = 0.6; p = 0.4). CONCLUSIONS: Circumcision decreases the risk of symptomatic UTI in preschool boys. The protective effect is independent of age.

(Emphasis mine)

----------------------------------------

EMedicine: Urinary Tract Infections

Causes: The proliferation of bacteria within the urinary tract causes UTI.

[...]

Neonatal circumcision decreases the risk of UTI by about 90% in male infants during the first year of life. The risk of UTI in a circumcised infant during the first year is about 1 in 1000, while an uncircumcised infant has a 1 in 100 chance of developing a UTI.

[...]

Deterrence/Prevention

[...] Consider circumcision of male neonates.


(Emphasis mine)

----------------------------------------

From: Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions

From page 63...
... In contrast, prevention of iatrogenic infections requires attention to issues of service quality, with an emphasis on TABLE 3-4 Strategies for Primary Prevention of Reproductive Tract Infections Type of Infection Prevention Strategy Sexually Transmitted Delaying sexual initiation (coital debut) ; Reducing number of sexual partners or rate of partner change; Changing the dynamics of partner selection; Reducing nonconsensual sexual exposure; Encouraging safer sexual practices; Promoting condom use; Providing voluntary counseling and testing; Promoting use of other barrier methods; Encouraging male circumcision

(Emphasis mine)

----------------------------------------

Regarding HIV:

Essential Drugs.org

Male circumcision has also been studied widely as a possible preventive measure. Observational studies have suggested that circumcision reduces the risk of acquiring and transmitting HIV infection, although previous meta-analyses did not confirm this.4 A recent prospective randomised trial of early circumcision compared with delayed circumcision among more than 3000 uncircumcised young men was stopped prematurely because of the considerable benefit of early circumcision. Circumcision was offered to men in the intervention group immediately after randomisation and would be offered to those in the control group at the end of follow up. The trial was stopped at the interim analysis after a mean of 18.1 months. Twenty HIV infections occurred in the intervention group and 49 in the control group, corresponding to a rate ratio of 0.40 (95% confidence interval 0.24 to 0.68; P < 0.001). When controlling for behavioural factors, including sexual behaviour, condom use, and health seeking behaviour, this ratio corresponded to a protective effect of 61% (34% to 77%).5 These data are encouraging but should not elicit a false sense of security and neglect of further preventive measures.

(Emphasis mine)

----------------------------------------

Cervical Cancer News

Circumcision Reduces Penile Human Papillomavirus Infection and Cervical Cancer in Female Partners

Women who are infected with the human papillomavirus (HPV) have a marked increase in the incidence of cervical cancer. It is uncertain whether male circumcision reduces the risks of penile HPV infection in the man and of cervical cancer in his female partner.

These investigators pooled data on 1,913 couples enrolled in one of seven case?control studies of cervical carcinoma in situ and cervical cancer in five countries in Europe, South America and Asia. Circumcision status was self-reported and the accuracy of the data was confirmed by physical examination at three study sites.

The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1,520 men and yielded a valid result in the case of 1,139 men (74.9 percent). Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent).

After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were significantly less likely than uncircumcised men to have HPV infection. Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised. Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination. They concluded that male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.

Comments: These data suggest that male circumcision may reduce the risk of penile HPV infection in men and the risk of cervical cancer in female partners of sexually promiscuous men.Since 80% of American men are circumcised, it is unlikely that increasing the frequency of circumcision would have an impact on cervical cancer in this country. The mainstay of cervical cancer prevention is still cytologic screening with the Papanicolaou test, as well as HPV testing that may soon become widely available. (Castellsagué X, Bosch FX, Muñoz N, et al, Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners. The New England Journal of Medicine. 2002;346:1105-1112.)

----------------------------------------

 
At Saturday, July 08, 2006 3:08:00 PM, Blogger Maurice Bernstein, M.D. said...

Moof, I am most impressed by your "Saturday Research" and thank you for the references. I am sure that if there were overwhelming evidence that male circumcision would be medically beneficial for a host of medical conditions, then it would be much more difficult to argue against the procedure, from a medical point of view. One could still argue about whether the surrogacy decision of the mother and father in favor of circumcision trumps any philosophical or cosmetic argument against it. One thing for sure, based on recent news, the relationship of Human Papilloma Virus and male circumcision may become moot in view of furture immunization of children and the effectiveness of the vaccine. Again, thanks Moof for your research. ..Maurice.

 
At Saturday, July 08, 2006 10:13:00 PM, Anonymous Anonymous said...

"I want to make a note that what I found was that the medical web sites I came across were overwhelmingly in favor of circumcision"

OF COURSE you did! they were from MD's. Everybody knows that MD's love circ. Esp. Jewish MD's, like our Moderator. No brainer.
If baby skins helped to finance your comfortable lifestyle...everyone whould be procirc! Thanks for pointing out the obvious to us.

 
At Sunday, July 09, 2006 7:09:00 AM, Blogger Maurice Bernstein, M.D. said...

Hisbodyhisrightz, I must caution you not to turn this discussion of male circumcision into an irrational and anti-Semitic rant. Examine your expression "everybody knows that MD's love circ. Esp. Jewish MDs, like our Moderator" Where is the documentation of statistically valid surveys for you to present to support your conclusion that "everybody knows" or that Jewish MDs support the act of circumcision? If you read what I personally wrote in a previous comment, you would find that your Moderator (me) has an open mind and has not made a decision about the value or worth or ethics of male circumcision. Therefore I am not one of the Jewish physicians who you want to dump into your unhsupported generalization.

A visitor to this thread wrote me this morning the following about the tone and difficulty establishing clarity of some of the postings here : "[the questions such as] medical, or more philosophical, about the lack of consent, or about the selfish interests of those promoting male cicumcision... all of these are legitimate questions that could have a bearing on how we should view this practice. But it doesn't help us to find any clarity when all these questions get blurred into a vague but emphatic rant
against male cicumcision. Being emphatic is OK with me, but vagueness about what is being claimed, and what _reasons_ one has for making
various claims is not OK." Well put!

I hope this blog and this thread is not only a resource for the subjects covered but also should be an educational tool for some visitors to learn about the rational and clear way of expressing one's view to another. ..Maurice.

p.s.- hisbodyhisrightz, my comments above are not ad hominem remarks at you as a person but only about what was written.

 
At Sunday, July 09, 2006 6:33:00 PM, Anonymous Anonymous said...

Dr. B

I believe that I am being rational and very clear here.

FORCED genital cutting of minor children is ethically & morally wrong. Period.

Futhermore, I firmly believe that you are pro-genital cutting on neonates. First, you do a lot of kowtowing to Moot (your pro-genital cutting guest) . All of your posts thus far have a very pro-circ flavor. The data you choose to present to us is all slanted towards PRO genital cutting. You have not once presented info that is anti-genital cutting or commented on any of the information which has been posted that supports not mutilating children. This is very curious to me.

“If one argument to continue or discontinue the practice of male circumcision is based on medical benefit or lack of benefit, then we should be presenting data which is evidence-based.” MB

Let me clarify this….you want ‘evidence’ that neonatal genital gutting is ethically and morally wrong?

"I must caution you not to turn this discussion of male circumcision into an irrational and anti-Semitic rant."

I am NOT anti-semetic! If I was I would have to be anti my mother and her entire side of the family. I love my mother deeply. In addition, I do not believe that JC was the son of God. I have one foot firmly planted with my Jewish ancestors. However this ‘tradition’ of mutilating our children sickens me to no end. Let me be clear here: I am anti Jewish MD's pushing Bris on every non-Jew they can in the context of their work, like I believe that you are trying to do in this blog.

One person's 'rant' is another person's passion. If labeling me 'anti-semetic' helps you to make sense of my “rant”....then your position is quite clear to me. You are forced pro genital cutting of helpless children. That is wrong. Period.

 
At Sunday, July 09, 2006 7:01:00 PM, Anonymous Anonymous said...

This is an exerpt from Doctors Opposing Circumcision.org

I highly commend the doctors who are finally starting to speak publically about the injustice of infant genital cutting. It is still pretty rare for an MD to say NO! to circ, but it appears that things could be changing a little with the formation of this organization.


George C. Denniston M.D., M.P.H.
President



--------------------------------------------------------------------------------
"Having to justify the foreskin is like having to justify breast feeding!"
--------------------------------------------------------------------------------



The End of Circumcision

With the formation of Doctors Opposing Circumcision (D.O.C.), we are proposing to end routine non-therapeutic neonatal circumcision in America. D.O.C., a rapidly growing international organization of medical doctors, intends to bring out the facts about this tragic practice.

Why Doctors will Stop Performing Circumcisions

All non­religious circumcisions in the U.S. are performed by doctors, who will soon be unwilling to perform this painful, contra­indicated procedure. Why?

Already, an ever-growing number of physicians are opposed to routine non-therapeutic neonatal circumcision. These doctors recognize that no one has the right to forcibly remove healthy sexual body parts from another individual. They recognize that doctors should have no role in this painful, unnecessary procedure inflicted on the newborn.

Routine circumcisions have been found to violate not only the Golden Rule, but the first tenet of medical practice, First, Do No Harm. Amazingly, circumcision violates all seven Principles of the A.M.A. Code of Ethics.

Circumcision is not valid surgery, by definition. Surgical procedures have been defined as: repair of wounds, extirpation of diseased organs or tissue, reconstructive surgery, and physiologic surgery (i.e. sympathectomy). Routine circumcision does not fall into any of these categories. Therefore, non-therapeutic infant male circumcision is not a valid surgical procedure. Doctors' licenses do not permit them to cut people unless they are performing surgery, nor may they harm their patients.

America has the highest rate of AIDS in the industrialized world, and is the only major country which circumcises a majority of its males. Is there a connection? We do not know. Before a doctor performs a circumcision, must he not have the answer to this question: might this baby have an increased risk of AIDS - as the result of circumcision?

American men are now documenting the harm that has been done to them by doctors who operated on them without their consent. The bizarre practice of having parents tell a doctor whether and when to operate occurs nowhere else in medicine. According to modern medical ethics, parents do not have the right to consent to a procedure that is not in their son's best interests. The removal of a healthy, normal part of the male sexual organ is not in their son's best interests.

The Courage to Change

Why has this behavior continued in the face of overwhelming evidence that circumcision violates a basic human right - the right to an intact body? In order for a doctor to stop circumcising babies, he or she must take a courageous step — conscientious objection to non-therapeutic circumcision of children.

The doctor must recognise that what has been done in the past was not in the best interest of the infant, and he must say, "I will not circumcise any more babies." Many doctors have already taken that step, and we honor them. Those who lack the courage to change continue to circumcise.

Many victims of circumcision have moved past denial, and have refused to permit this procedure to be done to their sons. Over the past 25 years, some 60 million American parents have had the courage to refuse circumcision for their sons.



--------------------------------------------------------------------------------

"Fear, pain, crippling, disfigurement, and humiliation are the classic ways to break the human spirit.
Circumcision includes them all."

 
At Sunday, July 09, 2006 7:27:00 PM, Anonymous Anonymous said...

"Separated at Birth".
An excellent pro-child, pro-intact body article.
A MUST read!


http://www.luckystiff.org/files/SeparatedAtBirth.pdf

 
At Sunday, July 09, 2006 7:30:00 PM, Anonymous Anonymous said...

"Where is my Foreskin?"
Another MUST read for people that are pro-children's intact bodies. Too much to post here on this bioethics blog, so I offer you the link here:


http://www.luckystiff.org/files/TheCase6Page.pdf

 
At Sunday, July 09, 2006 10:39:00 PM, Anonymous Anonymous said...

Dr. Bernstein, I haven't abandoned this thread, but I've been kept away by personal matters for a few days.

There's one thing I'd like to address ... there's no way to address all of it. The tone of some of the comments seems to border on hysteria, and there's really no good way to have a civil conversation under those circumstances.

HBHR said, in reply to my last post: "OF COURSE you did! they were from MD's. Everybody knows that MD's love circ. Esp. Jewish MD's, like our Moderator. No brainer."

HBHR, frankly, I don't care if both of your parents are Jewish, that's an anti-semitic statement. And not only that - your comment also takes everyone, every single individual, who's ever gone into medicine, and lumps them up into one big ball ... yet another prejudicial generalization, which makes it impossible by definition.

Yes, the medical web sites would of course point out medical reasons ... if the findings were different, the medical blogs would post those too.

I guess that you can try to promote your agenda, and then say that evidence be damned, the experts are wrong, and you're right ... but it still doesn't make it so.

A word of advice, although I probably shouldn't give it to you ... but which you can take or leave: you come across as shrill, and just barely hanging on to your dignity ... if you toned down your intensity, think before you react, cut back on the sarcasm and the unfounded accusations, drop the sad attempts at trying to tell a person that you know what they're thinking better than they do, then people may begin to take you more seriously.

The advice may sting ... but it's not intended as an offense.

 
At Monday, July 10, 2006 6:30:00 AM, Anonymous Anonymous said...

”There's one thing I'd like to address ... there's no way to address all of it. The tone of some of the comments seems to border on hysteria”
Calling someone hysterical (the implication is crazy) is often a very effective way to win an argumnet and lessen another person’s credibility. Criminal defense lawyers try use this stategedy all the time to get their killing clients off. It has been done for ages, but it is usually not that effective in the courts.





”HBHR, frankly, I don't care if both of your parents are Jewish, that's an anti-semitic statement. “
Sorry to disagree with you again. Bris is a REQUIREMENT to be Jewish. You can not be Jewish if you do not Bris your son. Please, by all means, name some significant modern day Jewish men who doesn’t support Bris. It’s almost UNHEARD of. Therefore…..Jewish people must love Bris! If you don’t believe me…attend one. It’s quite a party! You’ll see many happy faces I promise. That’s not anti-semetic…that is a true fact. Jewish people embrace Bris Milah. If you embrace something doesn’t that mean you have to love it too? Why on earth would someone embrace something that they didn’t love? That makes no sense.
As far as my generalization that ‘all doctors’ love circ. Yes, it was a generalization. Are generalizations wriong? Do you ever make generalizations? Perhaps we should start a new thred here for this subject. I will bet $100 that if you take your new baby boy to 100 OBGYN’s or PED’s across this fine country that almost 99% will cut your kid for you on demand. It’s as easy as asking a doctor for an abortion. It’s done everywhere, by most everyone (MD’s). That’s common knowledge.

”Yes, the medical web sites would of course point out medical reasons ... “
I apologize, medical websites have strictly medical reasons for endorsing infant genital cutting. Thank you for this clarification. Their motives are so pure! Have you forgotten what bog we are on? I HATE DOCTORS, is the name of the blog…not I LOVE doctors. You need to find your way to the I LOVE DOCTORS blog, and you will find more support there. I wonder what motivates an MD to skip the local on the poor lad? Well…it must be a medical reason! NEVER doubt those in positions of absolute authority. Yikes!
“I guess that you can try to promote your agenda,”
And you can try to promote your agenda. The kind & compassionate Republican agenda. And the agenda that says robbing innocent little children of what is rightfully theirs is just.
“and then say that evidence be damned, the experts are wrong, and you're right ... but it still doesn't make it so.”
So you want evidence that cutting a little baby’s foreskin off is morally and ethically wrong? HARD evidence? Ok, here’s something for you first my little right-winger. Give me some evidence that tatooing a newborn is morally and ethically wrong. EVIDENCE please!

”A word of advice, although I probably shouldn't give it to you ... but which you can take or leave: you come across as shrill, and just barely hanging on to your dignity ... if you toned down your intensity, think before you react, cut back on the sarcasm and the unfounded accusations, drop the sad attempts at trying to tell a person that you know what they're thinking better than they do, then people may begin to take you more seriously.”
I don’t need your goodwill. My approach is my choice. I am not going to sugar coat my anger here. Sometimes people want you to use a cool front when you argue, but I am downright DISGUSTED here and it is MY choice to let it show. Did you watch that video that I posted of that little child being torn apart? You certainly didn’t find it in your right-wing heart to comment on the suffering of that child. No big surprise there. Did you watch with your speakers ON or OFF? How can you tell me to be cool about a child being tortured like that…are you hysterical?

the video:

http://www.metacafe.com/watch/161143..._circumcision/

 
At Monday, July 10, 2006 7:43:00 AM, Anonymous Anonymous said...

Why I am not anti-Semitic

I love my spouse. But my spouse does something that makes me unhappy. My spouse snores loudly! That doesn’t mean that I don’t love my spouse.

I love my child. But my child does something that makes me unhappy! My child begs me for sweets all the time and never for healthy foods. I still love my child.

I love my father but he does things that make me unhappy! He can be cruel with his words sometimes. I still love my father.

I love my country, but I am unhappy with my president! I still love my country.

I love my Jewish ancestors, but they practice a ‘tradition’ that makes me extremely unhappy! I still love my Jewish ancestors.

My hostility is not towards Jewish people as a group. It is specifically towards an act, a ritual blood sacrifice on children. An act that is also carried out on non-Jewish children in the context of medicine.

I am opposed to the body modification of a minor child. I am opposed to inflicting severe and extreme pain on infants and children. I am opposed to the ritual blood sacrafices of children. I think that it is the strongest form of absolute authority. I oppose absolute authority. I oppose people that have power and abuse it. I believe in a system of checks and balances. I believe that people should have a say over what they keep and what they destroy on their own body. I believe that children have rights. I believe that it is a right of a child to decide for himself if he wants to keep his foreskin or shed it later. I believe that no one has the right to take this choice away from an individual. Unfortuately these are radical ideas to many many people.

 
At Monday, July 10, 2006 7:46:00 AM, Blogger Maurice Bernstein, M.D. said...

Hisbodyhisrights(z), you have repeatedly and forcefully made your views known to my visitors. On this blog, your viewpoint is unequivocal. Now what you haven't written so far is to tell us what you expect us to do to support your views and bring an end to male circumcision. Would you recommend that we write to our congressmen and senators and urge them to support the MGM bill as written or a modified version of the bill? Beyond these recommendations, I find nothing further needed as for your contribution to this thread. Thanks. ..Maurice.

 
At Monday, July 10, 2006 9:42:00 AM, Anonymous Anonymous said...

“Now what you haven't written so far is to tell us what you expect us to do to support your views and bring an end to male circumcision.”

I don’t expect you to do anything Sir. Continue to be complacent if you wish. If you actually decide that you really want to make a difference in this national movement to end the genital mutilation of our children, there are a 1000 things that you can do! For a start: take a public stand AGAINST’S MGM. That will take a lot of courage on your part. For if you do not denounce it emphatically…you support it indirectly with your silence & your ‘neutrality’.

“Would you recommend that we write to our congressmen and senators and urge them to support the MGM bill as written or a modified version of the bill?”

If you do not support the MGM bill, I would not recommend that you ask your legislator to support it. There are countless other ways that you can help to end MGM that are not related to this bill. Becoming an Intactivist is quite easy. Educating the public about the horror of MGM is easy. Warning: people wont like you for it. They will be very angry at you. I will discuss some further steps you can take since you asked:

1.Join doctorsopposingcircumcision.org A $40 membership fee
http://www.doctorsopposingcircumcision.org/about/member.html
2.Write your legislators and tell them that you want the common practice of performing neonatal circ without anesthesia to END! Ask them to make anesthesia mandatory, with strict fines and or jailtime for those who do not comply!
3.Become a Regional Director for www.nocirc.org. There are several other jewish members at Nocirc. There is ALOT to do in this organization!!! Attend the 9th annual Symposium on circumcision, genital integrity, and human rights in Seattle in August.
http://www.nocirc.org/symposia/ninth/symposium.pdf
4.Make a donation to www.nocirc.org
5.Put a bumper sticker on your car to promote awareness. I will send you one myself for FREE.
6.Send the NOCIRC PSA (a Free DVD) to healthcare providers across the country.
7.Attend the annual march in DC to end MGM (in March/April)
8.Help with the successful fight to get circ defunded with insurance companies. There have been many gains here!
9.Talk to people. Talk. Talk. Talk. Speak out against MGM publically. Leave info. packs with midwives and doula’s. Help support our media campaign.
10.Support this website: http://www.jewsagainstcircumcision.org/
11.Continue to educate yourself…there is so much to learn! Read ‘Questioning Circumcision” A Jewish Perspective, Mr. Ronald Goldman
12.Read Read Read. There is a ton of material to read about why MGM is wrong and how to end MGM
13.Join a Yahoo group and start talking to other Intactivists. Lots to discuss.
14.Tell people about the non-violent ceremony of Brit-Shalom. The girls get a non-violent ceremony…why shouldn’t our boys?
http://www.circumstitions.com/Jewish-shalom.html
15.Support continued dialog on your blog by those who want forced neonatal genital cutting to end. Obviously, I am no longer welcome here.

“Beyond these recommendations, I find nothing further needed as for your contribution to this thread. Thanks.”

Thank you sir for having such an'open your mind' here. Good luck with your bio-ethics class.
-HBHR

 
At Monday, July 10, 2006 10:14:00 AM, Anonymous Anonymous said...

(Pervious: July 7,10:25/July 7, 5:43)
Quote from: July 09/2006/ 7:01:27 “Over the past 25 years, some 60 million American parents have had the courage to refuse circumcision for their sons.”

Are these parents refusing to have their children circumcised or just following a trend? My friend’s son was born 32 years ago. Circumcising male infants was routine and covered by medical. Her second son was born 6 years later. By that time parents had to request the procedure, but it was still covered by medical. Therefore, her first child was circumcised but the second one wasn’t. Seven years after that point, parents had to request and pay for circumcision. As soon as parents had to request the procedure the numbers dropped. The drop dipped drastically once it wasn’t paid for under medical. There’s something very interesting about that and what it says about how much thinking goes into what patients, or in this case parents, allow.

Be it right or wrong patients tend to follow whatever they are told by the medical community. Example: Routine ultra-sounds performed on pregnant women. Is there any sound medical reason for doing this? There are reasons for doing ultra-sounds during pregnancy, but not in the majority of cases. Yet very few patients question this because it is routine and covered by medical. What does this say about the level of encouragement the average person, in or out of medicine, is given to think about and question what goes on around us?

The assumption is that the medical community is wise and knows what’s best. However, I’m sure that most doctors just follow along with what they were taught and most patients just follow along with what the doctor says. It might well be that nobody, in or out of medicine, has actually given what takes place in some areas much thought at all. I find it hard to believe if parents were asked if they wanted their child to have pain relief during circumcision, the answer would be no. I find it hard to believe if doctors, during training, were asked if they wanted to provide pain relief while performing a circumcision would say no. Yet??? I’m not convinced that parents are refusing circumcision, so much as just following along with which ever way the wind blows. If patients and doctors tend to follow the wind we’d better hope it’s a wise wind.

 
At Monday, July 10, 2006 4:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Thanks to Hisbodyhisrightz for a concise listing of examples of what my visitors can do to promote the view against male circumcision. I wish hisbodyhisrightz best wishes as he broadcasts his non-trival concerns onto other venues. ..Maurice.

 
At Monday, July 10, 2006 7:20:00 PM, Anonymous Anonymous said...

This has certainly been a lively thread.

Thank you, Dr. Bernstein, for being the host. I'm not sure if I would have been quite as welcoming as you were.

My final considered position is that the last thing we need is more legislation micromanaging our lives - and even more importantly, disrupting the bond between parent and child. For religious, medical and personal reasons, the choice to circumcise or not should be between the parents and the physicians ... not the government.

Finally, I have to agree with Dr. Engel: "Since man existed, parents rightly had the choice." We've already got far too much which gets between a parent's choice and a child.

Thank you again.

 
At Tuesday, July 11, 2006 12:58:00 AM, Anonymous Anonymous said...

For Dr Engel:

I do not believe it is true that "benefits lean toward positive results". Is so, then why does the Royal Australasian College of Physicians say this in its summary statement on routine circumcision of male infants and boys: "After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision." (their bolding)

http://www.racp.edu.au/hpu/paed/circumcision/summary.htm

Almost all the physicians responsible for this statement will be circumcised themselves or married to circumcised men (the circ rate in Australia was 90% in 1950, 12.6% now).

Coming from a non-circumcising culture, I find it very hard to understand why people regard it as an issue of parental choice rather than rights of the child. Some of the lesser forms of female circumcision are no worse than male circumcision, yet they are all banned, regardless of what the parents want or why. Even making an incision on a baby girl's genitals is illegal, yet many states subsidise totally removing a baby boy's foreskin.

Parents use the exact same reasons for genital surgery on girls as they do for genital surgery on boys, so why is only one sex protected?

 
At Tuesday, July 11, 2006 8:20:00 AM, Blogger Maurice Bernstein, M.D. said...

I have deleted postings by Bob from this thread because they are totally not in keeping with the goals of this blog to provide a place for rational and civil discussion of bioethics topics. Previous postings by others have already shown that this topic raises emotions highly and to me that it sufficient to put the topic in perspective. No further demonstration is necessary. Bob is welcome to return to present rational and non-inflammatory comments supporting the view taken. ..Maurice.

 
At Tuesday, July 11, 2006 7:51:00 PM, Anonymous Anonymous said...

Dr. Bernstein, I'm sorry for being a bit late here ...

This was in today's news on ABC, and it fits this thread. I hope you don't mind if I post it:

Circumcision May Prevent HIV Spread in Africa

Although I've been a little skeptical about this, my skepticism is melting.

Thank you for being such a gracious host.

 
At Tuesday, July 11, 2006 8:32:00 PM, Blogger Bob said...

Dear Maurice,
The sexual mutilation of little children outnumbers all other violent crimes against children and all other violent sex crimes combined.

I'm sorry that you burry your head in the sand and refuse to accept the voices of angry men who have been brutally violated by criminal child abusers wearing white coats. Your evil perpetuates itself by ignorance and arrogance.

Doctor, heal thyself!

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Tuesday, July 11, 2006 8:36:00 PM, Blogger Maurice Bernstein, M.D. said...

Moof, I think one should be very cautious about a one paragraph article referring to a paper which would require careful scrutiny regarding the quality of the statistics. This is particularly true, if as suggested in the article, the paper is extrapolating the results into broad generalizations. It might require the analysis such as the example (circumcision vs HIV) I presented on the July 8th comment by something like "The Cochrane Database of Systematic Reviews" as part of a meta-analysis. If the research presented in the paper was not a rigerous randomized controlled study as promoted by the reviewers of the Cochrane report, the results of apparent benefit of male circumcision on HIV infection might still be uncertain. While extrapolating potential benefit to the world community, though still a guess, would be worthy when one has definite proof of benefit, at present this would be premature. I have to be honest here, I haven't read the original paper myself but it is hard to believe without confirmatory randomized controlled studies, one could seriously jump to a conclusion such a benefit of circumcision. ..Maurice

 
At Tuesday, July 11, 2006 9:26:00 PM, Blogger Maurice Bernstein, M.D. said...

Bob of July 11th, if you were referring to me personally when you wrote: "I'm sorry that you burry your head in the sand and refuse to accept the voices of angry men who have been brutally violated by criminal child abusers wearing white coats. Your evil perpetuates itself by ignorance and arrogance." that obvious ad hominem remark is not tolerated in civil discussion. If you have read what I had previously written you would know that my head is not in the sand, I have no opinion as yet about the ethics of male circumcision and in fact I am also doubtful of any serious medical benefit has been proven. Moreover, I have never advised nor performed a circumcision. If you were writing about all physicians that too is an irrational conclusion. Just as I have noted to Moof in my last post about not jumping to conclusions regarding the positive medical benefit of circumcision, I am asking you to provide documentation of validity for statements you make. Thank you. ..Maurice.

 
At Tuesday, July 11, 2006 10:14:00 PM, Anonymous Anonymous said...

Um, excuse me?

Isn't the argument for the justifiability of 'prophylactic male prepucectomy' necessarily based upon the assumption that the male prepuce is vestigial, i.e. functionally irrelevant and meaningless tissue?

Maurice, if I could at least have a dialogue with you in particular about this, I would really appreciate it.

 
At Tuesday, July 11, 2006 10:38:00 PM, Blogger Bob said...

Ah Maurice. Your opposition to child abuse must be why you deleted my post about the "Best Method of Circumcision." No other method has been shown to be so effective in preventing future AIDS deaths, nor in preventing sexual violence against children.
Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Tuesday, July 11, 2006 11:52:00 PM, Anonymous Anonymous said...

"Male Circumcision: Should It Now Be A Crime?"

Absolutely. Female circumcision is a federal felony. Protecting female sex organs from the slightest pin prick while allowing amputation of 15 square inches (on average) of penile skin containing the most erogenous skin men have is blatantly unconstitutional. It establishes grossly unequal protection of the law in obvious violation of the 14th amendment.

Boys are injured and killed by circumcision just as girls are, only a lot more boys are injured and killed than girls because so many more boys are circumcised. What sex the child happens to be who is injured or killed is 100% irrelevant. Being male (or female or intersexed) offers no special advantage in the circumcision grave.

Parents have no right to injure their children. Deliberately injuring children unnecessarilyu is child abuse, plain and simple. Parents have RESPONSIBILITIES to PROTECT their children from unnecessary harm. The RIGHTS are all on the side of the owner of the sex organs in question. No person has ANY right to unnecessarily chop up other people's bodies without the informed adult written consent of the person to be cut unnecessarily. Circumcising healthy children is medically unnecessary. There is no medical dispute about that. Circumcising healthy children is criminal assault. So says medical ethicist Margaret Somerville, Founder and Director of McGill University's Center for Medicine, Ethics and Law. Read her chapter "Altering Baby Boys' Bodies - The Ethics of Infant Male Circumcision" from her book The Ethical Canary: Science, Society, and the Human Spirit at http://intact.ca/canary.htm.

Culture can blind us to obvious realities. don't hurt babies. How hard that simple bioethical rule is for some people to learn. The reasons people rationalize hurting babies are always cultural. Biology is on the side of the child. So is bioethics. Deliberately hurting babies unnecessarily is child abuse. It really is that simple.

Don't cut off other people's healthy body parts. They aren't your body parts. If you it do you go to jail.

A complaint was made that this uncompromising attitude is forcing this opinion on others. Yes it is. To prevent them from forcing harmful acts on others. Civilization requires force. It's called "law". We have laws against crimes like murder and rape. That's forcing civilization's view on murderers and rapists. We already have a forceful law against genital mutilation of girls. Even dogs and cats are protected from genital mutilation in the USA. Boys deserve equal protection for their sex organs with dogs and cats. Your culture and religion stop at other people's skin. Your ideas do not have a right to violate other people's healthy bodies. Human rights are universal and apply to all people. Males are people too.

 
At Wednesday, July 12, 2006 3:50:00 AM, Anonymous Anonymous said...

To me the torturing and mutilating of a male child through circumcision is a selfish, barbaric, and a crime against humanity. Anyone who says that it must be done for religious reasons is simply exercising some sick kind of control over that child. The religious excuse is just that, an excuse. No person has the right to chop off part of another persons anatomy just becaue they want to. It is sick and I believe that the individuals who do the chopping just as those who stand by and watch or permit it to happen are in need of serious mental help. As the doctor told me after the birth of my now 7 yr old son, "if other people were cutting off the pinky finger of their newborn male children would you follow suit and do that too?" I thank God for that mans comments to me and his wisdom. I went with the feeling in my soul, that this was wrong and barbaric. He is whole boy.

 
At Wednesday, July 12, 2006 7:31:00 AM, Blogger Bob said...

Dr. Maurice thinks that he can have "rational civil discussion" of a topic that is barbaric, uncivilized, irrational, demented, and totally insane, the bloody sexual torture and maiming of a hundred million boys and men! WRONG!

Dr. Maurice thinks he can point his finger to "those doctors over there" and claim that he doesn't share responsible for the sexual mutilation of a hundred million American boys and MEN. WRONG! It reminds me of the Holocaust, "I didn't exterminate Jews, it was those Nazis over there." They all said that. They all were guilty.

Every doctor who belongs to violent sexual predatory misandrist organizations such as the AMA or the local HOSPITAL, every doctor who claims membership in the medical establishment, and every doctor who looks the other way and pretends that you can have a "rational discussion" while his colleagues hack up the sex organs of another million helpless little children shares their guilt. Until the whole rotten medical monster cleans up it's sexual perdition on little children every one of it's members is guilty of the most evil crimes against humanity.

Doctor, heal thyself!

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 8:04:00 AM, Anonymous Anonymous said...

Can you imagine people arguing for female circumcision in this country the way some argue for male?

Parent's sacred choice! To chop up their daughters' sex organs? I don't think so. We put them in jail if they do, their religion takes a back seat to their daughters' sex organs. Freedom of religion is absolute only when it comes to religious BELIEF. Religious PRACTICE must meet tests of human rights and legality. People can BELIEVE in child sacrifice all they like, but if they start killing human children in their religious rites they'll be believing their religious madnness in jail where they can't kill any more children.

Looks better! To whom? To what culturally perverted tastes?

Smells better! Keep your nose to yourself if you don't like how she smells.

All her friends are! Who are her "friends"?

She should look and smell like her mom! Give me a break!

It's a sickness to think in these perverse ways. Whoever can't see that has been brainwashed by this temporarily perverted, genital mutlating culture. This is a short term aberation in the USA. It'll be over soon. We didn't used to do this. George Washington wasn't circumcised. John Adams wasn't. Thomas Jefferson wasn't. Nobody compained about how our first presidents' penises looked or smelled.

Why would anyone want to sexually disadvantage their son by "surgically" making his penis smaller and less functional? I put "surgically" in quotes because genital mutilation isn't surgery. It's a perversion of surgery. Surgery is only for therapy for sickness, for defect, or for injury. None of those apply to a normkal healthy penis. Genital mutilation is human vivisection. That's what the Nazi doctors got in so much trouble for at Nurenburg. It's criminal. Blatantly so.

Most of the world's women prefer whole penises, for reasons obvious to all but the most culturally abused and brainwashed, about 20% of the world's people. Give your son and all males a level playing field. Don't chop up some of their penises. It's not fair. It's injustice. Rank injustice. It's torture and mutilation. Every human being has an unalienable human right to be free of torture and mutilation.

Ask the world court to say so with respect to genital mutilation of children at http://MontaguNoCircPetition.org

You won't be in bad company. DNA structure discoverer Nobel Laureate Francis Crick signed it. Polio vaccine creator Jonas Salk MD signed it. Thousands of others from all over the world in every religion and on every continent have signed it. You can too. It's easy and takes just a minute or two. Join the movement. Sign the petition. http://MontaguNoCircPetition.org

 
At Wednesday, July 12, 2006 8:22:00 AM, Anonymous Anonymous said...

Bob's statement that "it isn't a crime to be born a man" seems to resonate with me the most.

You would never know that it wasn't a crime, considering that if you are born male you must be branded and maimed by your 'culture'.

That is so sad.

 
At Wednesday, July 12, 2006 8:24:00 AM, Anonymous Anonymous said...

In 2003, David and Michael Benatar presented a thoughtful discussion of the bioethics of circumcision in "Between prophylaxis and child abuse: the ethics of neonatal male circumcision."

Unsurprisingly, their article attracted criticism, exclusively from those with anti-circumcision views. It is interesting to read their response to that criticism along with the many views expressed here on this page.

 
At Wednesday, July 12, 2006 8:29:00 AM, Anonymous Anonymous said...

Maurice, regarding HIV, the Cochrane review predated the results of the Auvert study - the first randomized controlled trial to complete. It reported a highly protective effect of circumcision against HIV.

 
At Wednesday, July 12, 2006 8:59:00 AM, Blogger Bob said...

From American Medical News, Vol 39, No 40, dated October, 1996. The article contained the following quote:

“We as humanitarians and particularly as gynecologists, cannot allow females or any group of patients to be mutilated. I’m afraid that this is even more basic than religion. This is humanitarian.”
John C. Nelson, MD, AMA Trustee.

I wholeheartedly agree with the wisdom of this statement, but can not for the life of me resolve the abject hypocrisy that it represents. Upon comparing this dictum to the million and a third of boys who are mutilated by members of the AMA every year, I find their sincerity very, very hard to comprehend. Perhaps men/boys are not “any group of patients?” In the very misandrist eyes of the AMA and it's members, a hundred million sexually mutilated men and boys do not rise to the level of "any group of patients."

Perhaps saving boys/men from genital mutilation is not humanitarian because we are not even people?

I wrote to the AMA Medical News editor and to Dr. Nelson in 1996 asking why men don't rise to the level of "any group of patients." I got no answer. Their misandry is so deep that a hundred million sexually mutilated men are completely overlooked. To the misandrist AMA, only women are human.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 9:05:00 AM, Anonymous Anonymous said...

I must agree with Bob. People, whether male or female, should be free from mutilation. However, I must disagree with his implicit idea that circumcision is a form of genital mutilation. How can it be? No harm is done (there are numerous claims of harm, but nothing that holds up to scrutiny). The penis is fully functional (one might argue, based upon the evidence of reduced risk of disease, that it is actually improved). This does not appear to be mutilation by any reasonable standard.

 
At Wednesday, July 12, 2006 9:14:00 AM, Blogger Bob said...

In fact it was Jewish doctors who were largely responsible for the evil of promoting massive universal sexual mutilation of little boys in the USA. During W.W.II the Nazis identified Jews by their sexual mutilations, but some American Christians had been sexually mutilated so some European Jews claimed to be Americans to escape the Nazis.

After that war and the widely published horror about the Nazi Holocaust, American Jewish doctors campaigned hard for universal sexual mutilation of boys/men so that Jews could not be sorted out. Many Jewish doctors sought out membership on medical committees and then claimed to be reviewing medical information while they in fact were promoting anti-men violence for personal reasons. The Jews promoted decades of lies and deceit in the medical community over the maimed bodies of a hundred million American boys and men. One can understand their fear of the Holocaust, but it does not excuse their own leadership and participation in the sexual horrors being perpetrated against a hundred million helpless little children. In fear of the Nazi Holocaust, American Jewish doctors created one of their own.

Yes, a small percentage of American men were being sexually mutilated prior to WW II, but it was a very long way from the universal "routine" practice promoted by the Jewish medical community after the war. Jewish doctors like Maurice love to look the other way and pretend that they are having a rational discussion of the horror of child mutilation. The blame needs to be laid where it belongs, right at their Jewish child abusing feet.

Ancient religious sacrifice is not an excuse to torture and maim children. Ritual sacrifice of children should have been left in the past many generations ago. Barbaric ritual sacrifice is not tolerated for female children regardless of religion, as Dr. Nelson and the AMA points out, see Bob's previous post. Instead of promoting massive sexual torture of a hundred million innocent little boys, Jewish doctors should have demanded that all forms of Holocaust be ended. They became as guilty as those they feared.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 9:23:00 AM, Anonymous Anonymous said...

"How can it be? No harm is done"

says who...you? Millions of other people would strongly disagree with you here, not just the people on this insignifant little bioethics blog.

"there are numerous claims of harm, but nothing that holds up to scrutiny".

There are numerous claims of benefit...but nothing that hold up to any scrutiny either!

"The penis is fully functional (one might argue, based upon the evidence of reduced risk of disease, that it is actually improved"

The penis is NOT fully functional after it has been deskinned, and if you had a foreskin you might know that. But you don't. The natural mechanics of sex change when you remove the foreskin. There is no more gliding action. Sex becomes a pounding and not gliding motion. Yes semen can still be deposited...but the actual act of sex is COMPLETELY different for both the man and woman when the skin from the penis has been ripped away.


"This does not appear to be mutilation by any reasonable standard"

Maybe by your standards, and this is strictly because you are unable to admit to yourself that you are no longer the 'whole' man that nature intended for you to be. That's a big deal for a MAN to admit. It is only confessed by few men publically ... and they are ultimately the braver of the 2 sides to this argument.

 
At Wednesday, July 12, 2006 11:40:00 AM, Anonymous Anonymous said...

For a circumcised man to acknowledge that it is OK to leave his son intact he must also acknowledge (at least on a subconscious level) that what was done to him was wrong. It takes a lot of emotional strength to do that. For many who have been cut or who have consented to it for their child, it is much too threatening to consider that they have been hurt or that they authorized for their child be hurt.

It is much MUCH easier to just stand firmly with the crowd who holds the bloody razors, raised high to the sky, and chant 'parental rights' parental rights'!!!

 
At Wednesday, July 12, 2006 12:12:00 PM, Blogger Bob said...

One of the huge reasons why the AMA, the AAP, and their members haven't admitted that MGM is serious violent sexual child abuse is the matter of civil liability. Like sexually mutilated fathers these organizations and their member would face psychological and financial consequences if they had to admit malpractice. Psychologically an individual doctor would have to admit doing serious psychosexual violent crimes against hundreds of children. But financially is where the real resistance comes. If the medical community ever admits the obvious and acknowledges that MGM is sexual child abuse they could be subject to a class action suit or suits by every victim. Malpractice suits are already a large concern in the medical business, but nothing they have ever experienced would be on this scale or cost. In the US there are something like a hundred million sexually mutilated men and boys. If I were on the jury I would think that something like a million dollars for each victim might be adequate compensation, but trial lawyers could ask for much more. Even at a modest million dollars per victim, there are so many victims that the psychosexual perverts who hack up children, together with their hospitals and insurance companies could end up owing a hundred trillion dollars to their victims. That much debt would break them all.

The financial liability for a century of deliberate malpractice done to little children is staggering. They can't afford to admit their mistakes. So they try to bury their mistakes like all doctors do. Only this time they bury the mistake by continuing the lies. Denying that it was a mistake means that they have to keep pretending their lie, that it is "good" for the sexually mutilated children and men. Instead of ethics they choose the money. Even the term "bioethics" has become an oxymoron.

And the violent bloody sexual mutilation of helpless little children goes on and on.

Doctor's heal thyselves!

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 12:25:00 PM, Anonymous Anonymous said...

"says who...you? Millions of other people would strongly disagree with you here, not just the people on this insignifant little bioethics blog."

I have my doubts that the number is so high, but sure, some people would disagree. The question is whether they can present a reasoned argument in support of their belief.

"There are numerous claims of benefit...but nothing that hold up to any scrutiny either!"

Actually, the evidence for several benefits is very compelling, and with the exception of a few die-hard anti-circumcision activists, they are accepted.

"The penis is NOT fully functional after it has been deskinned, and if you had a foreskin you might know that. But you don't."

Please refrain from speculating about myself.

"The natural mechanics of sex change when you remove the foreskin. There is no more gliding action. Sex becomes a pounding and not gliding motion. Yes semen can still be deposited...but the actual act of sex is COMPLETELY different for both the man and woman when the skin from the penis has been ripped away."

Ok, what's your evidence? Give me hard, numerical data showing me that sex is worse for circumcised men.

"Maybe by your standards, and this is strictly because you are unable to admit to yourself that you are no longer the 'whole' man that nature intended for you to be. That's a big deal for a MAN to admit. It is only confessed by few men publically ... and they are ultimately the braver of the 2 sides to this argument."

Again, please refrain from speculating about me and make an objective argument instead.

 
At Wednesday, July 12, 2006 12:29:00 PM, Anonymous Anonymous said...

"One of the huge reasons why the AMA, the AAP, and their members haven't admitted that MGM is serious violent sexual child abuse is the matter of civil liability. ... If the medical community ever admits the obvious and acknowledges that MGM is sexual child abuse they could be subject to a class action suit or suits by every victim."

That has to be one of the most ridiculous arguments I've ever seen. Medical organizations are qualified authorities on the subject of medical issues, not whether something is or is not child abuse.

 
At Wednesday, July 12, 2006 12:41:00 PM, Anonymous Anonymous said...

i think you are way off here. It's the MD's who are on the front lines when domestic child abuse cases come in. They have to formulate a 'medical' opinion about what consittutes child abuse...or they can't report it.

The the child abuser ( in this case the circ'ing MD) has to loosly define what child abuse is (or rather appears to be), in order to make a report to a social services agency. The MD has NO ONE who holds judgement over him. His power over the child is completely unchecked, unless that is, he is has a conscious.

The MD is the one that must make a recommendation of child abuse if he suspects that a child patient on his gurney or his shift has been abused by his/her parents.

 
At Wednesday, July 12, 2006 12:42:00 PM, Blogger Bob said...

I has been wisely obsered over and over that if you really want to know what is going on, follow the money. The money is especially important if the face makes no sense. The medical organizations are all about money. DUH!

 
At Wednesday, July 12, 2006 12:52:00 PM, Anonymous Anonymous said...

"i think you are way off here. It's the MD's who are on the front lines when domestic child abuse cases come in. They have to formulate a 'medical' opinion about what consittutes child abuse...or they can't report it."

Yes, you're right to an extent here. But really, the MD's expertise lies not in saying 'this is child abuse', but in identifying the symptoms that might indicate abuse (broken bones, suspicious bruising, psychological problems, etc).

Maybe it would be helpful to take a step back, forget the words 'child abuse', and talk about what is really meant. What would this (hypothetical) policy statement look like, in medical/scientific terms?

 
At Wednesday, July 12, 2006 1:12:00 PM, Anonymous Anonymous said...

"Ok, what's your evidence? Give me hard, numerical data showing me that sex is worse for circumcised men."

First of all, MD's would NEVER do a study like this! They have way too much to lose.

I did not say that sex was 'worse' for circ'd men...I implied that it was different. Here is exactly what I said.

"The natural mechanics of sex changes when you remove the foreskin. There is no more gliding action. Sex becomes a pounding and not gliding motion."

The foreskin 'glides' or 'rolls' over the shaft of the penis. I know because I have played with them before. The natural penile anatomy of a circ'd man (who I have been with too) is completely destroyed. There is no gliding action anymore. There is a loss of skin (15 square inches) which is immensly pleasurable when it is rolled back and forth over and over onthe shaft.

If there is no skin left to roll over the shaft of your penis, you have to make due with whatever's left. After a circ, the skin on the penis is now taught....immovable. The natural mechanics of your penis are forever change as a result of this procedure. Really, it is not rocket science.

Once you truly understand the function of the male prepuce, esp. during sex, you can answer your own question.

Take sometime to get educated about the male prepuce, courtesy of
Dr. Paul Fleiss:

What Is the Foreskin?

Anatomical and Physiological Facts That Your Doctor May Not Know


The prepuce is a common anatomical structure of the male and female external genitalia of all human and non-human primates; it has been present in primates for at least 65 million years, and is likely to be over 100 million years old, based on its commonality as an anatomical feature in mammals.
Christopher J. Cold, M.D., and John R. Taylor, M.D.


WHAT IS THE FORESKIN?


The foreskin—also known as the prepuce—is the flexible, doublelayered sheath of specialized skin that covers and protects the glans (or head) of the normal penis. The foreskin is a uniquely specialized, sensitive, and functional organ of touch. No other part of the body serves the same purpose.

The foreskin is an integral and important part of the skin system of the penis. It is a complex and sophisticated structure with many interesting and unique properties. No other part of the body's skin covering duplicates the amazing design and functional possibilities of the foreskin. Among the many interesting features of the foreskin is the fact that it is highly elastic, entirely devoid of any subcutaneous fat, and lined with a sheet of smooth muscle.

The foreskin is more than just skin; it is a complex, highly mobile, and beautifully engineered organ composed of an intricate web of blood vessels, muscle, and nerves. In fact, the foreskin contains about 240 feet of nerve fibers and tens of thousands of specialized erotogenic nerve endings of various types, which can feel the slightest pressure, the lightest touch, the smallest motion, the subtlest changes in temperature, and the finest gradations in texture.

Nature has designed the delicate glans (commonly called the head of the penis) to be an internal organ. In the normal, intact penis, the glans is a glistening, rich red or purple color. The foreskin protects the glans and keeps it in excellent condition.

In many ways, the foreskin is just like the eyelid. It covers, cleans, and protects the glans just as the eyelid covers, cleans, and protects the eye. Also, just as the eyelid can open and close to uncover the eye, so the foreskin can open to reveal the delicate glans. The foreskin's inside fold is lined with a smooth red tissue called mucous membrane. This type of tissue is also found lining the lips, the inside of the mouth, and the inner fold of the eyelid. The foreskin's soothing inner fold gently keeps the surface of the glans healthy, clean, shiny, warm, soft, moist, and sensitive.


WHAT IS THE TUBULAR TIP OF
THE FORESKIN CALLED?

The akroposthion is the useful name that the ancient Greeks gave to the tubular, tapered "neck" of the foreskin that extends beyond the glans (head). The akroposthion smoothly extends beyond the glans, forming a soft, tapered, tubular sheath. This akroposthion of the foreskin functions as an extension of the urethra and conveys urine from the meatus (the urinary opening in the glans) to the outside world. The akroposthion varies in length between individuals. In childhood, it can represent at least half the length of the penis. Some boys have a foreskin that extends an inch or more beyond the glans. In other males, the akroposthion can be almost nonexistent, in which case the meatus and the surrounding portion of the glans may be exposed. Whatever the case, all lengths are normal.


HOW BIG IS THE FORESKIN?

The foreskin is the largest part of the skin system of the penis. It covers and usually extends far beyond the glans before folding under itself to its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold and comprises as much as 80 percent or more of the penile skin covering. In children, the foreskin often runs to impressive lengths, frequently representing over three quarters of the length of the penis.

If the average adult foreskin were unfolded and laid flat and unstretched, it would be approximately the size of a 3 x 5 index card. Moderately stretched, it would entirely cover a man's forehead or the back of his hand and fingers. That's a lot of skin!


DOES THE FORESKIN HAVE MUSCLES?

Yes. The foreskin, like the rest of the penile skin system and scrotum, is lined with the dartos muscle sheet. It is also called the peripenic muscle because it wraps around (peri) the penis (-penic). This remarkably powerful muscle is composed of smooth muscle fibers that run parallel to the shaft of the penis. The dartos muscle is involuntary and highly responsive. It contracts and relaxes in response to touch, temperature, and sexual excitement.

The dartos muscle is always in a state of tonus, or partial contraction—a condition of tension or readiness to contract or relax. The contractions of the dartos muscle are slow, sustained, and may produce great force, such as in cold temperatures.


WHAT ARE EVERSION AND REVERSION?

Eversion is the natural mechanical process by which the lips of the foreskin open and allow the foreskin to unroll and slide down the shaft of the penis to reveal the glans. When fully everted, the inner fold of the foreskin that embraces the glans is turned inside-out and moves along the shaft of the penis. Reversion is the reverse process that rolls the foreskin back up the shaft of the penis to cover the glans. Following eversion, the elastic skin system of the penis will usually have a tendency to return to its normal position, re-covering the glans and pursing the lips of the foreskin. Reversion is accomplished through the springlike action of the frenulum.


WHAT IS UNIQUE ABOUT THE PREPUTIAL ORIFICE?

At the very end of the foreskin lies the rose-colored preputial orifice, also known as the lips of the foreskin. Here, the muscle fibers form a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds. This functions similarly to the sphincter that closes and purses the lips of your mouth.

In terms of sensitivity, the lips of the foreskin are probably even more sensitive than the lips of the mouth in their ability to detect subtle differences in temperature, pressure, motion, and touch. The orifice remains closed most of the time, but can open up to allow the passage of urine. Thanks to its highly elastic nature, the preputial sphincter can easily and comfortably dilate over ten times its normal diameter to allow the glans to protrude.


WHAT IS SPECIAL ABOUT THE
INNER SURFACE OF THE FORESKIN?

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin is lined with a rich red-colored mucous membrane. It is divided into two distinct zones: the smooth mucosa and the ridged mucosa. The smooth mucosa lies against the glans penis. Here, researchers have discovered apocrine and ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.


WHAT DOES THE RIDGED MUCOSA DO?

Adjacent to the smooth mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats arise from the frenulum and encircle the inner lining of the foreskin. They allow the lips of the foreskin to open and roll back, exposing the glans. The ridged mucosa also gives the foreskin its characteristic taper.

The ridged mucosa is a highly vascular zone of specialized sensory tissue containing a dense concentration of specialized erotogenic nerve receptors. Eversion and reversion of the foreskin during erection and sexual play cause the pleats of the ridged mucosa to expand and contract like the bellows of an accordion. This movement allows every surface of the pleats to come in contact with the rim of the glans. The unfolding and refolding of the ridged mucosa over the glans allows all the erotogenic nerve endings to be stimulated, increasing sexual pleasure. If the foreskin is fully everted, the ridged mucosa will be repositioned around the shaft of the penis.


WHAT IS THE SMOOTH MUCOSA?



The last segment of the internal foreskin is the smooth mucosa, which extends from the last ridge of the ridged mucosa to the point of attachment at the coronal sulcus. The surface of this segment is composed of stratified squamous epithelial mucous membrane.


WHAT IS THE FRENULUM?



On the underside of the glans, the foreskin's point of attachment to the body of the penis is the muscular, bandlike ligament called the frenulum. If you turn your lower lip down, or your upper lip up, you will see a similar ligament that serves a very similar function in holding the lips in place. The tongue also has a frenulum that holds it in place. The frenulum functions as a spring, holding the foreskin in place over the glans and also drawing it back over the glans (reversion) after the foreskin has been retracted (eversion).


AT WHAT AGE WILL THE FORESKIN
FREELY RETRACT?



At birth, the foreskin is usually attached to the glans (head) of the penis, very much as a fingernail is attached to a finger. By the end of puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans. Separation of the glans and foreskin occurs as a result of hormones secreted during childhood and puberty. Erections, which naturally induce the foreskin to retract, also stimulate the separation process. This separation occurs in its own time. It is very important to realize that there is no set age by which the foreskin and glans must be separated. Even if the glans and foreskin separate naturally in infancy, the lips of the foreskin can normally dilate only enough to allow the passage of urine. This ideal feature protects your young son's glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, and only when he has discovered that his foreskin is ready to retract.

Parents should protect their child from doctors who try to retract his foreskin. Many doctors never learned about the normal development and care of the penis and are unaware that the foreskin should never be retracted by anyone, except its owner, and only when the penis has matured enough to make retraction free and easy.


WHY ISN'T THE FORESKIN USUALLY RETRACTABLE
UNTIL THE TEENAGE YEARS?



There is no need for the foreskin to be retractable until puberty. Only then are humans biologically programmed to become sexually mature. In babies and young children, the natural attachment of the foreskin to the glans protects the immature glans from injury and dirt. The firmly attached foreskin provides a natural protective barrier for the urinary tract. This is especially important in infancy and during the diaper-wearing years. Of equal importance, the attachment of the foreskin to the glans protects and preserves the head of the penis, allowing it to complete its development.


IS IT NECESSARY FOR THE FORESKIN TO BE
RETRACTABLE IN ADULTHOOD?



No. Many adults enjoy the comfort and security of a glans that is covered most or all of the time—even during erection. At this stage of life, the foreskin almost always has fully separated from the head. Full retraction is sometimes avoided if the lips of the foreskin (the preputial orifice) resist stretching wide enough to permit the passage of the glans. There is nothing wrong with this, even though many old-fashioned textbooks and many uninformed doctors (most of whom are circumcised) think that this is a problem called "phimosis."

Contrary to medical myth, a narrow preputial orifice does not make hygiene difficult. On the contrary: Important studies have found that the penis with a narrow foreskin opening is perfectly clean. Urination through the foreskin actually helps keep the penis clean and fresh. It is a beautifully designed system that functions with perfect efficiency.


SPECIAL MOISTENERS AND
EMOLLIENTS IN THE FORESKIN



All skin surfaces of the body require the constant moisturizing and soothing action of sebum—natural skin oil. Without it, the skin would dry out, crack, and bleed. To prevent this from occurring, the skin of the body is richly supplied with sebaceous glands. The natural secretion of skin oil gives the skin a healthy luster and enables it to do its job protecting the internal structures of the body from the external environment. Like skin, mucous membranes also require constant moistening. The mucous membranes of the eyes, for instance, are constantly bathed in moistening tears and other lubricating secretions from sebaceous glands in the inner eyelid. Similarly, the surfaces of the penis also require lubrication and moistening.


PREPUTIAL SEBUM (SMEGMA) AND ITS
IMPORTANT ANTIBACTERIAL PROPERTIES



Preputial sebum, or smegma, is the creamy white emollient that can sometimes be found coating the inner lining of the foreskin. It is a combination of secretions from many glands around the penis and urethra.

Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean rather than dirty. It is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All normal male and female mammals produce smegma. Dr. Thomas J. Ritter underscored its importance when he commented, "The vertebrate animal kingdom would be depleted without smegma."

Children produce very little smegma. During adolescence, the production of smegma markedly increases as the glands of the penis develop, perhaps in response to elevated testosterone levels. In adulthood, much less smegma is produced. It is natural that smegma would be most abundant during adolescence and young adulthood, since this is the time when males are at their peak of sexual drive and when human males are biologically programmed to engage in mating. Smegma is most needed at this time to facilitate the smooth operation of the penis.

Apart from its lubricating function, smegma has antibacterial effects, most especially during infancy. Antibacterial substances are passed from mother to child during breast-feeding and are secreted in the baby's urine. Breast-fed babies receive substantial amounts of beneficial compounds called oligosaccharides. When ingested, these compounds are secreted in the urine where they prevent certain types of bacteria from adhering to the urinary tract and the inner lining of the foreskin. Animal experiments have found that special cells called plasma cells in the inner fold of the foreskin secrete a compound called immunoglobulin. These secretions protect the penis against harmful bacteria. It is interesting to note that these antibacterial secretions increase in response to bacterial invasion.


SPECIALIZED NERVE RECEPTORS IN THE FORESKIN



The innervation of the foreskin is impressive. Genitally intact males know from personal experience that the foreskin is one of the most sensitive parts of the body. Consequently, for over a century, some of the most respected names in medical science have turned their attention to this part of the body. Anatomists have transformed this inner knowledge into careful scientific observations about the complex innervation of the foreskin. As the most richly innervated part of the penis, the foreskin has the largest number of nerve receptors, as well as the greatest variety of nerve receptors. These specialized nerve endings include Meissner's corpuscles, free nerve endings, end bulbs of Krause, corpuscles of Ruffini, Pacinian corpuscles, genital end bulbs, genital bodies, Merkel's disks, Golgi-Mazzoni corpuscles, and Vater-Pacinian corpuscles. These remarkable organs provide the foreskin with an amazing ability to detect the slightest sensations of touch, motion, temperature, and pressure. We are still unaware of all the facts about these fascinating structures. Future research may discover even more nerve receptors in the foreskin and help clarify what useful purposes they serve.


EROGENOUS ZONES OF THE FORESKIN



The foreskin is what's known as a specific erogenous zone. This means that it is richly equipped with a high density and concentration of specialized and sophisticated nerve receptors that convey pleasure. The only other specific erogenous zones on the male body are the conjunctiva of the eye, lips, nipples, perianal skin, and the head of the penis. The presence of specialized erogenous nerve receptors makes this part of the body especially important.

The primary zones of erotogenous sensitivity are the frenulum, ridged mucosa, the preputial orifice, and the external fold of the foreskin. All of these zones are orgasmic triggers. Continuous and gentle stimulation of any one of these areas can elicit pleasure, orgasm, and ejaculation.


HOW THE GLANS COMPARES WITH THE FORESKIN



Most people are surprised to learn that the glans penis is one of the least sensitive parts of the entire body. Obviously, this news may be worrying for circumcised males. The glans is insensitive to light touch, heat, cold, and even to pinpricks, as researchers at the Department of Pathology in the Health Sciences Centre at the University of Manitoba discovered. The corona of the glans contains scattered free nerve endings, genital end bulbs, and Pacinian corpuscles, which transmit sensations of pain and deep pressure. The glans is nearly incapable of detecting light touch.

The nerve receptors of the corona are designed to be stimulated through the medium of the foreskin. Direct stimulation of the glans of the intact penis is most pleasant when the stimulus mimics the moist, massaging action of the foreskin. The moving ring of pressure created by the lips of the foreskin and ridged mucosa stimulate the nerve receptors in the rim of the glans. While pleasurable stimulation of the frenulum and ridged mucosa is instantly perceived, sensation of the corona is slow and gradual. When fully stimulated, the erotic sensations felt in the corona are perceived as having a slow, warm, and rich quality. As nice as this is, it hardly compares to the erotic sensations generated by the foreskin. Circumcised males have been robbed of a normal body part. They have also been robbed of a normal level of sexual sensation. Just as a person whose lips were amputated could never really appreciate the sensations that lips can convey, so a circumcised male can never understand what his genitally intact friends experience. This helps explain why some circumcised males defend circumcision so vehemently. They have no idea what was taken from them and are psychologically unprepared to deal with their loss.


ISN'T THE FORESKIN A VESTIGIAL ORGAN
LIKE THE APPENDIX?



No. First of all, the appendix is hardly a vestigial organ. This myth was created back in the nineteenth century when medical science was too primitive to figure out the purpose of the appendix. Doctors back then were foolish enough to think that any organ whose function they were unable to understand was functionless and vestigial. Nowadays, we know the appendix to be an important part of the immune system, producing large quantities of lymphocytes and pumping them into the small intestine. Similarly, the myth that the foreskin is a vestigial organ was invented by circumcisers as an additional justification for imposing mass circumcision on the American people. The foreskin cannot be vestigial. The results of a fascinating study conducted by Dr. Christopher Cold and Dr. Kenneth A. McGrath demonstrate that the human foreskin is an evolutionary advancement over the foreskins of other primates. The human foreskin is far more sophisticated and responsive, as their comparative anatomy studies prove. This is seen most clearly in the evolutionary increase in corpuscular innervation of the human foreskin and the simultaneous decrease in corpuscular receptors in the human glans relative to the innervation of the foreskin and glans of lower primates. In other words, in monkeys and apes, the glans is more sensitive than the foreskin. In humans, this is reversed, so that the foreskin is more sensitive than the glans. If the foreskin were "vestigial," this advancement would never have taken place and the human foreskin would be either equally or less sensitive than the ape foreskin.

It is important to remember that there are no vestigial organs or body parts. Each and every part of the body serves a specific, important purpose. If the foreskin failed to serve a purpose, it would have disappeared millions of years ago. Drs. Cold and McGrath conclude that, over the last 65 million years, the foreskin has offered reproductive advantages. It must also be remembered that sexual selection has refined the external genitalia of every creature, including man. The human foreskin is the product of millions of years of evolutionary refinement, and, as such, the human foreskin represents the epitome of design perfection.

 
At Wednesday, July 12, 2006 1:16:00 PM, Blogger Bob said...

You are right that the MDs are on the front lines of "child abuse." They are on the front lines in more ways than one. MDs are required to report injuries that appear to be child abuse, but the violence they do to children are excluded.

There are two kinds of child abuse, reportable child abuse and actual child abuse. What doctors report are the reportable child abuse. But the laws generally exclude medical treatment by a licensed physician so they ignore all the child abuse done by doctors. It's actual child abuse, but it's not reportable child abuse (as long as it actually is done for medical treatment). When a doctor hurts a child and it is not actual medical treatment, then it is actual child abuse whether or not the doctor wants it reported or not.

In the State of Florida, for example, sexual child abuse resulting in permanent injury to the child's sex organs is a death penalty crime. The law excludes bona-fide medical treatment. However there is a very serious question whether sexual mutilation of a healthy normal child is medical treatment at all. In common medical definitions medical treatment has to be done as the result of an illness or injury. Medical treatment does not include actions by a doctor unrelated to an illness or injury. For example, an OBGYN is prevented from doing penile insertion into a healthy female patient and calling it medial treatment. If the medical business were ever forced to admit that hacking up the sex organs of healthy normal little children is not medical treatment, a bunch of Florida doctors could be in a world of legal trouble. A parent's consent does not constitute either medical treatment or justification for child abuse. In my opinion, the doctors who hack up the sex organs of healthy normal little children for money, or for psychosexual perversion, all ought to be prosecuted and punished to the full extent of the law. Sexual child abuse with permanent physical injury to the child is a very serious crime. A white coat does not change it at all.

Doctors heal thyselves!

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 1:25:00 PM, Anonymous Anonymous said...

"Maybe it would be helpful to take a step back, forget the words 'child abuse'"

It is so much more comfortable to forget about child abuse, isn't it? I am RIGHT with you here! Unfortunately that would be in the best interest of the children.

"and talk about what is really meant."

oh I see, you want me to sugarcoat it for you. Bob can you help me out here? No probabally not. :)

How does this work for you?
Circ is a gross abuse of power. Does that make you feel more comfortable?

"What would this (hypothetical) policy statement look like, in medical/scientific terms?"

I am not sure I understand your question here. Can you restate it?

 
At Wednesday, July 12, 2006 1:27:00 PM, Anonymous Anonymous said...

what I meant to say in my last post was:


"Unfortunately that wouldn't be in the best interest of children."

 
At Wednesday, July 12, 2006 1:53:00 PM, Anonymous Anonymous said...

"Take sometime to get educated about the male prepuce, courtesy of
Dr. Paul Fleiss:

What Is the Foreskin?"

This appears to be nothing but an opinion piece of questionable merit, and with several obvious mistakes. Do you have anything remotely approaching scientifically credible evidence?

 
At Wednesday, July 12, 2006 2:04:00 PM, Anonymous Anonymous said...

"It is so much more comfortable to forget about child abuse, isn't it? I am RIGHT with you here! Unfortunately that would be in the best interest of the children."

I think you misunderstand. I'm saying let's forget about the words and concentrate on what is meant.

"oh I see, you want me to sugarcoat it for you."

No, quite the opposite. Consider the following:

1. "Mr Smith abused a child."

2. "Mr Smith came home drunk every night and beat his son with his belt or, sometimes, a baseball bat. His son was always badly bruised, suffered a broken collarbone twice, and broken ribs on three occasions. His son complains of severe pain in his chest and back, and has suffered minor damage to one kidney."

Which is sugar-coating? Which is specific? If anything, the latter is more shocking to read. That's because it doesn't use the words 'child abuse', but graphically describes their meaning.

"How does this work for you?
Circ is a gross abuse of power. Does that make you feel more comfortable?"

No, it's just as bad. It's using vague, sweeping, melodramatic statements instead of precisely conveying meaning. Try to find something closer to no. 2 above.

 
At Wednesday, July 12, 2006 2:25:00 PM, Blogger Maurice Bernstein, M.D. said...

Can I interrupt here for a moment to ask a question that I asked before: Why is it that most of the writers to this thread (except Bob) are anonymous in the full sense of the word? No true full names or pseudonymns are given and no contact information is provided. My full name and title is presented and my e-mail address is on this blog. Why can't others take full responsibility for what they write? Is there something too personal that one needs to hide despite whichever circumcision view one supports? For the purposes of clarity of reading and understanding what is written here, to understand who is supporting and who is rejecting what view, it is important to make these identifications. I really don't have much faith or reliance on statements made by people who make no effort to identify themselves. Thank you. ..Maurice.

 
At Wednesday, July 12, 2006 3:06:00 PM, Anonymous Anonymous said...

Maurice, I mostly agree with you on the anonymity issue. I would guess that the reasons fall mostly into one of two camps: either "just can't be bothered to", or "afraid of potential consequences".

I'm glad you're still following the thread, though, and I look forward to seeing your response to my own earlier question. I'll be checking the thread every so often for a while to come, so if you missed it and would like me to repost, rather than having to do a page search for my ID, just say so.

 
At Wednesday, July 12, 2006 3:57:00 PM, Anonymous Anonymous said...

"Maybe it would be helpful to take a step back, forget the words 'child abuse', and talk about what is really meant."

What is REALLY meant? Hmmm. I think if you would like to know what is really meant you need to watch a video. Then you can see what is really meant. Please watch the circ video with the audio loud. I believe this "clip" was posted at the top of this thread. Do you define abuse only at the hands of parents? Do you define abuse only in the following form form? Is that pretty clear cut to you? You are not able to see abuse in other contexts? Outside of the family...in the society???

"Mr Smith came home drunk every night and beat his son with his belt or, sometimes, a baseball bat. His son was always badly bruised, suffered a broken collarbone twice, and broken ribs on three occasions. His son complains of severe pain in his chest and back, and has suffered minor damage to one kidney."

There are other forms of abuse and other types of abusers.

I will translate the medical abuse for you like this:

Once upon a time, a beautiful, perfect new baby was born. He had the great misfortune of being born male, and the double misfortune of being born male in the US during the masturbation hysteria era.

This beautiful perfect little baby boy was pronounced 'healthy' in every way by the attending MD, except for one small birth defect at the end of his little penis.

The MD and his BIG FAT medical organization recommended to the parent that immediate intervention take place!

The fragile new child is carted off to the CIRCUMCISION ROOM!

The doctor straps the baby down to the circumstaint board and applies betadine solution as an antiseptic.

(baby starts to whimper)

A drape is placed over the baby to try to maintain a sterile field. A quick check is done to make sure that the baby’s penis is ‘normal’.

Because a baby's prepuce is usually naturally adherent to the glans (this is true of both males and females), it must first be torn away in order to perform the circumcision. The doctor applies clamps and inserts the nose of a pliers-like instrument to tear away the foreskin from the glans.

(The child screams in agony now.)

Once this is done, the clamp is used to make a crush line for the dorsal slit. The dorsal slit allows the bell to be placed under the foreskin easily.

(The MD shows no mercy…he only sighs and mumbles “there there”)

After the dorsal crush has been applied for long enough to reduce the chance of bleeding, the dorsal slit is made with a scissors inside the crush line.

(The child continues to cry out in horible pain. Unable to move. His tiny body violently thrashes under the tight straps.)

Now the doctor puts the bell of the clamp over the glans and arranges the base plate over the foreskin. Note that the flange of the bell is slightly larger than the beveled hole in the base plate.

He next pulls the foreskin through the space between the bell and the base plate, making sure that the end of the dorsal slit is above the base plate.

(the child is hysterical now, literally being terrorized on his first day alive.)

The arm of the bell is now inserted into the yoke and the nut is tightened. When the nut is tightened, the rocker arm will pivot at the notch, pulling on the arm of the bell and crushing the foreskin between the bell and the base plate. Using a scalpel the foreskin is now cut against the bell at the base plate and removed.

(the child’s face is turning blue. Tears are streaming down his face, he continues to wiggle and scream in pain…no one there to protect him from the monster at his penis)

Now there is a wait to allow the clamp assembly to crush the blood vessels to lessen the chance of bleeding. The clamp is removed. Because of the crush, the remaining skin is stuck to the bell and must be pulled away with the fingertips and gauze.

(The child is exhausted after his brutal genital assault. He goes on shut down to recover. Sleep…sleep, sweet boy say the MD.)

It’s amazing how hard it is to get people to understand what abuse looks like.

 
At Wednesday, July 12, 2006 4:42:00 PM, Blogger Bob said...

"Maybe it would be helpful to take a step back, forget the words 'child abuse', and talk about what is really meant."

If you don't like the words, "child abuse," you can call it a "zucchini." Your language doesn't change the violent sexual mutilation of innocent little children, just about the worst kind of sexual child abuse imaginable short of murder. That is what is really meant.

Those who hack up the sex organs of helpless little children ought to be prosecuted and punished to the full limits of the law.

Doctor heal thyself!

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 4:50:00 PM, Blogger Bob said...

"How can it be? No harm is done (there are numerous claims of harm, but nothing that holds up to scrutiny)."

Sorry to burst your bubble bub, but hacking off part of someone else's body is serious harm.

But just for the sake of argument let's try yours on for size:

Hack off your hand and you can still walk, no harm done there.

Hack off your legs and you can get a wheelchair and still get around. No harm done there.

Hack off your head and you can't think, but you don't think anyway, no harm there.

No, buster, your argument that hacking off someone else's body parts causes no harm is fatally flawed. Cutting off body parts IS HARM! It is real serious HARM!

If you still aren't convinced come over here and hold out your hand. I can get my sword and explain it to you up close and personal.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Wednesday, July 12, 2006 6:01:00 PM, Anonymous Anonymous said...

"How can it be? No harm is done (there are numerous claims of harm, but nothing that holds up to scrutiny)."

I can NEVER for the life of me, understand how people can be so blind about what 'harm' is. My God. It is so simple. It is physical and mental damage. Circumcision includes both. Harm is destroying apart of another person's healthy body against his will. It is the aggressive & painful destruction of healthy normal body tissue on a defenseless child. There is absolutely no medical, moral, or cultural justification for it what-so-ever. You can justify it from now until you die....it is wrong to hurt babies. It is wrong to hurt babies. It is wrong to hurt babies.

 
At Wednesday, July 12, 2006 8:52:00 PM, Blogger Maurice Bernstein, M.D. said...

"If you still aren't convinced come over here and hold out your hand. I can get my sword and explain it to you up close and personal."

Bob, just as you would delete anyone making threats on your own blog, I look at your last sentence as a threat and it is not funny. You can write in a civil and non-threatening manner or if not you and any other visitor who writes likewise is out of here! Bob, it dumbfounds me how you can order civility by visitors on your own blog but not be civil on mine. ..Maurice.

 
At Wednesday, July 12, 2006 9:03:00 PM, Blogger Bob said...

Dear Maurice,
It never ceases to amaze me how anyone can consider someone who practices or defends the violent sexual torure and mutilation of little children as "civil." Advocacy of extreme cruelty to children is not civil by any stretch of imagination.

Unfortunatly there is not the least concept of the meaning of "civility" or "ethics" anywhere on this blog. A decent ethical human being would be screaming for the extreme violence against children to stop and the evil perpertrators who hurt children be punished for their crimes. Its no wonder that so many people have come to realize that the medical industry lost its ethical guideposts a century ago and has no ethical values nor moral compass.

 
At Wednesday, July 12, 2006 9:40:00 PM, Blogger Maurice Bernstein, M.D. said...

I am asking those who write about circumcision show civility (politeness, the act of showing regard for others)in their writings. I am not defining the subject matter, circumcision, as civil. I am defining how a person writes about the subject. That means no ad hominem remarks and no personal threats and consideration for the views of others. Simple courtesy in communication. ..Maurice.

 
At Wednesday, July 12, 2006 10:45:00 PM, Anonymous Anonymous said...

There is no justification for the circumcision of male infants. It was instituted in the US in the 1870's to "cure" masturbation. By the 1920's it was realized that masturbation was not harmful and that circumcision did not prevent it. The practice should have ended there and then. But for some reason, the medical establishment felt obligated to find other reasons to continue it. Hygiene, prevention of VD, prevention of urinary tract infections, prevention of cancer, and most recently, pervention of AIDS have all been invoked as rationalizations for what is really an ingrained sociological custom.
It is interesting that no studies have been done on circumcised women to see the effects on incidence of vulvar cancer or transmission of AIDS. This illustrates that the studies done on men are after-the-fact attempts to rationalize an entrenched custom. They are not about medicine. Not really.
It is also interesting that doctors continue to perform this operation on the majority of male infants in the US, despite the fact that AMA, and APA no longer support it. This is about habituation.
The circumcision of girls has been made illegal in the US, despite the fact that it iss not practiced here. It is only right that boys be afforded the same protection.

 
At Thursday, July 13, 2006 12:24:00 AM, Anonymous Anonymous said...

Mmmm, well. . .since, on the one hand, my original post has gone without a response, but, on the other hand, there's been a lot of other posts in the meantime, I guess I can replicate my original post without feeling, on the gripping hand, like I'm spamming.

So.

Um, excuse me?

Isn't the argument for the justifiability of 'prophylactic male prepucectomy' necessarily based upon the assumption that the male prepuce is vestigial, i.e. functionally irrelevant and meaningless tissue?

Maurice, if I could at least have a dialogue with you in particular about this, I would really appreciate it.

 
At Thursday, July 13, 2006 2:41:00 AM, Anonymous Anonymous said...

Bob,

"If you don't like the words, "child abuse," you can call it a "zucchini." Your language doesn't change the violent sexual mutilation of innocent little children, just about the worst kind of sexual child abuse imaginable short of murder. That is what is really meant."

Sure, I understand that you feel that way. I call it a minor surgical procedure. To be honest, I don't think that you're helping your position by using such hystrionics.

"No, buster, your argument that hacking off someone else's body parts causes no harm is fatally flawed. Cutting off body parts IS HARM! It is real serious HARM!"

No, that's change. Whether it's harm or not depends upon the consequences. The examples you chose were cases in which the body part had obvious utility - hands allow us to do many things, and the harm of their removal comes from the inability to take part in these activities.

That's what I'm asking for: clear evidence of harm, as in reduction of value or inability to perform some activity.

 
At Thursday, July 13, 2006 6:33:00 AM, Blogger Bob said...

This discussion reminds me of the fictional work "120 Days" by Marquis de Sade. In his fiction psychosexual perverts hacked up the sex organs of children for their own demented gratification. For his evil fiction, de Sade was sent to prison where he spent the rest of his tormented life.

There are some real difference between the horrors discussed on this forum and the evil that de Sade wrote about.

The big difference is that de Sade's characters were fiction. These evil perpetrators are real and the screams of the mutilated little children are real.

In 120 Days, de Sade's characters kidnapped children and hid them away in a castle to avoid public knowledge of their demented acts. Even the twisted mind of de Sade couldn't imagine such evil being done with public knowledge. But today they openly hack up little children's sex organs and pretend that it's acceptable. They have "polite, civil" discussions about evil that two centuries ago couldn’t' be openly written in fiction without the author being sent to prison.

In 120 Days, de Sade's characters hacked up the sex organs of a few dozen children. Today they sexually mutilate children by the millions.

I am left wondering. If writing the fictional account of sexual torment and mutilation of children is a crime that decent society punishes by sending the author to prison, what should the punishment be for the abject evil that openly performs the horrors of the fiction?

 
At Thursday, July 13, 2006 7:41:00 AM, Anonymous Anonymous said...

I am assuming there are actual victims of this crime in here. There are also perpetuators of this crime in here. Dr. Maurice, how can you expect victims of this horrific crime to be polite and civil? I understand that you are just trying to be a good moderator here, abd maintain 'the peace' but would you ask a woman to be polite and civil to her rapist if she had the chance to confront him? The victims of this crime must be polite and civil when they discuss their childhood torture? The victims of this crime must be polite and civil when they discuss their sexual rape in infancy? The victims of this crime must be polite and civil when they discuss the evil done to them by men in white coats when they were too helpless to defend themselves? The victims of this crime must be polite and civil when they discuss the cruelty that was inflicted upon them as an infant? The victims of this crime must be polite and civil when they discuss the gross injustice done to their bodies? The victims of this crime must be polite and civil when they were denied a choice in this matter?

I am speechless. I am sure that must 'work' for you though.

 
At Thursday, July 13, 2006 7:45:00 AM, Blogger Maurice Bernstein, M.D. said...

To those visitors who have asked me to engage in discussion about aspects of the male circumcision issue, I thank them for their request but I have to decline. I must admit that in my entire medical career, male circumcision was not a medical or social issue in my thinking or my practice. I have never performed circumcision and more importantly for some on this thread, I have never ever recommended circumcision. Further, this thread on my blog was not started by me but started by other visitors on the “I hate doctors” thread.

With regard to the issue of male circumcision, as yet, I have no opinion one way or the other. I am still trying to learn the facts by those writing to my blog. I therefore have nothing to contribute to the issue itself at this point.

Nevertheless, I can say that I find the very manner of expression of views by some of my visitors is of such a character to turn off rather than turn on other visitors, including myself. (You don’t forcefully pound someone over the head with your arguments and expect them to remain conscious.) As a physician long in practice, I see an almost pathologic fervor and anger expressed by some of my visitors on the topic. If this represents a daily expression in their private lives as well as here on the blog, I worry for them about their social relationships and personal medical health. Such chronic long-standing anger is not at all healthy in terms of mental health and cardiovascular disease as examples. I would give the following medical advice: “cool it!” ..Maurice.

 
At Thursday, July 13, 2006 7:50:00 AM, Anonymous Anonymous said...

See no evil, the situation is that only one 'side' believes that any crime took place at all. The purpose of the discussion is to determine whether it is indeed a 'crime'. If you or anyone else insists upon presuming that outcome, and refuse to act reasonably in the process, then you are sure to fail in attempting to convince others of your position.

 
At Thursday, July 13, 2006 8:21:00 AM, Anonymous Anonymous said...

“the examples you chose were cases in which the body part had obvious utility.”

That’s exactly what the argument is in a ‘nut’shell Jake. The Anti-circ crowd feels that the male foreskin DOES have obvious utility. We know that you feel that it doesn’t.

By advocating routine infant circumcision (RIC), you advocate for the removal of all male foreskins based on the personal assumption that the forskin serves no real purpose and has no real function or value. Whether or not it does have function or value is really besides the point here.

By taking this platform you advocate that an individual NEVER get the chance to research this for matter for himself and NEVER get the chance to make an educated decision for himself about what the utility of the foreskin might or might not be.

Who’s penis is it?

Doesn’t it make sense that the ‘owner of the actual penis’ be the final one to judge whether or not the foreskin has any utility? None of us would be here right now arguing if we just let the owner of the penis be the final judge in the matter.

Why is it so threatening to give someone that choice? I just don’t get it.

Your EXTREME position to deny all men the chance to make up their own minds about whether or not their foreskin has any utility or not is without a doubt characteristic of communist rule. You are advocating for absolute power over the individual’s body…there is no trace of democratic principals in that stance at all. I take it you must abide by communist values. I live in the US, we have been reared to believe in Democracy and place the highest value on our personal freedom.

By advocating RIC, you advocate for the removal of all male foreskins. You deny the individual involved an actual choice about it, by imposing your biased viewpoint that the foreskin has no utility at all. There is no justice in that for the man who owns the penis and must live with your decision.

 
At Thursday, July 13, 2006 8:46:00 AM, Anonymous Anonymous said...

I am saddened by not at all surprised that you Dr. M. coldly dismiss the valid emotions of the people here who think that circumcision is wrong. I am getting rather bored of you claiming that you don’t have an opinion on the matter. I think that’s a cop-out. I find it incredibly hard to believe that a grown man (of the Jewish faith) and with a medical degree has no opinion on the matter by this point. I think that your callous dismissal of the feelings expressed by the anti-circ crowd here is evidence enough for me about what your position is on this matter. You can claim that it is the ‘raw emotion’ of the anti-circ argument that turned you off…but you had your mind made up from the get-go.

What we really need is a moderator that is actually neutral...not just one claiming to be neutral. Perhaps this kind of moderator wouldn't be so quick to dismiss the legitimate feelings expressed by those who oppose male genital mutilation.

 
At Thursday, July 13, 2006 8:49:00 AM, Anonymous Anonymous said...

See no evil, I'm afraid that you misunderstand my position. I don't even advocate elective, let alone routine infant circumcision. What I do advocate is informed decision-making on the part of parents.

Now you are correct in stating that, in my judgement, the foreskin has no real purpose, function or value, but it does not follow from that that they all be removed. However, any argument predicated on the idea that it has these qualities is unlikely to be convincing to me. There are three possible choices:

1. Find convincing evidence that it has these qualities.

2. Adopt a different argument that does not rely on them.

3. Ignore me. :-)

 
At Thursday, July 13, 2006 8:51:00 AM, Blogger Bob said...

Dear Dr. Maurice,

You said, "As a physician long in practice, I see an almost pathologic fervor and anger expressed by some of my visitors on the topic."

You blame the victims of the abject horror of sexual mutilation for their anger. You look the other way and pretend that the evil sexual crimes against children are something to "make up my mind" about. You are the one who fails the test of civility, of compassion, and even of reality. Your comment is an example of the kind of callous disregard for real people and real suffering that is why so many people hate doctors. Whether you hold the knife yourself or merely look the other way while your colleague hacks up another child is irrelevant. You are part of the medical establishment and share their collective crime.

It's not the many angry people who are the problem, Doctor. It is the violent sexual child abusers who are the problem. They, the ones who hurt little children for sick sexual gratification and money, are the ones who need the psychological reassignment. They are the reason for the anger by decent people. They are the criminals who have hurt so many. And you, Dr., by your cavalier attitude and "I haven't made up my mind" crapola about massive medical malpractice are PART OF THE PROBLEM!

In almost half a century of angry men talking nice and polite to the medical business you doctors have closed your ears and turned your backs and continued the massive crimes against children.

In almost half a century of organized groups asking politely for the violence done to children to be ended, you doctors have ignored every one and continued the evil child abuse. You "haven't made up my mind" while the children scream and the money keeps pouring in.

No, doctor, your studied indifference to the screams of the children and the angry shouts of decent people have gone unheard far too long. The time for you to listen politely and clean up your own profession is over. It's time for decent citizens to take action, by whatever means necissary, to clean up the feasting filth and stop your horror show against our children.

After almost half a century of being nice, being polite, and being totally ignored, decent people are no longer going to be nice with your kind of Holocaust against children. It is time for decent people to make you and your kind change. Evil that feeds on the tortured flesh of children can not be allowed to continue. That kind of tormented evil does not deserve to live on the streets with decent human beings. They must be eradicated to save our children.

Maybe thirty years in the slammer or a nice tight rope will get your attention. Polite words certainly have not and will not.

 
At Thursday, July 13, 2006 9:42:00 AM, Blogger Bob said...

Maurice,
I have taken the liberty of posting some of Bob's comments on The World According to Bob, along with a quote of your response, for the benefit of Bob's regular readers. I have also invited them to come here and add their comments on MGM to your discussion.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Thursday, July 13, 2006 10:46:00 AM, Anonymous Anonymous said...

Dr. Maurice,

You say that you have no opinion one way or the other so far. I wonder what it would take to convince you? It's been established by the AMA that the benefits of circumcision are at best minimal and do not outweigh the risks and complications. Common sense tells us that the foreskin is a product of natural selection and is therefore there to serve a purpose. Surgical removal of a body part needs a strong justification. If a body part is healthy then what is the justification for removing it? If you look at the overall picture it becomes obvious that circumcision is being done for social, not medical reasons.
Simple common sense dictates that if it ain't broke, don't fix it.
So why are you reluctant to put an end to this practice? I'm curious.

 
At Thursday, July 13, 2006 11:01:00 AM, Anonymous Anonymous said...

"It's been established by the AMA that the benefits of circumcision are at best minimal and do not outweigh the risks and complications."

Actually, they have stated no such thing. Why do you feel the need to present your opinions as theirs?

 
At Thursday, July 13, 2006 11:55:00 AM, Blogger Bob said...

Jake Waskett said.."What I do advocate is informed decision-making on the part of parents."

Isn't that what Andrea Yates said?

Sorry Charlie, parental authority is not an excuse for child abuse. Cutting up children's sex organs, doing permanent physical sexual injury to a child, can not be justified by parental authority.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Thursday, July 13, 2006 12:20:00 PM, Anonymous Anonymous said...

Quote: “In 120 Days, de Sade's characters kidnapped children and hid them away in a castle to avoid public knowledge of their demented acts… I am left wondering… If writing the fictional account of sexual torment and mutilation of children is a crime that decent society punishes by sending the author to prison, what should the punishment be for the abject evil that openly performs the horrors of the fiction?”

The book referred to was written, if I have this correct, in 1784 and not published until 1904. Was it written by de Sade while he was in prison or was he in prison because he wrote it? Patients are at a disadvantage when trying to communicate with the healthcare community because it holds the power. Each detail must be correct or it is easy to discredit an argument. I am not sure which is true/ was he in prison for writing the book or did he write it while in prison?

 
At Thursday, July 13, 2006 1:10:00 PM, Anonymous Anonymous said...

I got here through a link from bobstruth.

I see one of the earliest comments repeats the canard that MGM is medically justified as a measure against AIDS. In a word, that's nonsense.

Genital mutilators have a long history of inventing spurious medical justifications for MGM. When it first came to America, it was touted as a measure against masturbation. Of course no sane person would hold this today, so they've hopped from one spurious justification to another. In just the past 20 years or so, they've touted MGM against penile cancer - rare enough that any such justification is meaningless - to urinary tract infections (UTIs)- which the alleged connection turned out to be just a lie - and now to AIDS.

Specifically, AIDS "statistics" from Africa. I put "statistics" in scare-quotes deliberately, because AIDS statistics from Africa are essentially nonsense. They are "diagnosed" on a 12 point scale. The patient doesn't need to be HIV-positive or have Karposi's sarcoma or anything of the kind. An example of how very non-specific the scale is: Significant weight loss plus chronic fatigue alone is worth 6 points. Add a chronic cough and you're up to 8 points if I rememeber correctly, two thirds of the way to an AIDS diagnosis. Meaningless.

Plus you have to ask yourself, if 10 years ago there were 30 (?) million AIDS cases in Africa, and surely very few of them would have survived 10 years, where are 30 million deaths?
They just aren't there.

So the latest MGM excuse rests on a completely meaningless foundation. Of course. Like all those before it, is just a lie.

 
At Thursday, July 13, 2006 1:13:00 PM, Anonymous Anonymous said...

Jake Waskett said.."What I do advocate is informed decision-making on the part of parents."

This utterly misses the point. Parents do not have a right to mutilate their children, regardless whether they are informed or not.

 
At Thursday, July 13, 2006 1:14:00 PM, Anonymous Anonymous said...

Jake Waskett said...
"It's been established by the AMA that the benefits of circumcision are at best minimal and do not outweigh the risks and complications."

Actually, they have stated no such thing. Why do you feel the need to present your opinions as theirs?
________
Jake,

Okay, here is the exact quote from the AMA policy:

"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision, however these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's well-being, parents should determine what is in the best interest of the child."

The phrase: "These data are not sufficient to recommend routine infant circumcision" says to me that the "potential benefits" are minimal, as does the phrase "...the procedure is not essential..." I think it can be inferred from the paragraph that the benefits do not outweigh the risks. If they did, the decision-making would not be deferred to the parents.
Savvy?

 
At Thursday, July 13, 2006 1:17:00 PM, Anonymous Anonymous said...

"n just the past 20 years or so, they've touted MGM against penile cancer - rare enough that any such justification is meaningless - to urinary tract infections (UTIs)- which the alleged connection turned out to be just a lie"

What a startlingly misinformed comment. Far from being a lie, every single study to investigate the issue has confirmed the protective effect against UTIs, with a remarkable degree of consistency - approximately 1/10th the risk. Please see Singh-Grewal et al's recent meta-analysis.

 
At Thursday, July 13, 2006 1:22:00 PM, Anonymous Anonymous said...

Jake Waskett said.."What I do advocate is informed decision-making on the part of parents."

'This utterly misses the point. Parents do not have a right to mutilate their children, regardless whether they are informed or not'.

Exactly what I was intending to say to him as well. Thank you.

 
At Thursday, July 13, 2006 1:23:00 PM, Anonymous Anonymous said...

"The phrase: "These data are not sufficient to recommend routine infant circumcision" says to me that the "potential benefits" are minimal,"

What it actually means is that the magnitude of the benefits alone is not sufficient to warrant recommending the procedure for all baby boys. It is thus wisely left to parental discretion.

"as does the phrase "...the procedure is not essential...""

Funny, I would have thought that meant it was not essential. Like vaccinations, for example.

"I think it can be inferred from the paragraph that the benefits do not outweigh the risks. If they did, the decision-making would not be deferred to the parents."

Like vaccinations? Oh, wait, that decision is left to the parents, isn't it? So does this mean a) that the benefits of vaccination do not outweigh the risks, or b) that your line of reasoning is faulty?

 
At Thursday, July 13, 2006 1:26:00 PM, Anonymous Anonymous said...

"This utterly misses the point. Parents do not have a right to mutilate their children, regardless whether they are informed or not"

Ok, is circumcision mutilation at all? I would say that it isn't, so the point is irrelevant to the subject. Knowing, however, that many anti-circ activists use the term 'mutilate' as a synonym for 'circumcise', isn't that question precisely what we're discussing? If so, isn't this yet another example of begging the question? And if so, is this 'point' even worthy of an answer?

 
At Thursday, July 13, 2006 1:29:00 PM, Anonymous Anonymous said...

Maurice Bernstein, MD wrote:
"Nevertheless, I can say that I find the very manner of expression of views by some of my visitors is of such a character to turn off rather than turn on other visitors, including myself. (You don’t forcefully pound someone over the head with your arguments and expect them to remain conscious.)"

There's some truth in this. And it's not the first time I've encountered that sort of reaction to anti-MGM views. On the other hand, you mustn't let yourself be ruled by mere inertia. The status quo is just wrong.

"As a physician long in practice, I see an almost pathologic fervor and anger expressed by some of my visitors on the topic."

Certainly fervor and anger, yes. I think "pathological" is a stretch. We are victims of a serious crime committed against us when we were too young to defend ourselves. The crime is still continuing against helpless babies. And individuals profiting from the crime offer disingenuous excuses for it, even to our faces.
There's nothing pathological in being outraged about that. Any decent person would be.

Certainly there are those who prefer blissful ignorance, who prefer to accept what was done to them and ignore the ongoing crime. They have a right to feel that way. But they are not better for it.

 
At Thursday, July 13, 2006 1:41:00 PM, Blogger Bob said...

Jake Waskett said... "Now you are correct in stating that, in my judgement, the foreskin has no real purpose, function or value"

That is a totally irrelevant argument Jake, in fact it's a red herring designed to divert discussion. It doesn't matter whether or not you or the parents or some hired baby butcher thinks the child's body parts are "useful" or not. Its not your body!

What you have been insisting on is the removal of rights of boys and men to decide for ourselves what part of our body is important or useful to us, and what parts aren't. You argue to deprive boys and men of our rights so you and hired baby butchers can deprive us of our body parts that you or someone else decides to hack off.

You repeatedly claim to believe that it is not the person who's body is being cut's right to decide. You argue that someone else, parents for example, should decide for the person having body parts hacked off. Like I said before, Jake, I'm willing to test your argument. Let's see if it holds up for you and your body. I'm willing to decide for you whether or not your body parts are useful and needed, or not. I can assure you that I am very well informed and can make an "informed decision" on these matters.

If you are truthful about your argument you will come here and let me decide which if any of your parts are useless and need to be cut off. If you are not being truthful you will be unwilling to relinquish that control.

Which is it Jake? Do you believe that you should have control of what parts of you are cut off of your body? Or, do you believe that you have no right to make that decision? Time to put your body where your mouth is.

 
At Thursday, July 13, 2006 2:02:00 PM, Anonymous Anonymous said...

Pro Circ Moderator says:

“Nevertheless, I can say that I find the very manner of expression of views by some of my visitors is of such a character to turn off rather than turn on other visitors, including myself. (You don’t forcefully pound someone over the head with your arguments and expect them to remain conscious.) As a physician long in practice, I see an almost pathologic fervor and anger expressed by some of my visitors on the topic. If this represents a daily expression in their private lives as well as here on the blog, I worry for them about their social relationships and personal medical health. Such chronic long-standing anger is not at all healthy in terms of mental health and cardiovascular disease as examples. I would give the following medical advice: “cool it!” ..Maurice.”

I have been thinking more and more about this statement of yours. It is extremely disturbing & twisted to me. You sit up there on your high pedestal and blame & pity the people who have suffered from the gross injustice of genital modification!

You blame them for being RIGHTFULLY angry over their butched genitals!

Are you sick doctor? Me thinks so.

Blaming the victim. How outrageous of you! How dare you arrogantly dismiss the collective anger of a crowd of people that cries “STOP CUTTING US WITHOUT OUR CONSENT”! How dare you lecture us about ‘chronic long-standing anger’ not being good for our mental health. If you really gave a damn about anyone’s mental health, you would find it in your cold clinical heart to show some compassion here. Which you clearly can’t. How dare you condescend to us by giving us some of your sick medical advice to “cool-it”. You are one of the most distastful and smug MD’s I have EVER had the unfortunate expierence of talking to. What a vile taste you leave in my mouth.

 
At Thursday, July 13, 2006 2:05:00 PM, Blogger Bob said...

Jaine asked about de Sade's prison terms, "Was it written by de Sade while he was in prison or was he in prison because he wrote it?"

I'm not an expert on de Sade by any means, but my understanding is both are true. Apparently de Sade began writing 120 days and other works while in the Bastille prison immediately before the French Revolution, and is said to have been partly responsible for inciting the riot that is now known as "Storming the Bastille." He was released from prison and held some functionary positions in the new French republic. A few years later Napoleon had him arrested for his "obscene" literature and he spent the rest of his life in prison or insane asylums. His literature about the mutilation of children was so bad that he was thought to be insane for having written it.

Today, the same kind of evil sexual mutilation of the sex organs of children goes on in uncounted numbers. What was once thought "insane" and criminal even to write is now common place.

The sadistic cruelty of MGM goes on and on. Millions of helpless little children scream as their tender organs are brutally maimed for perverted sadism or cruel profits.

Bob

Catch more of The World according to Bob at: http://bobstruth.blogspot.com/

 
At Thursday, July 13, 2006 2:09:00 PM, Anonymous Anonymous said...

The foreskin is not an evolutionary mistake. The foreskin has numerous protective, sensory, and sexual functions.


1.Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands -- glands that produce the sebum, or oil, that moisturizes our skin.11 The foreskin produces the sebum that maintains proper health the surface of the glans.

2.Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.12 Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface.13 Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infection.14

3.Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.15 These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.16,17,18,19,20,21,22,23

4.Coverage during Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

5.Self-stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

6.Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.

7.The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.24 Researchers at the University of Manchester found that the human foreskin has apocrine glands.25 These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.
Source: http://www.mothering.com/articles/new_baby/circumcision/against-circumcision.html


If American doctors were better educated on the functions of the foreskin they would not see it as "extra skin" which can only cause problems.

85% of the men worldwide are NOT circumcised. Circumcision was popularized in America in the Victorian era as a "cure" for masturbation and then touted as a cure for everything from bedwetting to poor eyesight. Doctors simply could not accept that cutting off a fully functional part of male genitalia was a bad idea so even now we see these very poorly designed and terribly flawed and misleading "studies" which tout circumcision as a way to reduce HIV, HPV, and UTI's.

Circumcision does not offer significant reduction of UTI risk.
The American Academy of Pediatrics (AAP) has issued two statements which, when read together, constitute a substantial change in AAP policy toward the prevention of UTI in infants. First, in 1997, the AAP Workgroup on Breastfeeding recommended breastfeeding as highly beneficial in preventing a wide range of infections including UTI.44 Second, in 1999, The 1999 AAP Task Force on Circumcision abandoned the previous stance of the 1989 Task Force on Circumcision that circumcision may provide protection against UTI.52 The 1999 Task Force found that the bulk of the UTI studies were so methodologically flawed—by failing to control for confounding factors such as breastfeeding—that no meaningful conclusions could be drawn from them.52 The 1999 AAP Task Force on Circumcision could not, therefore, recommend circumcision to reduce UTI (or any other disease).

The 1999 AAP Task Force on Circumcision did, however, declare that breastfeeding produces a three fold reduction in UTI in infants. Two separate panels of the AAP, the Work Group on Breastfeeding and the 1999 Task Force on Circumcision, now recommend breastfeeding to reduce incidence of UTI.44,52 As Outerbridge points out, breastfeeding is very effective in reducing incidence of UTI in both boys and girls.45

The circumcision proponents now claim that circumcision is necessary to prevent UTI because UTI can cause renal failure.53 However, new evidence has disproved even that claim.51,53
Source: http://www.cirp.org/library/disease/UTI/

The only studies to show a significant difference in the rates of UTIs in circed vs intact boys was also inherently flawed- the group which was labeled as "intact" for the study consisted of mainly preemies who are more prone to infections of all kinds and the circed group consisted of full-term healthy babies. Obviously the preemies are going to have a higher rate of UTIs than normal term babies. It has nothing to do with circumcision status.

If circumcision protected against HIV or HPV why does America have a higher rate of both than European countries where none of the men who are not Jewish are circumcised?

The studies which have indicated a reduced risk of HIV transmission are inherently flawed in design. The rearchers took a group of African men and circed one group and left one group intact- then they tested the groups for a certain period of time following surgery. The men in the circed group obviously could not have sex for some time due to recovering from surgery. So essentially you have one group of men having more sex than another group and you wonder which group will come up with more cases of HIV? Obviously the group which had more opportunities to have sex with women who have HIV- the intact group. There is nothing inherent about the intact penis which predisposes it to HIV infection.

The AAP now states that they do not recommend routine circumcision. It is a cosmetic procedure performed on an unconsenting minor. That is unethical. If I am worried my daughter might get breast cancer sometime in her life can I just opt for a newborn mastectomy? When will parents and doctors realize that the only person who has the right to alter the genitals is the person to whom they belong? My 17 month old son is intact and has never had a UTI. I believe it is his right to decide if he wishes to be circumcised or not. He can have it done if he wishes, but if I had allowed him to be circumcised at birth then he would have no choice and would have to live with my decision for the rest of his life.

In Africa many look at female genital mutilation as "cleaner" and "prettier" and many mothers want for their daughters to be "circumcised." This is appalling to many Americans. How can we be horrified at people cutting off parts of the female genitalia when everyday foreskins are ripped from the glans of little baby penises and cut off, reducing future sexual sensation.

Why can't people just leave genitals that don't belong to them alone and intact?

 
At Thursday, July 13, 2006 2:18:00 PM, Anonymous Anonymous said...

I think Jake feels it's ok to cut boys, but NOT girls.
I think the "MD" would agree too.

Am I correct here 'gentle'men?
It is one sided.

Girls genitals are superior to boys genitals! It's really that simple to them.

You may cut a boys genitals but YOU MAY NOT cut a girls genitals.

Boys do not have the same rights as girls...this is common knowledge.

 
At Thursday, July 13, 2006 2:48:00 PM, Anonymous Anonymous said...

First, thank you Bob for answering my question.

Second, am I reading different posts than other people? Where has the moderator stated he is pro-circ? Is this a creative writing blog? I thought the moderator stated he was undecided, had not performed the procedure, nor had he encouraged parents to choose it. How exactly does this translate into pro-circ? Since when does being undecided about something mean a person is ‘pro’ or otherwise? I need to know exactly when that rule came in so I can estimate how long I’ve been pro-this-and-that without being aware of it.

 
At Thursday, July 13, 2006 3:15:00 PM, Blogger Bob said...

Well, See no, hear no, according to the AMA girls are a "group of patients" for whom the AMA has humanitarian concerns. A million boy, on the other hand, are not "a group of patients" or perhaps not even human, according to their AMA Trustee who is quoted in an article on genital mutilation in their official publication:

From the AMA in their American Medical News, Vol 39, No 40, dated October, 1996.

"We as humanitarians and particularly as gynecologists, cannot allow females or any group of patients to be mutilated. I'm afraid that this is even more basic than religion. This is humanitarian." John C. Nelson, MD, AMA Trustee.

You are right hear no, see no. At the AMA and for their baby butcher members, boys aren't even human and have no rights.

 
At Thursday, July 13, 2006 3:17:00 PM, Anonymous Anonymous said...

Maurice said: "To those visitors who have asked me to engage in discussion about aspects of the male circumcision issue, I thank them for their request but I have to decline. . .as yet, I have no opinion one way or the other. I am still trying to learn the facts by those writing to my blog. I therefore have nothing to contribute to the issue itself at this point."

Um, but, Maurice. . .that's exactly why I asked you to engage in a dialogue with me ITFP. That's the very reason itself why I asked my question -- to inform and educate.

I prefer to ask questions -- and respond to them -- rather than just make assertions; I find the former method much more informative and educational, while the latter tends too often to descend into pointless, childish "'Yes it is!' 'No it is not!' 'Is!' 'Is not!'" wrangling.

Won't you please reconsider? It is increasingly apparent that you are the only person here who is at all likely to acknowledge even just the existence of my original question, and if no one else here will engage me in dialogue, I do not understand how either of us can be expected to learn anything about that area of the subject.

 
At Thursday, July 13, 2006 3:42:00 PM, Anonymous Anonymous said...

As a circumcised male, I think that circumcision should be a crime, punished the same as FGM. My parents and their butcher doctor had no right to take away parts of my penis.
I have an intact son and he has never ever had a UTI. My wife has had several. What parts should we cut off her, doctor??

 
At Thursday, July 13, 2006 3:42:00 PM, Anonymous Anonymous said...

Since baby girls are protected from circumcision then it is sexist to not protect baby boys from circumcision as well. There could always be a provision for Jews, but not for Christians as the New Testament specifically states that circumcision is not necessary.

As the (intact) wife of an intact husband I cannot begin to fathom how the penis even works without the foreskin. The foreskin is such an integral part that I cannot conceive of how circumcised men can have intercourse.

Male genital mutilation was started to prevent masterbation (obviously didn't work!) and so that boys would equate their penis with severe pain. It was started to control men's sexuality. Not something I would want for either a husband or a son and I hope with all my heart that my daughter finds an intact mate someday.

love and peace.

 
At Thursday, July 13, 2006 3:45:00 PM, Anonymous Anonymous said...

One more quick thing... I have had many many UTIs as an intact female - several before ever having had any sort of sexual relations with anyone. My intact husband has had exactly ZERO. Should I then be circumcised? How extreme should my circ be? And in what way exactly would that protect me from future UTIs? The same way being circ'd would supposedly prevent a man from having UTIs?

love and peace.

 
At Thursday, July 13, 2006 3:46:00 PM, Anonymous Anonymous said...

"Um, but, Maurice. . .that's exactly why I asked you to engage in a dialogue with me ITFP."

If Dr. M. is not Pro-circ, why on earth does he need to remain in hiding with his true stance on infant circumcision? Shhhhhh.... it is a big secret! You are not allowed to know it. He will NEVER reveal it to you.

Are we to believe that this bio-ethics professor has 'not made up his mind' yet? I doubt that very seriously. Does he have kids? Are any of them male? Were they circumcised? If they were...he probabally made up his mind at the time of their birth.

In fact, the one & only thing that we do know about Dr. M. and his opinion is that he is quite "worried" about 'our' (the anti-circ crowd I presume) current mental health.

Very clever Dr. M. Very subtle, but very clever.

Anyone for nuts?

 
At Thursday, July 13, 2006 4:17:00 PM, Blogger Bob said...

Getting back to Maurice's original question about the proposed legal ban on MGM, it is essential that boys be given equal treatment under the law. Our current sexist protection of girls but not boys reflects strong cultural bias favoring the rights and privileges of females at the expense of boys and men. A good book on how our culture has legalized this systemic misandry in all aspects of life including medical malpractice one can read a recent very thoroughly documented scholarly book, Legalizing Misandry: From Public Shame to Systemic Discrimination Against Men by Paul Nathanson and Katherine Young.

When the Female Genital Mutilation Act of 1996 was being debated in Congress I corresponded with the misandrist female Senator who was its sponsor. She was polite enough to reply, but her reply amounted to an affirmation that only females mattered in her political career. At the moment I don't recall her name and haven't bothered to find the original correspondence today.

I notice that the currently proposed Federal Prohibition of Genital Mutilation Act of 2006 does not have a single congressional sponsor. Not surprising for a Congress that voted 100% for the VAWA renewal. To our elected representatives, females matter, men and boys don’t'. They won't consider any law that disallows a female's "rights" to harm her son. The Dems are completely misandrist. The Reps are misandrist without exception. None of them of either party will stand with men, with fathers, or speak up to protect children if they are male. Only females matter to Congress. Misandry doesn't get codified into law by accident. Our elected misandrist representatives do it on purpose.

The Federal Prohibition of Genital Mutilation Act of 2006 has to be passed or the violent sexual maiming of millions of boys and men will continue. On this blog we have seen how far the baby butchers are from sanity. They ignore the shouts of angry adults as easily as they ignore the screams of tortured babies. They have simply turned their backs on rights organizations for decades. They have a government protected monopoly drunk with it's abusive power over people, and despite some awareness that many people hate doctors they control life and death of the those who are sick. Power has corrupted them all so thoroughly that only force will get their attention.

The violent sexual mutilation of little children outnumbers all other violent child abuse and all other violent sex crimes combined. They obviously won't stop the evil by themselves. Their evil must be stopped and our children must be protected from their heinous crimes by whatever means necessary.

 
At Thursday, July 13, 2006 4:20:00 PM, Anonymous Anonymous said...

Quote:“If Dr. M. is not Pro-circ, why on earth does he need to remain in hiding with his true stance on infant circumcision?”

Wasn’t the stance “undecided.” Since when does undecided translate into “hiding”? I am obviously processing “Dr.M’s” responses in a different manner than others. No disrespect to the moderator but is his opinion of so much value that others can’t relax until he provides it? Or am I missing something here? If someone tells me they are undecided I take their word for it and provide them with time to decide. This way I know that when they do decide it will have value because they had time to think about it.

 
At Thursday, July 13, 2006 4:39:00 PM, Anonymous Anonymous said...

His stance is 'unknown'.
He can not or will not take a public stance on this issue.

"No disrespect to the moderator but is his opinion of so much value that others can’t relax until he provides it?"

When the 'neutral' moderator takes aim at the mental health of the anti-circ crowd, I am unable to 'just relax' as you say.

Can you process that?

 
At Thursday, July 13, 2006 4:51:00 PM, Anonymous Anonymous said...

Yes, I think I can process that. Although I’m far too lazy to go back and check to see if the first demand for the moderator to respond was made after his comment on physical and mental health. In my opinion members of the medical community do tend to play the mental health card a bit too often. It is an easy card to play. However, take a look at all the cards that have been played on this table before being overly offended.

 
At Thursday, July 13, 2006 6:44:00 PM, Anonymous Anonymous said...

I support the ban on all non-medical circumcisions for children under the age of 18. To me it is a human rights matter. I don't belive religion gives you the right to perform cosmetic surgery on a baby. Doesn't seem that hard to understand to me. We don't allow religious groups to circumcise baby girls, it's the same thing. Over the age of 18, well that is between the man and his penis.

 
At Thursday, July 13, 2006 7:41:00 PM, Anonymous Anonymous said...

Yes, goodness gracious, of course it should be illegal to cut of part of someone else's genitals without his or her explicit consent.

I mean, is that so hard to understand?

If circumcision has some benefit that outweighs the risk in a person's mind (religious, medical, sexual, aesthetic) then certainly a man ought to be able to make the appointment with a qualified surgeon to have it done.

I could decide tomorrow to have my labia removed, but would I support parents deciding to have their daughters' removed summarily?

Er, no.

 
At Thursday, July 13, 2006 8:15:00 PM, Blogger Bob said...

Anonymous said: "As a circumcised male, I think that circumcision should be a crime, punished the same as FGM. My parents and their butcher doctor had no right to take away parts of my penis."

Once again the evil baby butchers won't listen to the loud shouts of angry MEN who hate them for the violence that has been done to our bodies. For a century the evil baby butchers have pumped out a series of misdirection and lies intended to deflect the criticism and persuade vulnerable young women to give up their babies to be sacrificed on the altar of greed and sadism.

One of the troubles is that it takes the baby 20 years to grow up and then usually another several years to figure out that the lies he has been told about his body are just lies. We were sexually mutilated and will never know the joy of normal sexual feelings. By that time the baby butcher who hacked us up has most likely retired or died.

I once knew an angry man who researched the baby butcher who had hacked him up. His goal was to find the sadistic bastard and explain to him in the most forceful way possible that his crimes against children can not go unpunished. Unfortunately the baby butcher had died before my friend could exact punishment. So my friend traveled over 2,000 miles to desecrate the grave of the sadistic slimeball. Of course desecrating the grave of a heinous child butcher won't make his stay in hell any worse, but my friend felt better having obliterated the marker and doing several acts of disrespect there.

About the same time I tried to find the sadistic baby butcher who had cut me up and destroyed my lifetime of normal manly feelings. I could find no trace of any baby butcher sadist by the name listed in my mother's records. I owe him by honor a serious injury, and I would have enjoyed repaying the debt of honor. But, like so many of the evil sadists who prey on little children the intervening years protected him. He was lost from hospital records and from community directories. It has left me wondering if the debt of honor should paid to some other sadistic baby butcher? Let Maurice ponder over that ethical question.

Speaking of Maurice, he claims to be something of a professor of medical ethics. If he had any ethical scrupels at all he would be soundly against the sadistic butchering of little children's sex organs. What Maurice seems to be is a medical industry excuser. His lack of ethical standards is what the medical industry now substitutes for permission to continue its atrocities. It's the same as favoring child mutilation, only it goes by a different name, more politically inoffensive. Whatever he calls it, it's neither ethical nor opposed to the violent sexual mutilation of little children. Men such as myself and the anonymous correspondent owe a debt of honor to those in the baby butchering business who hack up children, make excuses for them, and pretend to be studying ethics while excusing their sadism.

So Maurice, what is the ethics involved with my debt of honor? Since the sadistic baby butcher who did the crime was dead or gone by the time I was old enough to know about the debt, should it be repaid to his replacement or another baby butcher practicing the same sadism on other babies?

 
At Thursday, July 13, 2006 8:32:00 PM, Anonymous Anonymous said...

Help to OUTLAW Male genital mutilation (MGM)!

Sign Here:

http://www.thepetitionsite.com/takeaction/616953036?ltl=1152847585

 
At Thursday, July 13, 2006 8:59:00 PM, Blogger Bob said...

Here is the real "ethics" of hacking up little boys. When in doubt, when the human morality makes no sense, follow the money. The medical business makes billions selling the stolen flesh of little children. Medical "ethics" stooges look the other way as the dollars roll in. If you are a man under age 30, they cut you up and sold your body for profit. The only real "ethics" of these criminal baby butchers is sadism and money.


From: http://www.sexuallymutilatedchild.org/f4sale.htm
Since the 1980s, private hospitals have been involved in the business of supplying stolen foreskins to private bio-research laboratories and pharmaceutical companies who require human flesh as raw research material. They also supply foreskins to transnational corporations such as Advanced Tissue Sciences of San Diego, California, Organogenesis, and BioSurface Technology, who have recently emerged to reap new corporate profits from the sale of marketable products made from harvested human foreskins. In 1996 alone, Advanced Tissue Sciences could boast of a healthy $663.9 million market capitalization performance.

The after market for human foreskin is where the real money is made. Foreskins are sold to biomedical companies, which use them in the manufacture of insulin. They're also sold to middlemen, who package them for sale to research companies that in turn use them for biochemical analysis. Corporations such as Advanced Tissue Sciences (ATS), Organogenesis, BioSurface Technology, Genzyme, and Ortec International are taking cells from amputated foreskins and experimenting with artificial skin. Products like Dermagraft-TC, which sells for about $3,000 per square foot, are grown from the cells in infant foreskins and used as a temporary wound covering for burn patients. One foreskin contains enough genetic material to grow 250,000 square feet of skin.

ICCPR's [International Covenant on Civil and Political Rights, UN GA Resolution 2200 A (XXI)] slavery, forced labor, and traffic in persons includes the industry of a growing number of American medical hospitals and medical professionals colluding with scientific agencies harvesting neonatal foreskins for skin grafts, i.e., as compulsory organ donation.

Associations like Organogenesis (Canton, MA) have received approval from the USA's Food and Drug Administration (FDA) for its foreskin-based GraftskinTM, and has served Western Pennsylvania Hospital, with additional studies conducted at Yale University and Boston University (Stephen Brewer, New Skin Twin Life- and Look-Saver. Longevity September 1992: 18).

Another profit-oriented tissue engineering company, Advanced Tissue Sciences (La Jolla, CA), retrieves foreskins from hospitals so one foreskin can create 250,000 square feet of dermis ... [T]he annual market for dermis could be $1 billion to $2 billion. Advanced Tissue Sciences has sold about $1 million worth of cultured dermis to Proctor & Gamble, Helene Curtis, and other such businesses for pre-market testing. Advanced Tissue Science's foreskin-derived merchandise held a $32 million stock offering in the beginning of 1992 (Julie Pitta. Biosynthetics. Forbes 10 May 1993: 170-171). [The 32-page Advanced Tissue Sciences, Inc. 1997 Annual Report refers to "fibroblasts" but does not contain the word "foreskin."]

A Boston Globe frontispiece to its Business section reads: Companies See $1.5b Market in Replacement Skin Products. This article reveals another enterprise of genital mutilation-cum-scientific advance: BioSurface Technology of Cambridge, MA. All three companies face no shortage of hoarding and retailing foreskins, and are motivated by individuals like Dr. Tania Phillips, professor of dermatology at Boston University of Medicine, insisting foreskin gathering and cultivating is scientifically and technologically "very promising." (Ronald Rosenberg. 19 October 1992: 22-23).

 
At Thursday, July 13, 2006 9:52:00 PM, Blogger Maurice Bernstein, M.D. said...

Bob, I really do appreciate your postings (like the last one) when you provide documentation that can be confirmed to your claims. That is the proper way of supporting your claims. I also want to state that I feel personally injured when a lot of what I read is criticism of me as a moderator for not expressing a view one way or another. What everyone must understand that it is perfectly rational and proper for one to support an argument, to reject an argument or, as in my case, to find value on both sides and take a middle, uncommitted position but looking to move to one side or the other. For someone to accuse me of "burying my head in the sand" when I am looking in both directions for an answer is a wrong interpretation of my behavior. So you may say that the answer is obvious and by my not accepting the answers the majority of the visitors to this blog are writing I am, in fact, supporting your opposition and I am a criminal because of that, even though I have not committed any crime. I am not supporting your opposition. This is America and just as many in America will hold their own views privately or haven't made up their mind even in cases where the majority holds the view, it is our right as an American to be as ambiguous as we want. Now, as a physician and as a citizen I would be responsible to report to authorities any child abuse that was brought to my attention or that I observed. The abuse, which physicians have been instructed to report, does not include a history of male circumcision. It never has been a crime in the U.S. If it becomes law that male circumcision is a crime then as a physician and citizen I would promptly report it so that those who violated the law can be tried and punished.

If you all intend to continue this topic here, please don't attack me personally for everything you don't know about me or suspect about me or use me as an example of those you hate. And those of you, including Bob, who have anger about what was done to you as an infant without your consent, do something about it.. but do it legally. Don't threaten to cut off hands or worse. Take the matters that inflame you as criminal, illegal, unethical to resources that can do something about it: take it to the police, the courts, the state and federal legislature and if you think that the 2006 bill criminalizing male circumcision is the way to go--do everything legally that you can do to get it into law. And think before you write and write words and words which turn into a sea of angry rhetoric that will turn off any intelligent and thoughtful person. Most of what has been written here is not discussion, it is harangue. There have been exceptions by a couple of visitors here and as I mentioned Bob's last post. ..Maurice.

 
At Thursday, July 13, 2006 9:54:00 PM, Anonymous Anonymous said...

he phrase: "These data are not sufficient to recommend routine infant circumcision" says to me that the "potential benefits" are minimal,"

What it actually means is that the magnitude of the benefits alone is not sufficient to warrant recommending the procedure for all baby boys.

Then we agree that the benefits are insufficient to justify this procedure being done routinely, as it is still being done throughout the US.
Surgery should not be the default. It should be performed only when it is a matter of medical necessity.

"as does the phrase "...the procedure is not essential...""

Funny, I would have thought that meant it was not essential. Like vaccinations, for example.

Vaccinations are sometimes essential and sometimes not. They are responsible for the eradication of smallpox and the near eradication of polio, to give two examples of where they were essential. To give children smallpox vaccinations today would be foolhardy because there is zero risk of contracting smallpox and small but real risk of nasty complications.

"I think it can be inferred from the paragraph that the benefits do not outweigh the risks. If they did, the decision-making would not be deferred to the parents."

Like vaccinations? Oh, wait, that decision is left to the parents, isn't it?

Is it? When I was growing up, vaccinations were mandatory for all children. This is decided on a state by state basis. Where there is a clear and present danger of the spread of a dangerous illness like whooping cough, polio or measles, the decision is often made by the state and not the parents.

The point is, while vaccinations have been proven to have overwhelmingly positive benefits, circumcision has not. The various attempts to find medical justification for the practice has led to the cynical observation that circumcision is a solution in search of a problem.

Considering the fact that male infants ssometimes suffer from various complications and occasionally even die from this unnecessary procedure, it should be outlawed, just as it has been for baby girls.

 
At Thursday, July 13, 2006 11:05:00 PM, Anonymous Anonymous said...

MD says…
“I am, in fact, supporting your opposition and I am a criminal because of that, even though I have not committed any crime. I am not supporting your opposition.”

What on earth does this mean? It makes no sense to me. Can you please restate it in another way? The first line seems to contradict the last.

MD says…
“The abuse, which physicians have been instructed to report, does not include a history of male circumcision. It never has been a crime in the U.S.”

Not all injustice has a law in place to prohibit it. That is the point of the www.mgmbill.org, which I doubt that you would support.

MD says…
“And think before you write and write words and words which turn into a sea of angry rhetoric that will turn off any intelligent and thoughtful person.”

MANY intelligent and thoughtful people WILL and DO understand the emotions here. I am sorry that you don’t feel that you belong in those categories.

MD says…
“Most of what has been written here is not discussion, it is harangue.”

&


MD says…
“To those visitors who have asked me to engage in discussion about aspects of the male circumcision issue, I thank them for their request but I have to decline.”

I am really confused now! You want a discussion but you plainly decline to have it too??? What are you asking for here? A discussion or no discussion? Again these two ideas appear to contradict one another.

Quite of few people here feel that we ARE having a discussion Dr. Your interpertation of the matter is that we are ranting and giving you a lecture. That is just your personal spin on the matter.

 
At Friday, July 14, 2006 12:26:00 AM, Anonymous Anonymous said...

If someone strapped you, spread-eagled, against your will , to a board naked...it would be abuse

If someone forcibly peeled back parts of your sex organs that were fused together .... it would be abuse

If somone forced a blunt object INTO your genitals (the glans is an internal organ)... it would be abuse

If someone cut or tied off up to 50% your genital skin that was packed with nerves and blood vessals... it would be abuse

If someone only gave you a pacifier dipped in sugar and maybe some tylenol for the aforementioned pain... it would be abuse

If someone slipped you a roofie before they did this would it make it okay because you "wouldn't remember it anyway?"

If it "really didn't hurt" anyway, would you ever miss this VERY sensitive part of you genitals?



These are legitimate questions, as this is what happens to a defensless newborn every 28 minutes in the U.S.A. Over 80% of the rest of the world is intact.

 
At Friday, July 14, 2006 5:06:00 AM, Anonymous Anonymous said...

Jen wrote: "The foreskin is not an evolutionary mistake. The foreskin has numerous protective, sensory, and sexual functions."

It's interesting that you rely upon highly partisan websites displaying dubious evidence of scholarship, Jen. Let's investigate some of these claims, shall we?

"1.Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands -- glands that produce the sebum, or oil, that moisturizes our skin.11 The foreskin produces the sebum that maintains proper health the surface of the glans."

Let's test this. Can we find evidence of decreased protection (ie, increased risk of infection or inflammation) or sensitivity?

In terms of infection, the reverse is true. As I showed here, there is considerable evidence of increased protection from infection.

In terms of sensitivity, despite this old myth being widely accepted, no study has ever shown it to be true. In fact, every one of the four studies to investigate has found no difference. Here is the most recent.

"2.Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.12"

Actually, no. The author has failed to read his own references, one of which - a histological study of the prepuce - reported that "unlike true skin of the penile shaft and outer surface of the prepuce, the mucosal surface of the prepuce is completely free of lanugo hair follicles, sweat and sebaceous glands." (source) This confirms earlier work, that stated: "A special search was made for glandular tissue. No such tissue was found in the material (part B of figure)," and "Smegma appears to be desquamated epithelial debris collecting in the preputial fold and is not the product of glandular secretion." (source)

I could go on, but it is quite apparent that this source is insufficient for our purposes.

Now, does anybody have credible evidence of functions?

 
At Friday, July 14, 2006 5:15:00 AM, Anonymous Anonymous said...

Leestein wrote: "Then we agree that the benefits are insufficient to justify this procedure being done routinely, as it is still being done throughout the US."

I disagree that it's being done routinely. As far as I'm aware, it is only done electively, with the proper consent being obtained.

"Surgery should not be the default. It should be performed only when it is a matter of medical necessity."

I disagree. I think 'best interests' is a better test.

"Is it? When I was growing up, vaccinations were mandatory for all children. This is decided on a state by state basis. Where there is a clear and present danger of the spread of a dangerous illness like whooping cough, polio or measles, the decision is often made by the state and not the parents."

It may vary by state or time. As far as I'm aware, it's upto the parents (albeit usually with a lot of encouragement).

"The point is, while vaccinations have been proven to have overwhelmingly positive benefits, circumcision has not."

The difference is only in degree.

"The various attempts to find medical justification for the practice has led to the cynical observation that circumcision is a solution in search of a problem."

Such observations are invariably from those who have prejudged the situation.

"Considering the fact that male infants ssometimes suffer from various complications and occasionally even die from this unnecessary procedure, it should be outlawed, just as it has been for baby girls."

That's irrational. Circumcision has a very low complication rate, and it is easy to show that the number of deaths prevented are far, far greater than those caused. If one were to outlaw everything that had an immediate risk, however small, our lives would be considerably poorer (not to mention shorter).

 
At Friday, July 14, 2006 5:23:00 AM, Anonymous Anonymous said...

Several posters have asked whether I am opposed to female circumcision.

I regret that I have not researched this issue as well. I am aware that it is currently illegal in many western countries, but in my view this is insufficient basis to conclude that it is morally or ethically wrong (there are, after all, no shortage of bad laws). In my view, the only valid way to assess the situation is to look at established evidence of benefit and harm. If the procedure has a net benefit or is neutral (like male circumcision), I see no reason to oppose it. On the other hand, if there is a net harm, then I would oppose it.

If someone would be kind enough to summarise the scientific evidence of risks and benefits, I would gladly respond. Since there are several different procedures that are given this title, I would appreciate it if you would clarify what evidence relates to which type.

 
At Friday, July 14, 2006 7:04:00 AM, Blogger Bob said...

Maurice wrote, "Don't threaten to cut off hands or worse."

What's this? Maruice is opposed to cuting up people? His mind "isn't made up" when baby butchers cut off worse from a million children, but he's against Bob cutting up anyone. Again, he demonstrates the kind of studied myopia that comes with his profession. His job is to find "ethical" excuses for medical practices. Any crime, no matter how heinous, is acceptable if done while wearing a white coat. Forget that hacking up children violates the published ethical standards of the AMA and the AAP, as well as the UN's International Accord on the Rights of Children. He "hasn't made up my mind," about baby butchers cutting up a million children, but he is quick to object to the prospect of Bob doing a similar crime to one of his cohorts.

Sorry Maruice, your doubletalk adomintion is not supported by convincing data. Bob hasn't made up his mind about cutting off body parts.

 
At Friday, July 14, 2006 7:13:00 AM, Blogger Bob said...

Some years ago an article in Mother Magazine published an estimate that 300 babies per year are killed by MGM in the USA. Hard data is difficult to find because baby butchers typically write their own "cause of death" excuses, and only rarely attribute the cause of death to their own perverted sexual psychopathy. The official cause of death goes into the records as "infection," which in turn was caused by the sexual mutilation. The count of the dead, 300 per year, is the only published estimate that I've seen so until better data is obtained it's the one I use.

For Jake and Maurice, how do you justify the annual deaths of an estimated 300 healthy normal children? And what do you call it? I call it murder.

 
At Friday, July 14, 2006 7:41:00 AM, Anonymous Anonymous said...

"For Jake and Maurice, how do you justify the annual deaths of an estimated 300 healthy normal children? And what do you call it? I call it murder."

I call it a gross exaggeration of a rare but tragic event. In the US, there are approximately 2 million male births per year, so that would correspond to 0.015%.

Wiswell and Geschke reviewed the records of 136,086 boys. 100,157 of these were circumcised. No circumcised boy died, but two uncircumcised boys died of complications of UTIs. They also report that no deaths occur in a larger group of 300,000 boys. Speert reviewed the records of 566,483 circumcised infants, and found one death. Gee and Ansell reviewed the records of 5,521 circumcised infants, and found no deaths. King reported on 500,000 neonatal circumcisions, with no fatalities. Trevino reports that no deaths occurred in 650,000 circumcised boys.

Thus, a conservative estimate of the true rate is 1 in 500,000, or 0.0002%. This would correspond to 2-3 deaths per year.

Are any deaths acceptable? No. Sadly, however, everyone dies of something. This is a real risk of circumcising, but there are equally real risks associated with diseases that circumcising prevents (or, strictly speaking, reduces the risk of occurrence). Indeed, one can easily calculate that the number of deaths prevented through circumcising is significantly greater.

Refs
Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989 Jun;83 (6):1011-5.
Speert H. Circumcision of the newborn: an appraisal of its present status. Obstet Gynecol. 1953; 2: 164-172
Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics. 1976 Dec;58 (6):824-7.
King LR. Neonatal circumcision in the US in 1982. J Urol. 1982; 128: 1135-36
Trevino S. Personal communication to Wiswell T. 1987

 
At Friday, July 14, 2006 7:53:00 AM, Anonymous Anonymous said...

Jake says...."Several posters have asked whether I am opposed to female circumcision. I regret that I have not researched this issue as well. I am aware that it (FGM) is currently illegal in many western countries, but in my view this is insufficient basis to conclude that it (FGM) is morally or ethically wrong (there are, after all, no shortage of bad laws). "

Wow. You can't even conclude that female genital mutilation (FGM) is immoral or unethical. That's says alot about you. You go on to suggent that the FGM law is a bad law too? Truly unbelievable.

Well, at least you are an equal opportunity genital mutilation promoter.

That's actually amusing. Thanks. :)

 
At Friday, July 14, 2006 8:04:00 AM, Blogger Maurice Bernstein, M.D. said...

Bob writes:"Bob hasn't made up his mind about cutting off body parts." Again, I request as moderator that you do not, as you did in a previous post, imply threats. You clearly would not accept threats on your blog and I don't accept it on mine.

I know from the statistics I am receiving that there are many visitors to my blog and this thread that are not participating. To some of them, some of the commentary written here must seem irrational and unfair. One commonly used method of expression seems to be taking the words of others out of context to make a point. SeeNoEvil,HearNoEvil clearly used this technique on writing: "MD says…
'I am, in fact, supporting your opposition and I am a criminal because of that, even though I have not committed any crime. I am not supporting your opposition.' What on earth does this mean? It makes no sense to me. Can you please restate it in another way? The first line seems to contradict the last. In context, if the entire sentence was reproduced, I had written "So you may say that the answer is obvious and by my not accepting the answers the majority of the visitors to this blog are writing I am, in fact, supporting your opposition and I am a criminal because of that, even though I have not committed any crime. I am not supporting your opposition." What I wrote was the way I was being judged, by remaining silent I was supporting the opposition. What in effect was done was to take my statement out of context in order to show that I am confused and unable to make a consistent point.

I want to make this perfectly clear: I am critical of neither side of this issue. I haven't learned all the facts. I never started this thread but I am interested to read the documented facts that Jake and occasionally even Bob have presented. I AM HIGHLY CRITICAL HOWEVER OF HOW SOME OF THE VISITORS ARE HANDLING THE PROCESS OF DISCUSSION. The process of discussion demands openness NOT anonymity, fairness NOT personally attacking an individual because of religion, profession or views. In addition, completeness in the presentation of what is described as facts such include not only documentation of the sources but a faithful summary or conclusion of the original. And finally,use your words with care. ..Maurice.

 
At Friday, July 14, 2006 8:05:00 AM, Anonymous Anonymous said...

"Wow. You can't even conclude that female genital mutilation (FGM) is immoral or unethical. That's says alot about you."

I sincerely hope so. I would not want to be a person who made knee-jerk reactions. I prefer to make calm, considered analyses in light of all the available evidence.

"You go on to suggent that the FGM law is a bad law too? Truly unbelievable."

I'm not saying that it is bad. I'm saying that one has to remain open to that possibility. Assuming that something is wrong because it is illegal, in effect, says "I am not able to make this decision myself. I need politicians to tell me what is right and wrong." It is also logically equivalent to assuming that something is right because it is not illegal - does that mean that rape or murder are perfectly ok as long as you're in a country without laws prohibiting them?

 
At Friday, July 14, 2006 8:32:00 AM, Anonymous Anonymous said...

MD says:
"What I wrote was the way I was being judged, by remaining silent I was supporting the opposition. What in effect was done was to take my statement out of context in order to show that I am confused and unable to make a consistent point."

Actually I wasn't trying to do that at all Dr. I AM CONFUSED about your statement. Even when I put your statement into context, it doesn't make sense to me. This is why I asked you to clarify it please. I understand that you are trying to say that you support the opposition with your silence. I guess one is to assume that if you broke your silence it might be a different story. In any event, your post is still confusing to ME, because of these two opposing statements:

MD says...

"I am in fact supporting your opposition." &

"I am not supporting your opposition."

What do you mean by the second statement when it is in context? Thank you for clarifying this for me.

 
At Friday, July 14, 2006 8:52:00 AM, Blogger Bob said...

Maurice writes, "Bob writes: 'Bob hasn't made up his mind about cutting off body parts.' Again, I request as moderator that you do not, as you did in a previous post, imply threats. You clearly would not accept threats on your blog and I don't accept it on mine."

Our blogs are very different, Maurice. Bob doesn't allow anyone on his blog to advocate sexual torture and mutilation of helpless little children on a massive scale, you do.

Our moderator ethicist is clearly opposed to the suggestion of cutting off body parts, calls it a threat, but only when it's not a guy wearing a white coat. He "hasn't made up my mind" about cutting up body parts from a million children per year in the US. Well, Maurice, cutting up little children is not a threat, it's an actual practice, a very violent abusive bloody screaming terrorist practice.

Cutting off body parts is an evil crime that has been done to many of the male correspondents and readers on this discussion. As I said before, and you ignored, I owe a debt of honor to the evil baby butcher who hacked off part of my body. The only question is whom do I owe it to? As a professional in the field of ethics it could be a real question that needs resolution. Instead of considering the ethics of honor you immediately felt threatened and applied your double standard of justice -- what doctors do to me is acceptable, what I do to doctors is not. Even the suggestion that I might return the favor to the scum slimeball baby butcher is unacceptable.

Maurice claims that he "haven't made up my mind." What he's really saying is that he supports the status quo for however long it takes to force the issue, and the status quo is the massive butchering of little children's sex organs for sadism and profit. In many court cases the judge issues a temporary injunction to stop the harm while the court decides the issue. In Maurice's case he advocates continuing the mutilation of millions more children while he hems and haws and delays a decision. He doesn't like to be confronted with the truth of his so-called indecision, but that's what it is, continual support for the status quo.

Well, Maurice, I don't share you double standard of justice and threat. I don't categorically excuse violent sex crimes because the perpetrator wore a white coat or because he only attacked and maimed boys. I still owe a debt of honor to the baby butchers. But I haven't made up my mind what part of what doctor to hack off. If that's a "threat" then you need to get your forked tongue together and say that you oppose violence. Otherwise your double talking lies and one-sided protection of white coated baby butcher slime is clear for all to see.

 
At Friday, July 14, 2006 8:58:00 AM, Anonymous Anonymous said...

Jake says...
"Assuming that something is wrong because it is illegal, in effect, says "I am not able to make this decision myself. I need politicians to tell me what is right and wrong."

On the same token Jake, assuming something is RIGHT (like MGM) just because it isn't illegal YET, says 'I am not able to make this decision for myself. I need politicians to tell me to tell me what is right and wrong'.

It boggles my mind that you have 'calmly' and 'rationally' concluded for yourself that the practice of female genital circumcision is moral and ethical on female children.

 
At Friday, July 14, 2006 9:16:00 AM, Blogger Bob said...

"For Jake and Maurice, how do you justify the annual deaths of an estimated 300 healthy normal children? And what do you call it? I call it murder."

Jake responded, "I call it a gross exaggeration of a rare but tragic event. In the US, there are approximately 2 million male births per year, so that would correspond to 0.015%."

I don't call it exaggeration Jake. A few years ago when I read the statistic I asked a friendly doctor about deaths that he knew of personally. He told me that a boy had died from MGM in our local hospital the previous year, in a town of fewer than 15,000 people. The official cause of death was NOT listed as MGM but was written up by the attending baby butchers as "complications of infection." The mutilated children don't just up and die on the operating table, their wound gets infected from hospital bred resistant germs or from the constant urine and feces that get applied to the wound in practice. Boys who die from MGM die several days later and like the child who died in my town the parents are never told the truth about why he died. In fact the doctor who told me the story from his own hospital refused to tell me the names of the child or the attending physician because a very expensive malpractice lawsuit could be initiated if the real cause of death ever got back to the parents. He said that he knew of other deaths from MGM in hospitals in nearby towns and medium size cities.

Yes, Jake, it's very rare for baby butchers to admit that their crimes are murder, not just sexual child abuse. It's very rare for baby butchers to admit that the cause of death is their tortured elective and unnecessary surgery on a healthy normal child. It's very rare for baby butchers to admit, even to themselves, that a healthy normal patient was killed by they malevolent malpractice. So you can cite all those fictitious "studies" all you like Jake, they do not reflect real deaths of real children. It is exactly that kind of lies that makes the baby butcher industry so untrustworthy. For a century they have published lie after lie after lie, and claimed to be studying the issues, "I haven't made up my mind" while the carnage goes on and on and on.

Even if only one baby dies from surgery that didn't need to be done that is reason enough to stop the carnage. The father of the dead baby doesn't care if the statistics on killing HIS children are small. It's time to stop the lies, stop the "I haven't made up my mind" delay after delay.

Jake also has declined to allow his proposed value system to be used on himself. He won't allow Bob or anyone else to decide if his body should be hacked up. He's demonstrated himself as a double speaking liar who talks one way and believes another, someone who will bend every truth to continue the psychosexual pathology of cutting little children's sex organs.

It's time that decent people storm the hospitals and force the evil baby butchers to stop sexually torturing and mutilating little children. And the corresponding rate of murder of children, death during criminal sexual child abuse, has to end too.

 
At Friday, July 14, 2006 9:30:00 AM, Anonymous Anonymous said...

"According to the : College of Physicians and Surgeons of British Columbia. Infant Male Circumcision. Jun 2004."

In my opinion these Colleges are a joke. Quote from the site: “At all times the physician must perform the procedure with competence and at all times...”

The job of these Colleges appears to be to protect doctors from patients. Write this College and ask what the standard of care is for circumcision in practice, not words, or better yet how it defines and supports the word “competence”. I promise it will be so vague it would be all but impossible to prove a doctor hadn’t been competent. As posted on this blog, check out the CBC website and the documentary “First Do No Harm” to see how the standard of care is actually implemented. http://www.cbc.ca/fifth/donoharm.html

Doctors do not have to tell patients how little training they have in an area. It’s self-governing. This is acceptable because the standard of care is set so low it allows doctors to practice on patients as if they are toys to be learned from. One could be anti-circ simply based on how low the standard of care is. This, within a community of professionals that make a habit of hiding mistakes and are under no obligation to provide the public with information on who is good at the job and who isn’t. Contact this College and ask how many complaints they get per year. Then look at how many doctors are found negligent and for what. I would guess that a doctor who had a fling with a patient would be in a lot more trouble than one who messed up a circumcision due to poor skills.

 
At Friday, July 14, 2006 9:50:00 AM, Anonymous Anonymous said...

"On the same token Jake, assuming something is RIGHT (like MGM) just because it isn't illegal YET, says 'I am not able to make this decision for myself. I need politicians to tell me to tell me what is right and wrong'."

I made a similar remark further on in that paragraph...

"It boggles my mind that you have 'calmly' and 'rationally' concluded for yourself that the practice of female genital circumcision is moral and ethical on female children."

I haven't said that. Please read my comments again. I've said that I'm open-minded, and willing to be persuaded by evidence. Without that evidence, I'm not prepared to judge.

 
At Friday, July 14, 2006 9:55:00 AM, Anonymous Anonymous said...

Bob, please be advised that this is the last time I will address you in this thread. If you cannot conduct yourself in a civil manner, you don't deserve the dignity of a reply.

 
At Friday, July 14, 2006 9:58:00 AM, Blogger Bob said...

Maurice wrote, "I want to make this perfectly clear: I am critical of neither side of this issue. I haven't learned all the facts."

For most of a century the baby butcher industry has cut up a hundred million American boys and men while repeating words similar to Maurice's, and it's not acceptable.

In court cases the judge issues a temporary restraining order to stop the carnage while the litigants gather and present arguments and the decision is made. They do not allow people to violate other people while waiting to make up their minds.

I the medical business, the FDA prohibits the sale or distribution of medicines until AFTER they have been proven to be both safe and efficacious. They do not allow doctors to widely distribute them to patients year after year while waiting for proof that they are ineffective.

But there is no such requirement for surgery. Doctors are free to do elective surgery without caring if it is either safe or efficacious. For more than a century the baby butchers have mutilated the sex organs if a hundred million American boys and men without any convincing evidence that it is either safe or efficacious. Decade after decade they have published lie after lie about why it is done, to reduce masturbation, to prevent gonorrhea, to prevent UTIs, to prevent AIDSs, and on and on. Those who try to protect children do years of expensive research and prove that the latest claim is bogus, but the psychosexual pathological baby butchers just toss out the next red herring.

The proposed law printed at the top of this page does not prohibit surgery on children's sex organs when there is a legitimate medical reason. It only prohibits non-medical sexual mutilation. If baby butchers were truthful about their concern for children they would support rather than oppose (delay forever while reviewing data) the law. All the red herrings and "I'm not convinced" arguments while the blood of children continues to be spilled are dishonest support for pathological practice of cutting up children.

One of the most common phony excuses that has been used for the past century is to say, "my mind isn't made up" while they continue the evil bloody practice of hacking up another million children year after year. If their mind really isn't made up they would demand that the practice of sexual violence on children be stopped while the decision is made. That is what honest reasonable people do in legal situations and in authentic medical practice decisions like the FDA rules. When there is a lock of proof, when there hasn't been a positive decision, the default is to stop the violence. It is the height of dishonesty to claim not to have made up his mind while supporting the continuation of the violence against children. Decade after decade, and now century after century, the lying baby butchers have continued the pathological violence against children while claiming not to have made up their minds. They say they are waiting for conclusive evidence, they are reviewing the facts, they are examining the data, and all the while they are cutting up the sex organs of millions of children and selling the stolen flesh for billions of dollars. That "not made up my mind" lie was a lie in the 1940s, in the 1950s, in the 1960s, and it's still a lie. Nobody believes it any more no matter how many times you repeat it. IF you hadn't made up your mind, doctor, you would STOP THE VIOLENCE while the data is compiled.

 
At Friday, July 14, 2006 10:15:00 AM, Anonymous Anonymous said...

Hallelujah Bob!!

 
At Friday, July 14, 2006 10:37:00 AM, Blogger Bob said...

Jake Waskett said.."Bob, please be advised that this is the last time I will address you in this thread. If you cannot conduct yourself in a civil manner, you don't deserve the dignity of a reply."

Sorry to burst your pathological bubble Jake, but hacking up the sex organs of a million children is NOT civil. You deserve something, but I can assure you it is not a dignified reply.

 
At Friday, July 14, 2006 11:19:00 AM, Anonymous Anonymous said...

See no, hear no says:
“It boggles my mind that you have 'calmly' and 'rationally' concluded for yourself that the practice of female genital circumcision is moral and ethical on female children."

Jake says,
“I haven't said that. Please read my comments again. I've said that I'm open-minded, and willing to be persuaded by evidence. Without that evidence, I'm not prepared to judge.”

See no, hear no says:

You never said that you were ‘open-minded’, or that you were ‘willing to be persuaded by evidence’ that female circumcision is wrong. This is exactly what you stated Jake:

"Several posters have asked whether I am opposed to female circumcision. I regret that I have not researched this issue as well. I am aware that it (FGM) is currently illegal in many western countries, but in my view this is insufficient basis to conclude that it (FGM) is morally or ethically wrong (there are, after all, no shortage of bad laws). "

The FGM law of 1996 made female circumcision illegal in the USA. Our politicians decided for us that female circumcision is ethically and morally wrong for girls inside the US, and passed their law to validate their position. Jake seems to feel that the FGM law is an “insufficient basis” to conclude that female circumcision is morally or ethically wrong. Reread his statement above to verify that. He goes onto say that there’s no shortage of bad laws. The implication is clear to me. FGM is a bad law to Jake. Jake feels that no one, as yet, has had a sufficient basis to conclude that female circumcision is morally or ethically wrong. In his opinion it would stand to reason, it is quite acceptable for the practice of female circumcision to continue until people can come forward with more sufficient data in order for him to decide that female circumcision is morally and ethically wrong.

I really need to find that video clip for you all, of the female circumcision! 4 men forcefully hold down this little 6 year old girl African girl. Her underware are off and her legs are spread wide apart. One man holds one leg apart, and the other man holds another leg apart. One man is sitting down and ‘cradling’ her from behind (so that she doesn’t hurt herself I guess. In these 3rd world countries (where the latest AIDS hoopla study comes from) they don’t have enough money to buy the circumstraint boards that we use here in the US to pin our kids down. Anyway the man in charge (in between her legs) is using his knife to cut away parts of her genital flesh. This is an ANCIENT tradition there! They feel it is more sanitary and beautiful. The child screams in agony, thrashing, screaming, crying. Begging ‘please, no, stop’, ‘please, no, stop’, ‘mommy, daddy, please, no stop’. Crying. Screaming. Thrashing some more. ‘AHHHHHHHHHH!!!’ ‘HELP!’ ‘Mommy, daddy, please, no stop’. ‘Hurting me. Stop’. Screaming, begging for mercy. The adults that pin her down, say ‘there, there’, ‘we are almost done’.

Dr. Maurice says he needs more sufficient date too before he can judge if circumcision on children is morally and ethically wrong. He cries out for grand ‘scientific data’ with every post he makes. If the ‘data’ isn’t there for these two men, the practice of cutting the genitals of both little girls and little boys should be allowed to continue until it is scientifically proven for them that it is morally and ethically wrong to do so.

One little problem here, I don’t think that you can even use ‘scientific data’ to proove that something is or is not morally and ethically wrong.

How do you proove that something is morally and ethically wrong? Oh I know….The Bible! The Torah! The Quran! The Enquirer! The answer has got to be in one of these publications!

Which one? How do we decide?

Doctor Maurice, I will defer to you here. Which publication do you think we should we refer to, to decide whether or not circumcision of little children is morally and ethically ok? Your Jewish right?

 
At Friday, July 14, 2006 11:45:00 AM, Anonymous Anonymous said...

'Zen Monster's' post was beautiful. I wish I would have held my reply to Jake until after I had read her post and thanked her for something so meaningful.

 
At Friday, July 14, 2006 11:45:00 AM, Anonymous Anonymous said...

"The FGM law of 1996 made female circumcision illegal in the USA. Our politicians decided for us that female circumcision is ethically and morally wrong for girls inside the US, and passed their law to validate their position. Jake seems to feel that the FGM law is an “insufficient basis” to conclude that female circumcision is morally or ethically wrong. Reread his statement above to verify that."

Correct, the existence of a law against something does not make that thing wrong.

"He goes onto say that there’s no shortage of bad laws. The implication is clear to me. FGM is a bad law to Jake."

You have misunderstood. The fact that there's no shortage of bad laws merely illustrates my point that law is a poor guide to morality. I have explicitly stated that I have insufficient knowledge of the evidence concerning female circumcision to judge it right or wrong. If I cannot judge the procedure that the law prohibits, it follows that I cannot judge the law either.

"Jake feels that no one, as yet, has had a sufficient basis to conclude that female circumcision is morally or ethically wrong."

No, I feel that I do not have this basis.

"I really need to find that video clip for you all, of the female circumcision! 4 men forcefully hold down this little 6 year old girl African girl. ..."

I wouldn't bother. Sensationalism doesn't work. I don't like being manipulated. As I read your description, I'm mentally inserting a sterile environment, proper anaesthesia and so on, so that I can see whether the procedure in general is a problem, or whether a particular instance of it is.

 
At Friday, July 14, 2006 11:48:00 AM, Blogger Bob said...

See no evil, hear no evil said...
"Hallelujah Bob!!"

Glad you liked it. You may republish any of my blog entries if it will help to pursuade people to stop hurting children.

 
At Friday, July 14, 2006 12:35:00 PM, Blogger Bob said...

We read their posts, "I'm not convinced," the evidence is not convincing," "I haven't decided yet." They ask for "data." They ask for "proof." Decade after decade they use red herrings to divert the question into discussion of masturbation, gonorrhea, cleanliness, UTIs, and now AIDS. They pretend to be concerned about rights and talk about rights, while ignoring the rights of the child who's body is being sacrificed. The talk about "ethics" but ignore the bloody tortured elephant in the middle of the room while they divert attention to the dust bunnies in the corner. They criticize those who demand an end to the violence and pretend to be "open minded" if only sufficient information is provided to make a decision. But, no matter what is provided, no matter which one of their red herrings is proven false, it is never enough. They just stonewall the obvious and "aren't convinced." Decade after decade, and now century after century the bloody mutilation of children continues while they remain "undecided."

It does not serve any humanitarian purpose to argue with someone who's so disingenuous. Good and valid arguments are ignored. They were never interested in the arguments anyway. The arguments were only their red herrings intended to divert energy away from the real questions of sexual perversion and their psychotic fascination with the sex organs of children. It's not about being convinced and it never was. It's not about scientific research and it never was. No matter how good the research, how valid the arguments, they will NEVER be convinced. It is a total waste of time arguing with them because you are falling for their fraudulent diversion away from the real issues, the screams of the tortured children.

It's always been about the blood, the screams, and the violated flesh of tortured children. It's always been about preserving their access to children for their horrible psychotic sexual gratification. That is all that it's ever been about.

 
At Friday, July 14, 2006 12:56:00 PM, Anonymous Anonymous said...

Dan says...
"Unless the parents are Muslim or Jewish, there is no compelling reason to cut the genitals of either a boy or a girl."

I would say this: unless the parents are inhuman, there is no compelling reason to cut the genitals of either a boy or a girl.

 
At Friday, July 14, 2006 1:13:00 PM, Anonymous Anonymous said...

Jake says:
“Correct, the existence of a law against something does not make that thing wrong.”

And it follows…. that the absence of a law ‘for something’ does not make that ‘something’ right either.

Jake says:
“law is a poor guide to morality”

what guide do YOU use Jake to judge whether something is morally correct or not? Does female circumcision sound morally corect to you Jake? Why or why not? Oh. I forgot. You only study the morality of male circumcision on little baby boys, not the circumcision of little girls. Perhaps the little girls are not quite as important to you? I guess you just havent gotten around to studying *that* morality yet hungh? Maybe next year.

Jake says:
“I have explicitly stated that I have insufficient knowledge of the evidence concerning female circumcision to judge it right or wrong. If I cannot judge the procedure that the law prohibits, it follows that I cannot judge the law either.”

Jake has ‘insufficient knowledge’ to judge whether female circumcision is right or wrong. He doesn’t mind that it continues even if it is wrong. He is too busy or bored to find out if it is female circumcision is wrong, but he devotes lots of time to the study of the morality of male circumcision.

So is it that you “can not judge the procedure that the the law prohibits” regarding female circumcision or that you ‘choose not to’ judge it, because, as you say their is ‘insufficient data’ that it is wrong.

Maybe you feel this way… “It doesn’t happen in my country anyway…so who the hell cares???”

Too busy to think about it this year? Too busy to consider it last year too? Do you ever have plans to consider the morality of female circumcision at all Jake? Or is your deep passion ONLY about the morality of male circumcision.

Jake says:
“I wouldn't bother. Sensationalism doesn't work. I don't like being manipulated. As I read your description, I'm mentally inserting a sterile environment, proper anaesthesia and so on, so that I can see whether the procedure in general is a problem, or whether a particular instance of it is.”

Jake feels that ‘the reality’ of a 6 year old little girl forcefully being held down and having her genitals cut off by elders (like MGM)is ‘Sensationalism’. My you are so full of contradictions and rich with compassion for little children.

The amount of thought & effort that Jake is willing to commit to think about about female circumcision is ZERO. He is too busy. Too bored or too disinterested. He mentally drives himself away from images of little children who have their genitals sliced apart against their will bytheir elders. Both boys and girls. It is more comfortable for Jake to imagine the little 6-year-old girl being circumcised in a sterile US hospital.

It is much more comfortable for him to imagine if she had her genitals modified here, not in Africa! But he will be the first to tell you that AFRICA has this great new study about MGM being a cure for Aids.

Right Jake?

 
At Friday, July 14, 2006 8:24:00 PM, Anonymous Anonymous said...

The Royal Australasian College of Physicians. Policy Statement On Circumcision. Sep 2004. http://www.racp.edu.au/hpu/paed/circumcision/summary.htm

"After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision." (emphasis in original document)

"The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit."

"Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure in the neonate."

 
At Friday, July 14, 2006 9:05:00 PM, Anonymous Anonymous said...

It is barbaric mutilation, and should absolutely be considered a crime. Parents of already circumcised boys should be forced to pay restitution.

 
At Friday, July 14, 2006 9:14:00 PM, Anonymous Anonymous said...

Maurice Bernstein, M.D. writes:
"I AM HIGHLY CRITICAL HOWEVER OF HOW SOME OF THE VISITORS ARE HANDLING THE PROCESS OF DISCUSSION."

Entirely understandable, with one poster calling you and the medical profession evil. That's just unneccessary.

If you don't want to take a public stance against MGM, that is your right. I don't hold with the "whoever is not with us is against us" ethic.


"The process of discussion demands openness NOT anonymity,"

I apologize for that. I haven't got a blogger account and I have no real use for one. I did not come here to snipe anonymously. I shall at least sign my posts, then.

"fairness NOT personally attacking an individual because of religion, profession or views."

Agreed up to a point. I think that pro-circ views reflect extremely badly on an individual's character, just the way pro-theft or pro-murder views would. But I see no point in making their character the issue.

"Don't threaten to cut off hands or worse."

I point out that there is a certain reversed quality to this. The pro-MGM people are in fact cutting off others' body parts. Some angry people - justifiably angry IMO - have responded by challenging pro-MGM postsers with rhetoric along the lines of "How would you like it?".

"And think before you write and write words and words which turn into a sea of angry rhetoric that will turn off any intelligent and thoughtful person. Most of what has been written here is not discussion, it is harangue."

This I strongly agree with.

Tom

 
At Friday, July 14, 2006 10:29:00 PM, Blogger Maurice Bernstein, M.D. said...

During the period when this comment section was down (not by me), a visitor titled Anonymous wrote to this blog only the following comment:
"You are evil, Doctor Bernstein." This ad hominem remark is intolerable on any blog including this one. I felt that despite all the harangue, there were some good and documented points brought out from both sides of the issue and that this still could be a valuable resource for visitors coming here still wanting to hear both sides. However, regardless of who does it any further comment criticizing the person presenting a view instead of or in addition to criticizing the view, will lead me to permanently close down this thread and prevent further postings either pro or con circumcision on any other portion of my blog. I mean it. ..Maurice.

 
At Friday, July 14, 2006 10:54:00 PM, Anonymous Anonymous said...

Well, that would be fine, Tom, except that I for one have behaved with courtesy and respect, but Maurice still won't engage in direct dialogue with me.

I don't wish to be offensive in pointing this out, Maurice, but when you exclusively, or almost so, address by name and in specific response only the people who angrily castigate you, not only does it tend to reinforce their behavior, but it also provides a comparative disincentive to those who are behaving with courtesy and respect to continue in that course.

If you really want to modify the behavior of those posting here, shouldn't you be responding positively to those of us who are behaving with courtesy and respect, and refusing to engage with those who angrily castigate you?

In all honesty, I am finding your own behavior more and more puzzling. In what areas do you need more facts? Do you disagree with the normal ethical primary which holds, as I understand it, that the retention of as much of the healthy, functional, non-pathogenic parts of the body as possible is a professional requirement?

And if that is the case, then again, I propose to you that any attempt at justifying 'prophylactic' prepucectomy must necessarily be based upon the assumption that the male foreskin is vestigial, i.e. functionally irrelevant and meaningless tissue. The proof of that, in combination with the above, then becomes the responsibility of those attempting to justify the procedure. They have not done so, which failure, by my understanding of medical ethics, automatically invalidates the procedure and requires an immediate moratorium against its further practice without a direct medical health necessity.

I do not understand why a seemingly singular and unique status among body parts of 'automatic disposability' appears to be being applied solely and exclusively to the male prepuce. If you can explain this to me, I would greatly appreciate it.

However, if you cannot explain it to me, I would even more greatly appreciate having that made clear. Then, perhaps, we can begin to identify and validate some particular 'facts' among those you believe you lack.

Because, Maurice, if you won't respond meaningfully to questions like this, then how else are we supposed to know what 'facts' you require in order to come to a intellectually and ethically satisfactory conclusion on the topic?

 
At Saturday, July 15, 2006 1:40:00 AM, Blogger Aesculapius said...

Hello. Doctors. Friends. Everyone.

What I am realizing is that circumcision is a hotter topic than religion or politics. And I see so many logical fallacies on this blog that I don't even know where to begin.

Obsequiousness
Distractions
Red herrings
Apples and oranges
Statistics
And to give some the benefit of the doubt, just plain old thinking errors

Circumcision is a hot topic because no doctor wants to think he has harmed another. No parent wants to think he or she has harmed his or her child. No man wants to think he’s been harmed. No woman wants her man to think he’s been harmed. And so the subject has a tight lid on it.

And the anger you see here is from lot of people who are expressing the powerlessness and grief they have felt for a long time. Some of them didn’t even know why they were upset all their lives, until they found out about circumcision. I was one of those.

As for laws regulating circumcision? There already is one – the FGM bill. Females are now protected against being cut in the US. Boys are not. Boys are fair game -- so far.

I am a circumcised female. Circumcised by the American medical system in the 1950s. I wrote a book about my own story and other circumcised women are finding it and contacting me as a result of it.

We are all rather displeased by the fact that we did not get a vote over the mutilation of our bodies. I also know many men who are displeased by the fact that their genitals were cut without their permission. I know a man who lost his glans to the scalpel and says he's ok with it. ???

But for those babies and children who might not grow up and appreciate having been cut, I suggest a moratorium on the practice of routine infant circumcision.

It's only respectful to allow people to decide for themselves. Isn't that where the ethics comes in? Isn't respect -- human rights -- the issue here? I don't believe in the rights of anyone else over your body... but your right over your own body. no one's hands should even touch a baby's genitals but his or her own. there will be plenty of time to check them out -- if and when they want that.

There is plenty of proof, that circumcision does not live up to the medical claims for it. Laumann's article in JAMA from April 2, 1997 ( http://www.cirp.org/library/general/laumann/ ) says that the health data is not all that different, whether men are c'd or not. I'd like to see research performed according to my own standards of investigation, but that will do, at the very minimum. If it is not all that different, then millions upon millions of men in the US have been cut needlessly.

In Europe, men live quite peacefully with their foreskins. Only approximately 6 in 10,000 require medical intervention, cutting. There are usually gentler, kinder, more moderate ways than cutting, to treat problems -- if they ever occur. Perhaps American doctors could learn from the Europeans – and Japanese, for that matter, since they rank far above us in health according to the WHO?

If doctors would do their research, they would find that no national medical organization in the world recommends circumcision... They would find that circumcision has no medical advantages in real numbers, only in statistics. And yet some doctors still push it. In fact, many do... More than half the boys in the US are still being cut. This indicates a lot of doctors are ill informed.

Honest? Ethical? The stock sales pitches are rather superficial and not worthy of a scientific medical field:

"You want him to look like his father, don't you?" and "It's cleaner," "Easier," and "He won’t fit in -- they'll make fun of him in the locker room." Are those reasons for cutting healthy skin ethical, doctor? Are those sales pitches respectful of the parents or the child? Are they worthy reasons for cutting someone’s healthy skin?

"Cleaner"? That argument surely be especially insulting to the 85% of men in the world who are not circumcised. Well then, what about women? Why not circumcise all women so they will be cleaner, like I am? Am I "clean"? I suppose so. I shower. And lord knows, I have no folds now, thanks to medical doctors, that will trap moisture or 'dirt'. ??? Did that make it ok for adults to hold me down and cut on my genitals? Loving? Respectful? Ethical?

Someone begged, "Please forgive me for the harsh tone of my comment, but this strikes at the very heart of a person's freedom of choice, freedom of religion, and bullies its way into the sacrosanct relationship between a parent and child."

"Freedom”? My freedom is to choose to cut someone else's healthy body? I should be free to hold someone down and cut his or her healthy body for my convenience? Freedom? Ethical? Sorry. I don't see it as a legitimate freedom or as ethical to cut anyone's healthy skin for my pleasure or convenience.

Bullies? On this blog? I think you are hearing from some very hurt and angry people. As for real bullies -- I can't imagine a more disproportionate power relation than that between a baby and an adult with a knife. Ethical?

I understand the word 'surgery' means to cut away diseased flesh... Yet doctors are cutting off healthy flesh. And that very healthy flesh is sold to human tissue traders to be used in the pharmaceutical and cosmetics industry. Is that ethical? To sell babies’ foreskins for a profit? For someone’s beauty cream?

The information used to justify circumcision is badly outdated and misleading. I'm sure you've heard of "lies, damned lies and statistics", no? Statistics may look convincing at first glance, but if you scrutinize the numbers, fact is they are circumcising approximately 100 boys to ostensibly save one or two from a UTI. Girls get more UTIs than boys and they are treated with antibiotics, not genital cutting. Is it ethical to cut boys when antibiotics work just fine for girls?

Penile cancer? There are only a few cases of penile cancer for every 100,000 men who are over the age of 70 and who have very bad hygiene... Is it ethical to cut 100,000 baby boys to save adults from having to explain to them about washing their genitals? Cleaner?

Pain? I don't believe pain or no pain is the core of this ethical problem. You may be able to reduce the pain during surgery, but the baby is going to be hurting for weeks after... Believe me. And some of us have hurt for years after... Some men have pain with every erection. I know a man whose penis bled with every erection… from the scar line. There is not only physical pain, but also emotional. Physical abuse, betrayal trauma, PTSD, anger, rage, fury, depression, grief, suicide... I'd sure like to be in charge of a research lab. Give me a team of researchers.

I have spoken to many men and women who have expressed great physical and emotional pain over circumcision. They just haven't been asked by the medical field yet. They weren't asked when they were children and they still haven't been interviewed. I am writing books to give them voices. What would the babies say, if we could understand their screams?

There are many questions I would like to see studied. Not just 'do babies feel pain?' -- of course they feel pain and of course no elective cutting should be performed on them that would incur pain, whether that pain can be numbed for the moment or not, whether their parents imagine it would be easier for them or not. Would it be alright for us to cut off the baby’s healthy toes if they were anesthetized? I don’t think you can really wrap your mind around how very bizarre it is to cut healthy genitals.

Perhaps we could also do a double blind project on “which penis feels better to a woman” and see who is really suffering from circumcision. The circumcised suffer, indeed, directly. And their lovers, spouses suffer from the loss of that movable shaft skin. I have done my own research on this subject and I can tell you my findings are that a penis without a foreskin is far less fun than a penis with all its working parts.

Does the foreskin have value, other than to tissue labs? Yes, to its owner. Http://www.cirp.org/library/anatomy/cold-taylor/ -- more information that should be required reading before anyone ever thinks about cutting off a foreskin.

If the aspect of 'fairness' is going to enter into this discussion, shouldn't we talk about fairness to the child and the adult he becomes – and his wife? If a healthy person does not have a right to have a whole body, then I call that unfair. And “bully”? Yes, I see there are some rather rude posts on this list, but I would not call them bullies. I would call anyone who holds down and takes a knife or a scalpel to a child's body, a bully.

Baby boys are targeted and stalked for their foreskins. The arguments for circumcision are flawed. There are some real ethics problems in the medical field.

One women who 'found' me due to my book lost her clitoris to an MD in the year 2000 -- without her permission, without her consent, without her prior knowledge. And no doctor she saw after that would speak to her about it... they told her to go back to the original doctor. ?????

This has been the story I've heard from other women as well, myself included. The medical field needs some genuinely concerned, honest and sincere ethics cops. The field is self-regulated and it is very sick. Doctors are afraid to speak up and protect patients against their peers.

I believe that if anyone could lay aside his or her prejudices and investments and be objective about male circumcision, they would not be able to just smile and accept it, or advocate it. They would be aghast. They would be appalled. They would be astonished that people who consider themselves to be modern and compassionate could even conceive of doing such a thing to a helpless baby. They would be ashamed for the circumcisers and their colleagues. They would cry for the babies. They would apologize to their sons. They would do everything they could to end the practice.

Doctors who could put their prejudices aside would go to www.doctorsopposingcircumcision.org ... And would watch the excellent video under "medical school curriculum" "the prepuce" and Jewish doctors would join www.jewsagainstcircumcision.org

My suggestion about ending mgm?

1) Amnesty to all doctors who have performed them in the past, before today.

2) A mass education effort that will take one day of newspaper, magazine and tv shows, internet contact and phone calls made by the professional medical organizations in the us to all doctors' offices. I am sure it can be done. Everyone could be contacted and re-educated by informed doctors.

3) Zero tolerance for any misinformation, solicitation or performance of circumcision tomorrow or any day after.

This socially sanctioned form of childhood sexual abuse has gone on long enough. It’s time to stop the cycle.

Respectfully.

 
At Saturday, July 15, 2006 3:57:00 AM, Anonymous Anonymous said...

See no evil said:

"And it follows…. that the absence of a law ‘for something’ does not make that ‘something’ right either."

Agreed.

"what guide do YOU use Jake to judge whether something is morally correct or not?"

Utilitarianism.

"Does female circumcision sound morally corect to you Jake? Why or why not? Oh. I forgot. You only study the morality of male circumcision on little baby boys, not the circumcision of little girls. Perhaps the little girls are not quite as important to you? I guess you just havent gotten around to studying *that* morality yet hungh? Maybe next year."

Ignoring your tone, you are in essence correct. (Male) circumcision is my principal field of interest. I simply don't have the time to dedicate to studying female circumcision in such depth, or for that matter many other issues which are doubtless important. However, this isn't a major problem, as the world does not rely upon my judgement in these matters.

"The amount of thought & effort that Jake is willing to commit to think about about female circumcision is ZERO. He is too busy. Too bored or too disinterested. He mentally drives himself away from images of little children who have their genitals sliced apart against their will bytheir elders. Both boys and girls. It is more comfortable for Jake to imagine the little 6-year-old girl being circumcised in a sterile US hospital."

No, my friend, you miss the point entirely. It is not that it is more comfortable. It is this: if female circumcision is wrong, it is wrong regardless of whether it is performed in a hospital or in the African bush. The best analogy I can think of is the theatre: a script is either good or bad, but a bad set and atrocious acting can make it much harder to determine this than a good production.

That doesn't mean that the 'set and actors' can't be good or bad themselves. There are very real ethical issues involved in holding a 6 year old down and operating against her wishes, for example. But it's so easy to get confused between the two, isn't it?

Zen monster tried to post a link above to a video of a circumcision. (S)he didn't post it correctly, but I suspect that it is the usual video favoured by anti-circumcision activists: the one apparently made in the 1970s in which no anaesthesia is used and the child is in obvious distress. Why is it used as an argument against circumcision, rather than an argument for anaesthesia?

 
At Saturday, July 15, 2006 8:27:00 AM, Anonymous Anonymous said...

Jake says...
"There are very real ethical issues involved in holding a 6 year old down and operating against her wishes, for example. But it's so easy to get confused between the two, isn't it?"

Amazing Jake! You seem to actually be suggesting now that there are some REAL ethical issues to holding down a 6 year old child and performing circumcision.

Yes, it is very confusing for you to make a distinction between female circumcision and male circumcision. Let me help you....

They both are children.
They both are powerless.
They both have genitals.
They are both being cut.
Neither consents.
Both cuttings are done at the parents request.
Both of them have erogenous tissue removed.
Both the parent justify it.
In both cases, the community uses religion to justify it.
In both cases, custom justifies it.
In both cases, conformity justifies it.
In both cases, the effects are minimised by its supporters.
In both cases, the surgery is performed by its adult victims.
In both cases there is pain involved.
In both cases there are complications and death involved.

Here's a question for you too:

There once was a small defenseless child that was held down with force by an adult. A knife was taken and put between the child's legs. The genitals were modified with careful precision and a sharp blade. The child cried. The child had no choice. The parents believed they knew better than the child. It happened on earth. They were all 'human'.

Was the child a boy or a girl Jake?

Does it matter?

 
At Saturday, July 15, 2006 8:30:00 AM, Anonymous Anonymous said...

Thankfully, my OB/Gyn told me RIC wasn't medically necessary many moons ago. I appreciate the honesty, and I'm proud to report my son(s) have NEVER had any infections and/or issues related to their foreskins.

I now question not only RIC, but WHAT is done to the foreskin AFTER amputation! I know of 1 hospital that sells the skin for RESEARCH and/or a new bandage. This means that the hospital gets paid for RIC and then gets more money selling the foreskins. I'm sure THIS is not told to the parents - that made the choice. In today's society, I for one would NOT be comfortable NOT knowing what is happening to the tissue. I've also heard an RN report that one Dr. at a military hospital required saving & storing all foreskins so HE could go fishing with them. Ethical - not!

 
At Saturday, July 15, 2006 8:33:00 AM, Blogger Maurice Bernstein, M.D. said...

I want to respond directly to Acksiom: The reason I am not going into a discussion myself regarding the value of the foreskin is because I have no information. I was never involved in removing it, advising to have it removed from an infant or even studied the subject, therefore unless you want me to make suppositions regarding its value, I am at a loss of what you are requesting. Foreskin and male circumcision was not a subject of instruction that I can recall when I was in medical school in the late 1950s. The subject of male circumcision has never been a subject which I have found available in the required continuing medical education courses. This topic as such has never been brought to my attention over all these years of practice in internal medicine. I have, of course, done genital exams on thousands of men and NONE and I mean NONE who were circumcised ever talked about their circumcision or told me about their concern about what was done to them as a child or expressed unexpected anger as I performed the exam. It is true I never asked the a direct question out of the blue:"What do you think about your being circumcised as an infant?" But why should I ask that unless I wanted to provoke them or present to them adjenda of mine? No one in the medical profession ever instructed me to ask circumsized adults their views of their infant circumcision. I was never instructed to take a poll. So that's it. Except for the very occasional male patient who presented with chronic symptomatic phimosis, I never referred any uncircumsized male to a urologist for circumcision.

Should I be criticized for not being involved more in the circumcision debate? Probably. But since in my career this subject was never brought up by teachers or patients and I was involved in dealing with more immediate and, yes, to me at the time, more serious medical issues, there was nothing to provoke me into investingating the cicumcision issue. Till now.. when the subject was brought up on the "I Hate Doctors" thread, I thought that this subject would be of interest for my education and perhaps those of others who come to my blog.
So I made a separate thread.

No visitor to my blog is required to participate. As moderator, I have the right to decide which topics I feel competent enough to voice an opinion. If I truely have no opinion, based on facts or philosophy, I do not have to engage in debate. I will not debate just because someone wants to pick me apart. And I don't have to pick apart other's views if I don't have the factual basis. I do have responsibility to see to it that whatever communication is occuring on my blog that it is civil and fairly presented.

Thanks for expressing your concerns about me. ..Maurice.

 
At Saturday, July 15, 2006 8:51:00 AM, Anonymous Anonymous said...

Maurics says:
"The reason I am not going into a discussion myself regarding the value of the foreskin is because I have no information."

What kind of information do you want? Many people have posted information on this blog about the value of the foreskin (pls. refer to Dr. Fleiss's article). Are you saying that you have no valuable information from the BIG medical organizations about the value of the male foreskin?

Let me ask.
Do you want the 'information' about the value of the male foreskin directly from the very same medical organizations that profit off of the foreskins and who also sell foreskins for more profit?

That's who you want your information from???? Can you clarify this?

 
At Saturday, July 15, 2006 10:00:00 AM, Anonymous Anonymous said...

Dr. Bernstein and everyone else, please view the following link. It describes, in detail, male circumcision as it is performed in the United States. This is from the UpToDate website. I'm sure many of the medical folks around here are familiar with it. Unfortunately, the full article is subscription only, but if you scroll down and look on the left side column, you'll find that a picture is worth 1,000 words.

http://patients.uptodate.com/topic.asp?file=postpart/2248

Doesn't the Gomco(tm) clamp look like a medieval torture device? I can't believe my parents consented to putting THAT on my penis. But then, I doubt they were even told anything but "Its good (for the doc's wallet.)" That's where the ethics come in.

 
At Saturday, July 15, 2006 10:05:00 AM, Anonymous Anonymous said...

"What kind of information do you want? Many people have posted information on this blog about the value of the foreskin (pls. refer to Dr. Fleiss's article)."

As I've already commented, that article contains numerous errors, did not have the benefit of peer-review, and is as such of questionable value. Perhaps you could find some information from an author who at least read his own references?

 
At Saturday, July 15, 2006 10:11:00 AM, Anonymous Anonymous said...

I find this from Maurice extraordinary: "Foreskin and male circumcision was not a subject of instruction that I can recall when I was in medical school in the late 1950s. The subject of male circumcision has never been a subject which I have found available in the required continuing medical education courses. This topic as such has never been brought to my attention over all these years of practice in internal medicine."

US doctors (including Maurice) never studied the foreskin. They (not including Maurice, apparently; not even in medical school, Maurice?) just cut them off.

What? Isn't it the physician's JOB to understand how the human body works and to protect healthy, functional human tissue whenever possible and treat disease and injury and defect? Isn't ethics in medicine performing that job responsibly?

Why has US medicine (including Maurice) disavowed all responsibility for LEARNING about the male foreskin? Why is ignorance their only excuse?

 
At Saturday, July 15, 2006 10:14:00 AM, Anonymous Anonymous said...

See no evil said:

"Amazing Jake! You seem to actually be suggesting now that there are some REAL ethical issues to holding down a 6 year old child and performing circumcision."

Actually, I said that there were real ethical issues in holding a 6 year old child down and performing any procedure against her wishes. The same would be true of a boy. But infants aren't capable of forming or expressing any wishes, so the situation is different.

"Yes, it is very confusing for you to make a distinction between female circumcision and male circumcision. Let me help you...."

Please don't misrepresent what I said. I said it was easy to get confused between the ethics of problem of holding down and performing the procedure on the girl against her wishes, and of female circumcision per se.

Dan Blackham wrote;

"Jake, it is morally wrong for someone to cut the genitals of another human being unless there is a compelling reason to do so or the other person has given his or her consent for his or her genitals to be cut."

Ok, Dan, I understand that this is your position. As I've already stated, I consider "best interests" to be the appropriate test.

 
At Saturday, July 15, 2006 10:36:00 AM, Anonymous Anonymous said...

jakew, I would have considered keeping my foreskin to be in my best interests, but the doctor'$ yacht payment overruled me. He provided no "informed consent."

 
At Saturday, July 15, 2006 10:41:00 AM, Anonymous Anonymous said...

Dr. Bernstein, from the home page:

"What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I will too! ..Maurice "

What are your thoughts regarding non-theraputic infant circumcision from a current bioethical point of view?

What leads you to believe it is ethical/unethical?

Cindy

 
At Saturday, July 15, 2006 11:01:00 AM, Blogger Maurice Bernstein, M.D. said...

Anonymous from today has clearly demonstrated a problem associated with some of the commentators to this thread--a tendency to blossom out a conclusion far beyond what someone else such as me has actually written simply to make a point. Such an example, provided by Anonymous was "Why has US medicine (including Maurice) disavowed all responsibility for LEARNING about the male foreskin? Why is ignorance their only excuse?" I was only speaking for myself and my own personal experiences with regard to foreskin, I said nothing about and I have no information regarding whether "US medicine" (whatever that represents) is disavowing responsibilities with regard to learning about foreskins.

In answer to "see no evil. hear no evil",who wrote: "What kind of information do you want? Many people have posted information on this blog about the value of the foreskin." For me, documented, referenced information about foreskin and male circumcision of infants from those writing on this blog is sufficient as starters. I hope that neither you nor others who have been thoroughly involved in this issue for years (perhaps beginning from initial experiences in grammar school toilets or gym class) and have had years to ruminate and to research the literature don't expect me, after only 10 days of reading this thread, that I should be criticized for taking time, wanting to do more reading and not coming to a conclusion one way or another about this issue.

Let's all remember the issue is male circumcision and NOT me. The conversation should be about the topic and not the participants! ..Maurice.

 
At Saturday, July 15, 2006 11:04:00 AM, Anonymous Anonymous said...

Jake asked: “Why is it [the circumcision film] used as an argument against circumcision, rather than an argument for anaesthesia?
This was my reaction after watching the film. Not providing pain relief during this procedure is very insightful into how medicine is taught and practiced. Most people are a product of their environment whether we like to see ourselves this way or not. I don’t see the point in blaming a doctor for performing a procedure that was 100 percent accepted as being good practice at the time. It would be like blaming parents for abandoning female infants, in a culture that dictates a female child will remove wealth (from an already poor family) in the form of a dowry. The problem isn’t the female child or the parents. The problem is that the training, via the culture, results in female children being viewed as a huge liability. It’s nice to think that all people, especially educated people, can rise above training and see what’s right but this is not often the case.
Just for perspective: The average IQ of medical graduates is 120. That’s the average, not the low end. Does anyone believe that the same IQ range can’t be found in a poverty stricken village, where culture/training dictates how people view the world, as in a school of medicine? Intellectuals/thinkers are in the 135-144 IQ range, 145-154-genius (e.g.,professors), 155-164 (e.g.,Nobel Prize Winners),165-179- high genius, 180-200 highest genius, 200 and up, beyond measure. Of course we could debate IQ scores and what they mean…
If patients want the medical community to start thinking about how it treats people, and the treatment or procedures done to people, then the key is in how doctors are trained. What type of training allows a doctor to subject a patient to needless pain? If doctors don’t think about something as obvious as providing the same level of pain relief they would expect, and demand, then what else is done by habit from one generation to the next? I’m not sure, although one can always hope, that I would not have performed circumcisions without pain relief if I’d been trained to do so. Never mind the next step, in questioning the procedure. This site might be if interest to some: http://www.mentalsoup.com/mentalsoup/basic.htm

 
At Saturday, July 15, 2006 11:12:00 AM, Anonymous Anonymous said...

Jaine, I fail to see why the circumcision is needed at all. Did the child's foreskin have a deformity? Was it diseased? Was it a threat to his health? Or was it a threat to the father's ego, a great unknown, and an easy $400 for the doctor?

What's so pressing about male circumcision that it must be done immediately, before the child can articulate his own opinion?

 
At Saturday, July 15, 2006 12:13:00 PM, Anonymous Anonymous said...

Regarding infant circumcision and UTIs, I have often wondered if the studies were invalid. Many parents still think that they need to clean under their young son's foreskins by forcefully pushing them back. As many of us know, this can lead to tears and infection.

Is there any way to know if the foreskin's of the intact infants examined during these UTI studies were being left alone, as they should be? If not, could there be funding for a study that takes this into account? I think that unless an impartial scientist can do the research with healthy, full-term circumcised boys and healthy, full-term intact boys who have never been retracted, then any information from these studies is suspect.

Any thoughts?

Reneé

 
At Saturday, July 15, 2006 12:14:00 PM, Anonymous Anonymous said...

Quote: “What’s so pressing about male circumcision…?”

Apparently, from information offered on this blog, the procedure was originally done to stop masturbation. Going with this information… In order to understand the concern over masturbation one has to understand the greater mind-set of society at that time. There is an old joke about masturbation that hints at the thinking. Adult to child: “If you masturbate you’ll go blind.” The child responds: “Can I do it just until I need glasses?” If people really thought masturbation could cause vision problems then it isn’t a big jump to lock into other ideas that might have formed the thinking at the time. The debate over this topic, in many circles, will lead to thinking about ‘what’s so pressing about male circumcision…” That is how change starts to move people in a new direction. How many people on this blog are positive they would not have believed that masturbation caused vision problems, if told this within the time frame and setting it was offered in? The mind-set has to be put into context along with the unfortunate truth that people don’t always stop to think, or they simply do not have all the information needed in order to know which direction to go.

 
At Saturday, July 15, 2006 12:36:00 PM, Anonymous Anonymous said...

I agree with Renee K. Its time to redo these studies and advise the participants on PROPER care of the foreskin. It would also help if the person in charge of the study wasn't a circumcision advocate like Wiswell, rather an unbiased scientist. My guess is that the difference in UTIs will be insignficant. My intact toddler has had no UTIs, that's for certain.

Besides, why the opposition to treating UTIs in intact boys with antibiotics? Why is circumcision always the first thing recommended? Is it ignorance or greed?

 
At Saturday, July 15, 2006 1:09:00 PM, Anonymous Anonymous said...

MD says:
." For me, documented, referenced information about foreskin and male circumcision of infants from those writing on this blog is sufficient as starters."

Here's a whole online library of 'documented, referenced', information for you to review. I suggest that you check-your self-in and get up-to-date.

http://www.cirp.org/library/

and

http://www.circumcision.org/
(A Jewish resource center)

 
At Saturday, July 15, 2006 4:49:00 PM, Blogger Maurice Bernstein, M.D. said...

In response to David B’s excellent question “is it ethical for an ethicist to moderate a discussion on a topic about which he adamantly denies any knowledge?”, the answer has do with the definition of the verb “moderate”. As taken from WordNet, the verb moderate is defined:

Meaning #1: preside over
Synonyms: chair, lead

Meaning #2: make less fast or intense

Meaning #3: lessen the intensity of; temper; hold in restraint; hold or keep within limits
Synonyms: control, hold in, hold, contain, check, curb

Meaning #4: make less severe or harsh
Synonyms: mince, soften

Meaning #5: make less strong or intense; soften
Synonyms: tone down, tame

Meaning #6: restrain or temper
Synonyms: chasten, temper

Based on the definitions, it would seem to me that the role of a moderator would be to preserve civility and fairness in the conversations. The ethical principles which I think the moderator must apply is beneficence (doing good to each participant and the product-the discussion) and justice (making sure each participant has equal opportunity to be heard). It is not necessary for the moderator to express his or her own views on the subject in order to moderate. In fact, like a umpire in baseball no favoritism should be held or expressed.

For the majority of the 360 or so threads on my blog, I started them and therefore I researched and usually already had a view when I posted them. In the case of male circumcision, the topic was begun by others, not me, and I had inadequate knowledge of the full details of the topic and had no opinion one way or another. Now I am learning and after a while I hopefully should come to some decision.
But I will do it in my own time and not be pressured into it by parties on either side of the issue. ..Maurice.

 
At Saturday, July 15, 2006 10:37:00 PM, Blogger Aesculapius said...

maurice, i believe you when you say you were not educatead about the foreskin in med school. i have a friend who has a collection of med school textbooks and he says that there was NO textbook that had a photo or drawing of an intact penis until recently... and at that time there was only ONE. so in the last 1950s, i am sure there was NO textbook that described the form or function of the prepuce.

there were many opinions, beliefs, 'old wives tales' but no real data. then taylor & cold did a very good anatomical study which i cited in my post from July 15 at 1:40am... www.cirp.org . the same information was actually available early in the 20th century.

i hope that you will bookmark www.cirp.org and when you have a question about circumcision, you will visit it and do a search on the topic. there is a wealth of information there... medical, psychological.

and as i mentioned in my first post, www.doc.org also has an EXCELLENT video for you to watch... it is under 'continuing education' -- 'the prepuce.'

i hope you will read these things soon. there is no need for all this debate. good information will answer many of the problems on the list.

education is needed. nothing should be cut off a human that is not thoroughly uunderstood. tonsils, appendixes... foreskins... can we end this soon? why, on earth, is the medical field so enamored with cutting? in other countries it is the LAST resort. here, it seems to be common, everyday fare.

i can sympathize with a man who has been circumcised who doesn't really want to know what he has been missing all his life... when men who are restoring their foreskins have their first 'full body orgasm' they often become very angry, realizing that they were robbed of this for so many years. i too would rather not know what i am missing. but if you really have a desire to know what circumcision is about, THAT is what it is really about. men now know what they are missing. they are talking with one another and finding out that circumcision was unnecessary.

i remember watching a highly educated health practitioner get a faraway look in his eyes when i explained to him that his circumcision at age 5 for phimosis was unnecessary... in europe they would have stretched the skin, not cut it off... he was in a state of shock. i remember another OB/GYN who said to me, "EVERYBODY needs lubrication from time to time." "Not if they have a foreskin," said i. he too got that very shocked look on his face.

the subject of circumcision has been a forbidden topic for many years. a secret. now it is no longer secret. some men who made it an issue several years ago were men who had been intact until adulthood, were sexually experienced and THEN lost their foreskins... they KNEW what they were missing. then they stretched and restored their foreskins and discovered they regained approximately 80-90% of the sensation.

a study is underway and being completed on the sensitivity of the foreskin vs the glans vs shaft... and perhaps that data will be released at the upcoming NOCIRC symposium in seattle (www.nocirc.org). perhaps you can attend.

i'll be speaking there. i'll have copies of my book.
www.aesculapiuspress.com . it's all about FGM in the USA. today i was at a workshop with ten women and now ten more women know that american doctors used to cut off little girls' clitorises.

time to stop the abuse, maurice. i hope you will get behind www.doc.org and www.jewsagainstcircumcision.org .
ethics? yes, indeed.

 
At Sunday, July 16, 2006 3:51:00 AM, Anonymous Anonymous said...

Patricia,

You discuss men experiencing their first 'whole body orgasm' while restoring their foreskins as though you were convinced of a direct causative link.

I'm afraid that the evidence indicates no more than a placebo effect.

The idea that the glans is more sensitive in uncircumcised males (and by extension, 'restored' males) is based solely on an assumption. No study has ever determined such a thing. In fact, four studies have addressed this question and all have found no difference. Here are links to three of those (I regret that I have lost the link to the other): Masters and Johnson (1966), Bleustein et al (2003), Bleustein et al (2005).

Though not directly relevant to 'restorers', a related idea is that of the sensitive foreskin. In fact, nobody has ever determined through tests that it is particularly sensitive. The most commonly cited paper is that of John Taylor, and a followup paper that he wrote with fellow NOCIRC activist, Christopher Cold. Since it presented original data, let's pay more attention to the first. Please read it carefully. Note that the suggestion that the prepuce is erogenous tissue is clearly presented as a hypothesis. Furthermore, note that the interesting feature of the 'ridged band' is that is is more dense (unfortunately Taylor declines to present hard numbers) in Meissner's corpuscles than the rest of the prepuce. (Many have misread this paper as implying that this band is more dense in these receptors than the rest of the penis, but although the authors make some bizarre and implausible claims about the glans, this is neither stated nor implied in the paper.)

In order to assess Taylor's postulate that this is erogenous tissue, then, we must consider the nature of the Meissner's corpuscle. What we find, in fact, is that it is receptive to light touch, especially fluttering sensations (the beating of a butterfly's wings, for example). We further find that it is a rapidly-adapting receptor - that is, it signals new touch but then quickly stops signalling until the stimulus is removed. A little thought suggests that such response characteristics mean that it is unlikely to play a significant response during sexual activity.

We might additionally test Taylor's hypothesis by suggesting that if he is correct, an adult ought to report less sexual sensation following circumcision. Few studies have assessed this. The largest and most recent was that of Masood et al (2005). Interestingly, the authors actually reported the opposite: more than twice as many men reported an increase in sensation than a decrease.

You are correct in noting that NOCIRC have (or had) a study underway to measure the sensitivity of certain penile parts. Unfortunately, the study's results will not be terribly useful in determining sensitivity in general, particularly sexual responsiveness. The description of the study's methodology, which was at one point on NOCIRC's site, indicated that it essentially determined the lightest touch that could be detected, using filaments of varying diameter. This means that, of all the types of stimulation to which our sense of touch responds, they measured only one. This type happens to be brief light-touch sensation, as detected by Meissner's corpuscles. Thus, one would expect the foreskin to appear the most 'sensitive', as measured in this way (a cynic might say that this is deliberate).

Your suggested strategy for finding information about circumcision is somewhat concerning. While CIRP make the full text of many papers available, which is valuable, they do have a strong anti-circumcision agenda, and as such their selection of papers is far from representative (their summary pages for each section are even worse, painting a highly misleading picture). If this strategy is what you personally use, then I would suggest that you are not giving yourself balanced information, and should immediately change your approach. Instead, start with the excellent PubMed database, identify interesting papers, and if you then want to read the full text but can't find it elsewhere, try searching CIRP.

 
At Sunday, July 16, 2006 7:07:00 AM, Anonymous Anonymous said...

"Social reformers are never, ever liked. They are always unpopular because they are always confronting a culture that doesn't want to know more about injustice for which they bear some responsibility." -Gregg Cunningham, Esq. Executive Director for The Center for Bio-Ethical Reform

 
At Sunday, July 16, 2006 7:39:00 AM, Anonymous Anonymous said...

and from the mouth of another Great human being came these words:

"What you do is obvious. Why you do so is less clear. I wonder when you will be ready to share your psychosexual motivations on this issue ... or will you find it necessary to take the fifth?

What needs to be examined is the psychosexual motivations of those who insist on cutting part of the penises off baby boys."

-H. Young

 
At Sunday, July 16, 2006 8:06:00 AM, Anonymous Anonymous said...

What is a Circumsexual?
(slang).

A ‘circumsexual’ is a man who finds thoughts of circumcision (the act itself) or the circumcised penis extremely erotic. They spend many long hours thinking about cut penises, and their political/psycho/sexual agenda is to promote routine infant circumcision in mass. There may be some variations, however most circumsexuals have a STRONG pro-circ agenda and it is directly linked to their sexual fantasies with the cut penis.

 
At Sunday, July 16, 2006 9:09:00 AM, Anonymous Anonymous said...

I don't know if circumcision is right or wrong.

I don't know if war is right or wrong.

I don't know if abortion is right or wrong.

But I do know this:
human beings are very
good a these 3 things:

destruction.
hurting.
killing.

 
At Sunday, July 16, 2006 9:47:00 AM, Anonymous Anonymous said...

Dr. Bernstein, you have been given many links and references to investigate the function and epidemiology of the foreskin and to medical research conducted to determine whether benefits of non-therapeutic infant circumcision and/or adult circumcision exist and if so, how significant such benefits may be.

As this site is dedicated to bioethical concerns, I think it fitting to supply links and references to other bioethicists and medical organizations who have touched on the bioethical considerations regarding non-therapeutic infant circumcision (some of which have been linked to previously on this thread).

http://www.intact.ca/canary.htm
"MARGARET SOMERVILLE is the founding director of the Centre for Medicine, Ethics and Law at McGill University, where she holds the Samuel Gale Chair in the Faculty of Law and is a professor in the Faculty of Medicine."

https://www.cpsbc.ca/cps/physician_resources/publications/resource_manual/malecircum
"A wider societal discussion on infant male circumcision is warranted based on a current understanding of bioethics that takes into account the non-therapeutic nature of the procedure as well as the high importance it plays in religious and traditional customs. This paper provides a discussion on current medical perspectives as well as relevant legal, human rights, and ethical considerations."

http://www.bma.org.uk/ap.nsf/Content/malecircumcision2006?OpenDocument&Highlight=2,circumcision
"British Medical Association - The law and ethics of male circumcision - guidance for doctors"

http://www.racp.edu.au/hpu/paed/circumcision/
"Royal Australasian College of Phyicians - Policy Statement on Circumcision"

Perhaps, eventually, you could summarize here the bioethical considerations that you see as valid with respect to the issue of non-therapeutic infant circumcision.

Cindy

 
At Sunday, July 16, 2006 11:02:00 AM, Anonymous Anonymous said...

Dr. Bernstein,

"No one person should have the right, or authority, to have any amount of normal and healthy tissue removed from another person."

Do you have an opinion of this statement? I'm not trying to pressure you into a decision, so please don't feel like I expect you to answer on here. This reasoning is why my husband and I left our two year old son intact. He's never had a single problem with his penis, including infections and UTIs. As I said in a previous post, the majority of infections are due to improper care. Since we know how to care for his penis, we run no risk of damaging or tearing his foreskin and causing a problem. With regard to UTIs, evidence shows that breastfeeding has a much more profound affect on prevention than circumcision ever could. He was exclusively breastfed for several months, and he is still breastfeeding a few times a day. Not only has he never had a UTI, he has never had even a cold. I'm sure if I could ask him, he would agree that he would much rather be breastfed to prevent illness than have a part of his penis removed.

Thanks for starting this discussion and having the willingness to listen to both sides.

Reneé

 

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