Talk:Circumcision/Archive 9

Archive 5

←

Archive 7

Archive 8

Archive 9

Archive 10

Archive 11

→

Archive 15

RFC

I have committed an RFC on the subject of my overhauled version vs the old version.

Relevant talk subjects so far are

• #Fringe Views
• #NPOV notice
• #Article Overhaul
• #Design by commitee

And otherwise, pretty much the entire talk page.

Dabljuh 23:13, 9 January 2006 (UTC)

I have read both versions and I think that the version I read when I arrived at the page was the least controversial, and had the least POV arguments (this may be the old version, hard to tell).

Overall, I think that the discussion of this topic flows best when the reader is provided with the following flow:

1. 1. What is circumcision
   2. Reasons for circumcision
   3. History of circumcision (worldwide rates should probably go here as opposed to the bottom)
   4. Effects/Risks/Emotional impact/Consent of circumcision

More Specifically

• The “In the United states, it is unclear….” Portion of “Circumcision Since 1950” is redundant with the United States portion of “Prevalence of circumcision worldwide”.
• Finally, the results of the jackinworld.com survey are misrepresented. The survey said that: 87.9% of circumcised men were happy with their penis and that 89.8% of uncircumcised men were happy with their penis. This is not a trivial distiction when one takes in the margin of error (not presented in the article that I could find). Given that the numbers are so close (1.6%), I would suspect that even a minute margin of error (like +/-1%) would make the groups non-significant. Therefore, the statements about the second part of this survey should be removed.
• Loved the talk page! DO11.10 05:13, 10 January 2006 (UTC)

Huge point! What is circumcision is almost totally omitted by both versions. I totally overlooked that problem when I overhauled the article as I failed to realize there's people that don't know what it actually is. The only problem is that the procedure is almost impossible to explain without good pictures, none of which are available under a free licence as far as I know. I would like to put forward a motion to contact the various circumcision information sites to release some of their material under the GFDL and thus making them available for the Wikipedia. Dabljuh

I like the Dabljuhs version better, except that I think it should not omit the issues of risk and consent which the original version addresses. —James S. 05:53, 10 January 2006 (UTC)

Thanks. True, consent is omitted, I figured that the issue of consent belongs to Bioethics of neonatal circumcision. I have not really changed the description of "risks", outside the context of infant circumcision, it wasn't in the article in the first place. Will update my version as soon as time allows. (or you may, of course) Dabljuh 07:52, 10 January 2006 (UTC)

Why file an RFC on a medical topic under society and law? Jakew 11:35, 10 January 2006 (UTC)

Sex also is part of that group. Don't know really. Also, circumcision is more of a social practice than a medical one. Dabljuh 13:16, 10 January 2006 (UTC)

Many people would disagree. I suggest that your view that it is more social than medical reflects your opposition to circumcision. Jakew 13:29, 10 January 2006 (UTC)

Or... maybe it reflects the view of the medical community, that circumcision is more of a social practice than a medical one. Seriously though, I just didn't spend much time selecting the right group to post the RFC to, I saw "sex" and all was good. If you think this would introduce bias (by introducing social rather than medical experts), feel free to add another RFC to the group of your liking to outweigh whatever bias you perceive. Dabljuh 13:47, 10 January 2006 (UTC)

I would suggest that in issuing policy statements on the matter, the medical community have implicitly recognised that it is, at least in part, a medical matter. Jakew 14:02, 10 January 2006 (UTC)

How do you figure that? It would seem to me that the content of their policy statements is, "there is no medical basis for this, so we're washing our hands". They direct parents to make their decision based on religion and culture, and on the medical issue they pause only to state that there is no convincing medical indication for routine neonatal circumcision. To me, that seems to indicate that the medical community have very firmly declared it a non-medical matter. -Kasreyn 16:05, 10 January 2006 (UTC)

I think you're confusing a medical decision with a medical issue, Kasreyn. It is only as a result of reviewing the (medical) benefits and risks, and finding nothing sufficiently compelling to recommend either way, that they felt parental discretion was the right approach. The very fact that they cite medical evidence should demonstrate that they feel it has medical aspects. Jakew 16:27, 10 January 2006 (UTC)

I suppose so, but it seems clear the medical aspects they refer to must mostly be risks and possible harm of circumcision rather than benefits, since they came out against it. Therefore if circumcision is a medical issue at all, to them at least, it's an issue of a procedure that is harmful on the balance. I'm not trying to insert a POV here but I'm very concerned that the article avoid granting routine neonatal circumcision a clearly unwarranted appearance of therapeutic legitimacy through painting it as a medical issue. -Kasreyn 16:01, 11 January 2006 (UTC)

The thought occurs that if they felt it was harmful on balance they would not have recommended parental discretion. Jakew 16:41,

Not necessarily. The medical establishment are well aware of the strong cultural imperative of parents to "normalize" their children via medically unneccessary surgery at birth. It's a desire rooted half in the need for social acceptance and half in the need to rationalize their own mutilated bodies: opposing circumcision requires telling an entire generation of men that their penises are damaged, and there's a hell of a lot of ego force opposed to you in that case.

This is just my opinion of course, but if you ask me, this is why doctors "advise" parental discretion when they know the procedure is harmful: because they would only make themselves look weak and pathetic if they advised against it... and were ignored. Doctors are aware that they need to maintain their credibility so that they can advise parents on other medical matters (such as routine infant diseases and SIDS), and they're afraid that if they oppose fallacious "common wisdom" (ie, "circumcision is beneficial"), they will succeed only at reducing their own credibility. If they lose credibility, the child who keeps his foreskin might be lost to meningitis, for example. From this viewpoint, their backing-down on the issue of circumcision may in fact be a cynical recognition that they are not equipped to wage culture war. -Kasreyn 08:54, 13 January 2006 (UTC)

Jake, I think you are confusing a medically unnecessary form of permanent body modification with a medically indicated surgery. There is no valid medical indication for the majority of male circumcisions. The majority of male circumcisions in the world are done for religious or cultural reasons. Most are done because the parents are Muslims. Very few circumcisions are medically necessary. A circumcision is only medically necessary if the male has a medical condition present that requires surgery for treatment. Unless there is a medical condition present that requires surgery for treatment, the circumcision is just another form of permanent body modification. The British Medical Association says it "would be unethical and inappropriate" to circumcise a boy for medical reasons when there are effective non-invasive methods of treatment available. However the BMA is much more tolerant of circumcision for religious and cultural reasons. -- DanBlackham 10:25, 13 January 2006 (UTC)

11 January 2006 (UTC) This issue is a no-brainer. The original article was POV-balanced (i.e. NPOV), and then some POV person came along and selectively deleted all of the stuff that went against their own personal POV. Such POV-pushing selective information suppressors make me sick. Oh by the way, here are some more facts about circumcision that I found: 1. In a study in Africa on the effects of circumcision on AIDS transmission, it was discovered that circumcised men (controlled for variables) have sex 20% more often (on average). 2. Circumcised men were found to have a higher incidence of unconventional sexual interests. You can interpret these 2 facts as either pointing to higher libido, higher sexual frustration, or something else, but they are worth including. LawAndOrder 16:19, 10 January 2006 (UTC)

There's many studies that try to provide statistical data on sexual behaviour, the problem is, for issues like that is hard to get reliable numbers. For example, the Lancet's meta study of ~40 AIDS/circumcision studies has indicated that the biggest statistical factor that affected the result of the study, was, if they would themselves check the individuals if they are circumcised or not, or if they would let the individual men just say themselves. The studies that do not verify the status of the males themselves had usually almost no statistically significant difference between the circumcised group and the control group, yet still claimed wild results. The other studies, that really went down on the guys to make sure the circumcised folks are circumcised and the non-circumcised ones aren't, had systematically different results. My personal interpretation is that a) A huge number of men don't know if they are circumcised or not, or b) The studies by their very nature cannot be made in a double-blind fashion and have to trust the participants of the study what they say they did. Thus, unfortunately, most circumcision studies are only of limited value. But informations in that detail shouldn't be in the article - Thats what we have external links for. Dabljuh 21:42, 10 January 2006 (UTC)

I believe LawAndOrder refers to the recent randomised controlled trial, in which the circumcision status of the men was definitely known, for the simple reason that the men were (or weren't) circumcised as part of the study. Incidentally, it would help if you would cite the meta analysis to which you refer (the lancet links on 'Dabljuh's version' do not work). Jakew 21:47, 10 January 2006 (UTC)

They should work, if you register yourself at The Lancet properly. Dabljuh 22:13, 10 January 2006 (UTC)

*Update* I have added stubs for "What is circumcision" and for "Risks of circumcision" to my version. Dabljuh 04:20, 11 January 2006 (UTC)

*Update* I have re-added the sections about consent and emotional impact. I have removed the bit about the internet survey. Its an internet survey, dammit. Dabljuh 04:40, 11 January 2006 (UTC)

Comment I find the revised version much easier to read and suggest that POV discussions focus on changes to that version. The images are a good idea. Lynn Payer's Medicine and Culture [1] offers some interesting insights into prevailing medical practice in several Western countries, especially with regard to differing practices regarding reproductive issues. She views differences in circumcision rates as part of a larger picture that includes vasectomy rates, hysterectomy rates, and cesarean deliveries. Doctors are more likely to perform procedures on one's private parts in North America. Medical consensus is different across the Atlantic. On another note, I'd like to see exploration of cultural differences within countries. I don't have research handy to back this up, but it appears that circumcision rates are far higher among United States citizens of European origin than among African-Americans. It also appears that in Mexico circumcision rates are linked to socioeconomic status, with circumcision being common among the elite and rare among poor people. Regards, Durova 07:57, 11 January 2006 (UTC)

Both versions touch the subject of cultural difference within the US only very superficially at the moment:

The National Center for Health Statistics stated that the overall rate of neonatal circumcision was 64.3% in 1979 and 65.3% in 1999. However, the rate for white infants was 0.3% lower in 1999 than 1979 and the circumcision rate for black infants increased by 6.5% over this time

I would prefer not to go too much into detail in the main article. Is it time to create Cultural evaluation of circumcision? It would look good in the revised article's "cultural" section for further detail on the issue. We already have "detail" articles on several aspects of circumcision, like medical, sexual, or ethical. Dabljuh 08:55, 11 January 2006 (UTC)

It sounds like a good idea to - erm - trim and separate a bit. Durova 18:31, 11 January 2006 (UTC)

Hehehe... Dabljuh 00:44, 12 January 2006 (UTC)

Some comments on Dabljuh's version

Please do not regard the following as an exhaustive list of criticisms. It is simply a start.

What happens during a circumcision? Suggest rewriting based upon a source describing a typical circumcision, with an explanatory note commenting that other techniques are used. As I recall, the AAFP have a page on adult circumcisions that should be suitable.

Risks of circumcision First sentence is not correctly-formed English. Next paragraph: glands should be glans. General comments: tone is slightly alarmist. Medical organisations emphasise that the risk is small and that most complications are minor. This should be noted.

Risks specific to infants "Several studies" need citations (I believe I cited a few in our debate). "One explanation" is this original research, or can you cite a source for the explanation? Text implies anaesthesia is never used for infants - this is incorrect. Canadian org is notable (but needs cite), NOHARMM is not. "Infants are at additional risk for complications" contradicts preceding text, and needs a cite. "There is also considerable risk of death." is POV. "Estimates range between" is a misrepresentation - the data is based upon recorded deaths, as with Gairdner. I explained this to you previously.

Effects of circumcision General comment: this is beginning to resemble medical analysis of circumcision, and is arguably redundant. Should really just have a brief summary here, with a link to that document (as is in the proper article).

Emotional This is in dire need of citations.

HIV Lancet links don't work (cite PubMed abstracts instead). Should note WHO position re the recent RCT. "Neither is the protection reliable enough" - this is your opinion, better to quote WHO instead. "Interestingly, The Lancet reports that male homosexuals" - this is one of 4 or 5 such studies. Furthermore, to say it is 'interesting' is POV.

Hygiene "While smegma is generally not believed to be harmful to health" - weasel words, cite please.

UTI "However, those studies have been criticised" no, some of them have. "The chance to get an UTI for an uncircumcised boy is about 1%, and the mortality is 1:50'000." Cite please. "As it is probable that infant circumcision causes more complications and infant deaths than the UTIs they are supposed to prevent" Cite needed. This looks like OR.

Cultural "In cultures where circumcision is the norm or the quasi-norm" This is your interpretation, and hence OR. Remove interpretation, replace with a different heading.

Intercourse "It is generally accepted that circumcision reduces the sensitivity of the male during intercourse" Cite needed. "The missing gliding action of the foreskin can make penetration more rigid and may make additional lubricant beneficial." Cite needed.

Masturbation "Circumcision was introduced in the English-speaking world as a measure to prevent masturbation" Nonsense. Circumcision was around long before the Victorian era when masturbation became an issue. I think you mean widespread infant circumcision. Even then, it is impossible to identify prevention of masturbation as the only reason, since many advantages were perceived at around the same time.

To be continued... Jakew 16:37, 11 January 2006 (UTC)

I think, most, although probably not all of the citations that you require, can be found by reading the CPS and AAP summaries alone, most other are found in other external links at the end of the article. Please, do not waste mine or anyone elses time by requesting citations of things that you know, just as well as I do or even better, that they are referenced in the external sources. Some of the things that you requested citation for, are your arguments that you brought up in our debate. I don't find it sensible to mutilate (cough) every sentence with an external link, if the external links at the end of the document are more than sufficient. Dabljuh 01:12, 12 January 2006 (UTC)

Wikipedia is an encyclopedia. We do not print unsourced information and then expect our readers to go do our research for us and figure out what might or might not be referring to. If there are sources for the statements that Jakew has flagged above, they should be added to the article. If there are no sources, then the statements are prima facie original research, and should be excluded. Which is it? Nandesuka 02:30, 12 January 2006 (UTC)

The third option. The sources are already there. I just tried to minimize the Harvard [2][3] style [4] of [5] citing [6][7][8] sources [9][10] because[11] that [12] might [13] harm [14] the [15] read flow [16][17][18][19] and [20] make the [21] article [22] less [23] useful [24] to readers [25][26][27][28] [29][30]. Dabljuh 03:10, 12 January 2006 (UTC)

Well, I have added aproximately a metric busload of links/sources and did some further modifications to the article to adress some of the perceived problems. But I must remind everyone: If you find something is wrong with an article, fix it. For stuff that anyone who is even halfway informed can find readily believeable, and knowing that it is sourced already about 20 times, I do not find it necessary to add more sources. Especially not for things that have their own Wiki article and thus, their own sources. You can do something as well and try to contribute to Wikipedia. Hell, some of the things are 1:1 copies from the current article and you request sources for those from me? I'm not going to let me being filibustered by fringe view POV pushers. Contribute or stay out! Sorry for the combative tone, but it is very frustrating to produce an useful article like this. Dabljuh 06:32, 12 January 2006 (UTC)

Dabljuh, I don't see the point in wasting my time editing an 'alternative version' of a page, simply to bring it up to the standard of the original version. I remind you that you requested comments on your version. I have given you some concrete, specific examples of what is wrong with it, in good faith, and you accuse me of being a fringe view POV pusher. Furthermore, when I ask you to provide a source, it is because policy requires it, not because I am deliberately being a nuisance. If something is true, then citing a source makes the article better. If it is not true, then in trying to find a source you are unlikely to succeed, and accordingly should remove the OR/POV, again making the article better. Jakew 14:20, 12 January 2006 (UTC)

Well, you have rewritten the "What happens during a circumcision" section. Would you have done that without me reminding you to? Would you have written that section at all? Would anything ever happen to this article as apparently it is perfectly fine according to you right now? I have decided to start an overhauled article because the current article does violate WP:NPOV. And not just that, it is an unstructured mess, witnessing of year long POV wars. The constant filibustering and statusquoism makes it very hard to get any changes done. What I'm asking for, is your cooperation and understanding of the issue. I ask you to refrain from unnecessarily requesting sources when you exactly know, it is already sourced several times. Why do you accuse me of trying to introduce original research all the time when you know the sources even better than I do? Why don't you add the sources yourself, rather than forcing me to search for them. Bring yourself in constructively, like you just did with the "What happens" section. That was good. I C&P'd that, with some editing. Dabljuh 15:21, 12 January 2006 (UTC)

Yes, I edited the section in response to your edit. Here, you see, you were making small, incremental changes - exactly as several editors have advised you to do, and consequently the Wikipedian process of improvement took place.

I know you feel that the article violates NPOV, but you have still not explained why, despite the fact that the notice directs the reader to discussion of the NPOV issues on the talk page. If you explain, clearly and carefully, and preferably with examples, where you feel NPOV is violated, we can discuss and try to resolve the issues. If you just complain that it violates NPOV there's nothing we can do.

Next, it is Wikipedia policy to require sources. You must provide them. I shouldn't even have to ask. Sure, I know the research well, and in some cases I could source comments, but what's the point? If you edit the main article I'm happy to do so, but on the little 'Dabljuh's version' backwater, what good will it do? Sometimes, on the other hand, I'm asking for a source because I suspect it to be original research. A good example being the 'it is generally agreed that circumcision desensitises' bit, which is clearly OR and weasel words to boot.

Next, the fact that I know the sources well is why I am able to spot original research so easily in unsourced material. When you know something well, it's easy to spot something new and, well, original. And original research should never appear in an article.

Finally, if you want to introduce new content you should be providing sources. It's not up to me to find them for you. Jakew 16:08, 12 January 2006 (UTC)

Well, I could quote Gairdner or Fleiss, but this paper by CIRP sums it up pretty much. Dabljuh 16:25, 12 January 2006 (UTC)

www.cirp.org is does not meet the requirement of WP:RS, and I see no indication that the article there has not been published in any peer-reviewed medical journals. Jayjg ^(talk) 17:23, 12 January 2006 (UTC)

Being an anti-circumcision activist site (and an unreliable source), it is hardly surprising that they would have such a position. Certainly it is clear that some people hold this view. However, the text doesn't state "anti-circumcision activists generally agree", it says "it is generally agreed". A suitable source for that would perhaps be an opinion poll in which the majority agreed it was so. In the absence of such a poll, however, it might be wise to look at published research, as summarised in sexual effects of circumcision, in which the matter is evidently far from clear.

Here is the problem: by using weasel words and failing to cite sources, you're endorsing an anti-circumcision POV. Jakew 17:32, 12 January 2006 (UTC)

CIRP is not an anti-circumcision site any more than the AAP, the AAFP, the CPS, the RACP or the ACOG are an anti circumcision organisation. All try to inform, both do not recommend routine infant circumcision. CIRP has a rich resource of informative papers and a good library, and most importantly, they do not disagree with the scientific consensus in any way. Circumcision was recommended as a means to reduce sexual pleasure in the late victorian age, and nobody not circumcised would disagree about the sexual sensibility of the foreskin. I am aware that you are not objectively assessing the facts here, as you are slanted by your own bias, but I will change the statement however to "CIRP asserts ..." with proper links and all that. Just to make sure. Since you haven't, alreadyDabljuh 17:48, 12 January 2006 (UTC)

CIRP is quite obviously an anti-circumcision site; it's very strange that you would claim otherwise. They only provide information which is against circumcision. Newspeak is unwelcome. Jayjg ^(talk) 17:52, 12 January 2006 (UTC)

There isn't much information pro circumcision to state. To assert otherwise, would be fringe view POV pushing. You may want to review the general assessments of the organizations I mentioned above. Dabljuh 17:57, 12 January 2006 (UTC)

You might find it worthwhile to do so, also, comparing each section in, for example, the AAP's policy statement with CIRP's corresponding page. For example, the med. orgs. cite papers showing decreased risk of UTI, while CIRP say 'no way'. The med orgs cite papers showing decreased risk of penile cancer, while CIRP say 'no way'. Another good example is HIV. Compare CIRP's page with the 2003 Cochrane review (a well-respected series of literature reviews). Notice anything? Despite the fact that they include this review on their site, CIRP are stating the exact opposite of the vast majority of papers!

You might care to search PubMed for papers on circumcision. Which ones do CIRP include? Take a look at the references of Singh-Grewal's UTI paper. Which do CIRP include? Here's another one: go to CIRP's page on balanitis. Notice that it comments on Van Howe's balanitis findings. Now look at my letter to Pediatrics. Which of the other relevant papers do CIRP cite? None! Surely you must be starting to see a pattern here? Jakew 18:11, 12 January 2006 (UTC)

Here's the thing. When all of major medical science comes to the conclusion that routine neonatal circumcision is not advisable, why not you? CIRP is not pubmed. They have to limit the number of papers they present, and choose select information that they find relevant. Have you ever counted how many possibly not notable papers that argue against circumcision they have left out? How many letters against circumcision did they not publish? I can agree they are a bit one sided, but to call them unreliable as a source is just unfounded. So medical associations have produced policy statements and assessments of circumcision that parallel CIRP's information and conclusion, that I do not see any reason not to trust their informations. Jake, seriously, stop worrying and take a wikibreak, you know why. This here is just distracting you from your real life problems. Dabljuh 18:25, 12 January 2006 (UTC)

As has been shown, www.cirp.org is highly selective in its use of sources, including only ones that are against circumcision, and even making anti-circumcision claims for them that the authors themselves don't make. As well, if you look on, for example, its FAQ page for parents (http://www.cirp.org/pages/parents/FAQ/), it strongly encourages parents not to circumcise their children, makes dubious and unscientific claims about the foreskin, and refers parents to www.nocirc.org, another strongly anti-circumcision website. Your disingenuous claims that you support circumcision and that www.cirp.org is not an anti-circumcision site, combined with your personal attacks on Jake, have, at this point, removed any further need for good faith regarding your edits and comments. Jayjg ^(talk) 18:33, 12 January 2006 (UTC)

• "After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision."

• And check out this fun handout from the CPS

Surely these institutions are just engaging in ANTI CIRCUMCISION PROPAGANDA with a possibly ANTI SEMITE BACKGROUND.

Reality check? Dabljuh 18:43, 12 January 2006 (UTC)

Sure, the RACP conclude that routine circumcision is not needed, but look at the details.

RACP: "Even though the evidence suggests neonatal circumcision may reduce the risk 10-fold, the rarity of the condition and its other recognised predispositions are such that universal circumcision is not justified on these grounds alone."

CIRP: "It is thus categorically not true that circumcision eliminates the risk of penile cancer ... Circumcision does not provide protection against penile cancer. Even if it did, it would no longer be necessary due to the expected availability of a HPV vaccine."

See? The RACP are honestly assessing the evidence, and reporting on it. CIRP, on the other hand, pretend that it doesn't exist. To paraphrase, the RACP says "circumcision does have a small number of benefits, but we don't recommend it", while CIRP says "circumcision has no benefits and it is really harmful. We strongly recommend against it."

Finally, please review WP:RS. CIRP is a personal website run by Geoffrey Falk and George Hill (of Doctors Opposing Circumcision). It takes an extreme position (though citing papers that they republish is fine). It does not respond to criticism. It is not a reliable source. Jakew 18:59, 12 January 2006 (UTC)

Er, the CPS handout speaks of a reduction of PC by a factor of 3. Now... does that mean the CPS is also a anti-circ-omg-integrity-movement site? Or does that mean the RACP is an omg-circumcision-advocacy-site? No it does not. It means they have come to slightly different data and intermediate conclusions, but it didn't that in the big picture, that circumcision is not recommended at all. Which is the scientific consensus. Welcome to the internet, where you take multiple sources and interpolate the truth. I still do not consider CIRP more unreliable than those other sites. Dabljuh 19:12, 12 January 2006 (UTC)

Then you must not have read - or failed to understand - WP:RS. Jakew 19:18, 12 January 2006 (UTC)

BTW, I've already changed that in my version long ago, so this is moot. I'll take a nap now. In the meantime, you can think of arguments why I should believe that CIRP is biased. And I mean a priori arguments that would explain their bias, rather than you documenting it in your mind. Dabljuh 19:22, 12 January 2006 (UTC)

For more documentary evidence, see Talk:Circumcision/Archive 7#CIRP links.

For an explanation, consider this. Geoffrey Falk explains in 'the psychology of a non-circumcision advocate' why he is opposed to circumcision. George Hill (a retired airline pilot) runs NOCIRC of Louisiana, is Executive Secretary of Doctors Opposing Circumcision, and at some point was invited by Falk to help him run CIRP. With these backgrounds, is anti-circumcision bias really so surprising? Jakew 19:32, 12 January 2006 (UTC)

And in any event, it is up to Dabljuh to show that this anti-circumcision site meets the requirements of WP:RS; so far, he has not. Jayjg ^(talk) 19:51, 12 January 2006 (UTC)

Lets review the relevant section in WP:RS shall we?

Scientific journals are the best place to find primary source articles about scientific experiments, including medical studies. The best scientific journals are peer-reviewed, which means that independent experts in the field are asked to (usually anonymously) review articles before they are published. This usually results in corrections and improvement, sometimes substantial. Many articles are excluded from peer-reviewed journals because they report questionable (or perhaps merely unimportant, in the opinion of the editors) results.

The fact that a statement is published in a peer-viewed journal does not make it true.

Even a well-designed experiment or study can produce flawed results. (For example, see the Retracted article on neurotoxicity of ecstasy published in the very prestigious journal Science.) The second part of peer review occurs after publication. Colleagues in the field will read the journal article and discuss it in various forums, including other journals in the same field and often later articles in the same journal. They may find self-evident flaws in the procedure used just by reading the article and applying their experience, or it may take a long process of trying to reproduce the results by similar or completely different means for the scientific community to determine that the original results were corrupted by some undetermined methodological problem, or to rigorously confirm the original result. The most reliable source for scientific information is the prevailing "scientific consensus".

Determining the scientific consensus could be done with a survey of experts in the field, but it can also be accomplished by following the state of discussions in respected journals.

There is sometimes no one prevailing view because the available evidence does not yet point to a single answer. Because Wikipedia not only aims to be accurate, but also useful, it generally tries to explain the theories and empirical justification for each school of thought, with reference to published sources. Editors should not, however, create arguments themselves in favor of, or against, any particular theory or position. See Wikipedia:No original research, which is policy.

Just because something is not an accepted scientific fact, as determined by the prevailing scientific consensus, does not mean that it should not be reported and referenced in Wikipedia.

However, although significant-minority views are welcome in Wikipedia, the views of tiny minorities need not be reported. See Wikipedia:Neutral Point of View. Significant-minority views should be reported as that, and should not be given the same amount of space in an article as the majority view.

Simply make readers aware of any uncertainty or controversy. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers, rather than: "Some say that ... (vague, unattributed theory), but others believe ... (vague, unattributed theory)."

So, we have a clear scientific consensus that opposes infant circumcision. All sources of information that contradict the scientific consensus must be taken with a grain of salt, naturally. The interesting part is, that neither CIRP, nor any of the genital integrity movement organizations, contradict the scientific consensus. Their articles are - in general - well referenced and compelling. There may be the occasional bit of polemics or gratious interpretation of other studies, but that is something no medical journal can be really cleared from.

For example, lets evaluate the notion that the foreskin is sexually sensitive. Its not hard to take a piece of foreskin, put it under a microscope and just start counting the sensual nerve endings and end up with a conclusion that it is, in fact, sexually sensitive and that its removal would diminish sexual pleasure. In the victorian age, the main reason circumcision was becoming popular because it could curb masturbation, a widely believed to be harmful at that time. And even these people knew, circumcision would diminish sexual pleasure. Even the ancient greeks disliked it, and you know what, the ancient greeks were right about everything!

So, it is not unreasonable to agree to the conclusions that CIRP makes with their papers regarding the sensitivity foreskin, it in fact would be unreasonable not to. Especially if one has a foreskin and has ever ever caught that shit in a zipper, I can tell you dammit, that hurts like fuck! But that is of course personal experience and it is flawed to use it as a scientific premise.

The scientific consenus is not to remove the foreskin. Not just because the benefits do not outweight the risks of the procedure, (or hold an extremely even balance according to the biased AAP) but also because of ethical issues.

I am quite certain, *some* of the members of the AAP are members of DOC as well. Or maybe the communist party. That doesn't change that the position paper - more or less - represents the scientific consensus. That none of the big medical associations support circumcision, does not make them or their assessment unreliable. In fact, if it did, despite the clear evidence of medical consensus that childhood circumcision is not recommendable, that would indeed make it unreliable. CIRP may be a bit biased and one-sided in their collection of articles, but that is also understandable when one notices that no procedure in history has been claimed (and disproved) to cure so many ills as circumcision.

You may argue about the incidence rates of HIV infections or UTIs. We argued about penile cancer, as I remember, and I quite clearly showed you that recommending circumcision as a procedure to reduce penile cancer risk is sheer lunacy. With objective assessment, the UTI risk is smaller than the risk due to circumcision. Recommending a circumcision as a preventive measure against HIV is similiarly unreasonable. And all of that is not just my personal assessment, it is the assessment of such illustrous organizations as the WHO and many other medical associations.

That CIRP is so reluctant to provide information about the possible benefits of circumcision is understandable if one reads the history of circumcision is so full of dubious claims, and lets one come easily to the conclusion that there is a psychological motive to find a new contemporary thing that circumcision supposedly cures or protects from every generation or so.

It does not mean they are unreliable. On the contrary, they assess the risks and benefits of circumcision in an objective manner, and unlike the major medical organizations, have no incentive not to raise a strong, ethical point. Circumcision is a social practice with so little medical benefits, an unreasonably large risk, and significant adverse side effects, that it would be unreasonable not to. CIRP represents the scientific consensus almost completely, although, as you correctly state, does not emphasize the benefits of circumcision, however small small they may be, enough.

None of this does make them unreliable. It makes them a bit one sided, and necessitates reviewing additional sources for additional material. But that is just the case with all of science. Calling them unreliable because they do not present enough argument pro circumcision is not reasonable, as, by the same standard, you would call the RACP or the CPS unreliable. In fact, as both of these organizations, as well as others, claim a complication rate of 2-10% of circumcision, and the AAP figure of 0.2%-0.6% has been repeatedly and reasonably been criticised, it therefore would be unreasonable to use the AAP's figure for complications in the article. That does not mean the AAP is not right, it simply means, they *may* be a bit biased in favor of circumcision. Nevertheless, they are also part of what represents the scientific consensus, just that their figure probably isn't right.

Just because a source gives you the idea that circumcision isn't exactly a good idea doesn't make it biased or unreliable. That is just what it is, objectively. On the contrary - if a source gives you the idea that circumcision is something medically or sexually beneficial, that would indeed be indicating a bias and unreliability. That is also my beef with the article, and why it has the NPOV tag right now. Dabljuh 03:14, 13 January 2006 (UTC)

Hear hear! I commend you, Dabljuh, on a cogent argument. I admire the dedication it must take to spend so much time on just the talk page. ^L_Wizard @ 04:47, 13 January 2006 (UTC)

Dabljuh, a recommendation for or against circumcision is not a scientific view. It cannot be, because it inherently contains a value judgement. Example: putting my hand in boiling water will cause scalding and, likely, burns (scientific fact). To recommend against, however, I have to incorporate the idea that that is a bad thing (value judgement). Weighing up is a human activity, not a scientific activity.

Looking at the scientific view alone, which requires assessment of facts with no value judgements, CIRP are diametrically opposed to the prevailing scientific opinion. I've shown that above. It makes no difference what excuses you care to make for this - they still hold this view.

Look at the scientific facts. Pretty much every medical organisation agrees that circumcision results in reduced risk of penile cancer and UTI. That, my friend, is the prevailing view. CIRP takes an opposing view. The WHO notes with interest the findings of the HIV RCT, but recommends waiting for the results of the other two before adopting circumcision programmes. CIRP says there's no chance of it protecting, and it probably increases the risk. On the scientific side, they hold a distinctly minority view.

But it is not that which makes them unreliable. It is the fact that CIRP does not meet the requirements of WP:RS.

Now, it's perfectly okay to represent a minority view, and it's fine to include reliable sources (papers, etc) that argue against UTI protection, for example. Equally, in terms of overall views, we should be including the mainstream view, as expressed by the med orgs (not recommending routine circ), as well as the minority views (recommend against / recommend in favour).

But we cannot simply overlook the requirements of WP:RS on the grounds that their overall opinion can, after some torturous reasoning, be considered similar to that of a few med orgs, and that differences on the facts can be excused because there is some conspiracy to promote circumcision. That is simply silly. Jakew 12:31, 13 January 2006 (UTC)

The Royal Australasian College of Physicians

Jake wrote, "To paraphrase, the RACP says 'circumcision does have a small number of benefits, but we don't recommend it', while CIRP says 'circumcision has no benefits and it is really harmful. We strongly recommend against it.'" However Jake's interpretation does not agree with the following direct quotes from the RACP policy statement.

• "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."

DanBlackham 10:40, 13 January 2006 (UTC)

Thats a weird way of paraphrasing it. BTW, check the Australasian Association of Pediatric Surgeons. Dabljuh 11:11, 13 January 2006 (UTC)

In the first statement, they don't say that it is medically contraindicated, in the second they merely note that it has been raised, but don't endorse it, and in the third they say nothing about harm outweighing benefit. Even with these carefully selected snippets, you've failed to show evidence that they believe it is harmful, or that they recommend against it. Jakew 13:05, 13 January 2006 (UTC)

The fictious president of the Nomansland Orifice Pediatrics and Explorers (NOPE) has today announced:

"Circumcision is total bullcrap. It really sucks ass, big time. Anyone who would possibly want to have this procedure performed should be whipped with an anchor. Human rights violation and all that. CIRCUMCISED MEN ARE NOT MEN ANYMORE! However, we will continue to offer it to people who wish to mutilate their kids on the basis of religious faith because they better come to us where we have sanitation and education rather than have the dumb fucks attempt it themselves on their kids with possibly catastrophic outcome."

See, when you're a national organization of anything bigger than Nomansland, you need to be somewhat intent on trying to explain matters in a polite matter. Regardless of science or your assessment thereof. In fact, there is only 4 positions such an organization can really take on the issue.

1. mandate it
2. recommend it
3. not recommend it
4. condemn it

Dabljuh 14:03, 13 January 2006 (UTC)

It's perfectly possible to express strong views in a polite and reasonable way, Dabljuh. For example, here is a hypothetical rephrasing of one of those sentences: "Review of the literature in relation to risks and benefits shows there is evidence of harm outweighing benefit for circumcision as a routine procedure in the neonate." See? Perfectly polite, but not the viewpoint that they chose to express. If you think they should have, fine! You're entitled to your views. You're entitled to lobby them to change theirs, or put up web pages criticising them for being 'biased', as some anti-circumcision activists have done. But for purposes of Wikipedia, you cannot misrepresent them or twist their words to mean something they did not say.

It's unclear what you mean by 'not recommend'. Do you mean literally an absence of recommendation, a neutral position, or a recommendation against? Jakew 14:16, 13 January 2006 (UTC)

Math. B = Benefit, H = Harm.

(not (B <= H)) => (H > B)

In plain english. If they come to the conclusion that benefit does not outweight harm, then that means the harm outweights the benefit of the procedure.

Oh, actually, I wonder what the stance of the medical consensus on Trepanation is... Dabljuh 14:14, 13 January 2006 (UTC)

Faulty logic. No evidence of benefit outweighing harm is (not (B > H)), and implies (H >= B). Jakew 15:05, 13 January 2006 (UTC)

I'd imagine they probably recommend against. Jakew 14:16, 13 January 2006 (UTC)

The American Medical Association does not recommend for or against Trepanation. Notice something? There's more: The American Association of Neurological Surgeons does not recommend Routine Trepanation. Notice something? That's how the system works. Dabljuh 14:32, 13 January 2006 (UTC)

They seem willing to take a strong stance at times: "The AAP holds a longstanding position recommending against direct-to-consumer advertising of infant formulas. This position is shared by the World Health Organization, American Public Health Association, American Medical Association, and others. The Academy believes that direct advertising of infant formulas to the consumer will decrease the incidence of breastfeeding, and that the value of counseling women to breastfeed will be seriously compromised by mass media advertising of infant formulas." Clearly, when they believe it is appropriate, they do specifically recommend against something. http://pediatrics.aappublications.org/cgi/content/full/99/5/749 Jakew 14:44, 13 January 2006 (UTC)

That is the polite version of a condemnation. Look up nestle#Baby_milk_marketing some time. Direct infant formula advertising in 3rd world causes probably more dead kids than circumcision in the first. That is a real shitbag action tbh. Dabljuh 14:50, 13 January 2006 (UTC)

I don't disagree, but the point is that it is a condemnation. It is an example showing that med orgs are willing to explicitly recommend against something, and this is distinct from an absence of a recommendation for. Which clearly demonstrates that your interpretation of the two as equivalent is incorrect. I'm curious to learn whether you'll concede this point now. Jakew 15:05, 13 January 2006 (UTC)

I wonder where you get that idea. I explained to you that there is a difference between "condemn" and "not recommended". I only know of the AAPS to condemn routine infant circumcision, I however do not know of a single medical association recommending it. Trepanation by comparison is not recommended, yet not condemned either by anyone afaik. Vaccinations are recommended and sometimes even mandated. Going to a doctor when you feel sick is "recommended". You should start to realize that if a medical association explicitely does not recommend a thing, then that means "we don't think thats a good idea" for medical reasons. When an association recommends something, that means "That is a good idea". When they explicitely state "We do not recommend" something, then that means a lot, because, most of the stuff that they "do not recommend" implicitely is really just a matter of common sense, like trepanation. There's just no way you can construct the medical consensus of "not recommended" as "almost recommended". Dabljuh 15:16, 13 January 2006 (UTC)

No, it logically means 'no deviation from neutrality specified'. But there's no reason to take my word for it. Here is an explanation from the AAP's task force that used those words in its conclusion: "There is no disagreement between the Task Force and the authors over the fact that there are potential medical benefits to circumcision. There is disagreement over the magnitude of these beneficial effects. The Task Force found the evidence of low incidence, high-morbidity problems not sufficiently compelling to recommend circumcision as a routine procedure for all newborn males. However, the Task Force did recommend making all parents aware of the potential benefits and risks of circumcision and leaving it to the family to decide whether circumcision is in the best interests of their child. ... When a procedure or treatment is not essential to a child's current well-being, a parent has no obligation to consent to it. Circumcision falls into that group of procedures that have potential medical benefits and some risks and should be evaluated by each family in the context of their personal beliefs and values as well as their ethnic, cultural, and religious practices. The Task Force respects the role of parents as decision-makers for their newborns and recommends that physicians discuss with parents the potential benefits as well as risks of circumcision so that parents can decide whether circumcision is in the child's best interests." [31]

I cannot see how you can possibly read that as a recommendation against. It's clearly a recommendation for parental discretion. Jakew 15:25, 13 January 2006 (UTC)

Ok, I can understand your confusion. The AAP statement is long and complicated, and they really are pussies about it, but ultimately they come to the same conclusion and do "not recommend" it. Dabljuh 15:19, 13 January 2006 (UTC)

Nope, see above. Jakew 15:25, 13 January 2006 (UTC)

Hmm, I have a question for the other editors. Wikipedia is, of course, not an American-viewpoint-only encyclopedia, and so it's quite proper to include viewpoints from other countries. How many is considered fair? Ie., we shouldn't just display the viewpoint of the medical establishment of one country, but how many countries' medical establishments should we reference in order to be fair? We can't refer to all of them, but a representative sample, at least of the ones who've taken some sort of stance on the issue, would seem to be fair. I'm also curious what, if anything, medical institutions in predominantly-Islamic nations have to say about the advisability of circumcision. -Kasreyn 11:18, 13 January 2006 (UTC)

My opinion was to have a medical association from all major english speaking countries. Namely, USA, Canada, UK, Australia/New Zealand. Check the external links in my article (and if possible compare them to the current one)

Assessment of Positions

Ok, there appears to be confusion about what Organizations mean. The policy/guideline statements/assessments are long and complicated. The important thing to understand is, an association's approval of a practice or action can be measured in 4 levels:

1. Mandate it
2. Recommend it
3. Not Recommend it
4. Condemn it

Confusion arises from the question whether the third item, "not recommended" means "recommendation against" or completely neutral/indifferent/ignorant about it. Key is to understand, when an someone explicitely releases a statement, completely neutral/indifferent/ignorant conclusions are rare.

The second thing to understand is, big organizations are politically delicate and can't, like we are used on the internet, resort to gratious employment of flames and gross language. This means, any sort of disapproval of a practice would possibly offend someone. The third item cannot possibly say "We think its a really dumb idea" because that is offensive. "Slight" disapproval in the world of politics is expressed by "not recommending".

A further item is to be taken into consideration in medicine: A medical practice that has no net benefit is, by its very definition useless, from a medical point of view. Compare to Homeopathy for reference about useless medicine. Most countries and medical associations have guidelines, rules, that tell the doctors not to perform unecessary treatment. Doing so may be considered malpractice, and even when the legal problems are ignored, may damage the reputation of a doctor. This has to be understood when reading the statements.

AAP

American Academy of Pediatrics position paper:[32]

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

Clear conclusion. They do not recommend.

AAFP

American Academy of Family Physicians statement [33]

The American Academy of Family Physicians recommends physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son.

The AAFP abstain from any sort of recommendation apart from discussion. This is actually a neutral/no position statement.

BMA

British Medical Association Guideline [34]

The medical harms or benefits have not been unequivocally proven except to the extent that there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues. Indeed, it would be difficult to formulate a policy in the absence of unambiguously clear and consistent medical data on the implications of the intervention.

Again, a neutral/no position statement. They are reluctant to formulate a policy.

CPS

Canadian Pediatric Society assessment [35]

The overall evidence of the benefits and harms of circumcision is so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns. There is therefore no indication that the position taken by the CPS in 1982 should be changed.

Very clearly, not recommended. Not convinced?

Compare with the parent handout: [36]

Circumcision is a “non-therapeutic” procedure, which means it is not medically necessary. Parents who decide to circumcise their newborns often do so for religious, social or cultural reasons.

After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.

RACP

Royal Australasian College of Physicians Policy: [37]

After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision.

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.

Again, Not recommended.

AAPS

Australasian Association of Pediatric Surgeons [38]

The Australasian Association of Paediatric Surgeons does not support the routine circumcision of male neonates, infants or children in Australia. It is considered to be inappropriate and unnecessary as a routine to remove the prepuce, based on the current evidence available.

We do not support the removal of a normal part of the body, unless there are definite indications to justify the complications and risks which may arise. In particular, we are opposed to male children being subjected to a procedure, which had they been old enough to consider the advantages and disadvantages, may well have opted to reject the operation and retain their prepuce.

Harsh! Outright condemnation!

Comments

We've been over this above, and you've just restated your interpretations. If they don't make a recommendation either way, they don't make a recommendation either way. You're free to feel that they probably wanted to recommend against but decided to be politically correct, but that is simply your opinion. Wikipedia is not about your opinion - that's the whole point of NOR. It is about honestly and truthfully representing pre-existing knowledge and opinions. Will you please stop wasting everybody's time with this repetitive, unprovable, and unverifiable nonsense? Jakew 16:10, 13 January 2006 (UTC)

You have to understand this from the perspective of a lawyer. These are legal statements. In 20 years from now on, when possibly 20 million men file a class action suit against all doctors involved in their circumcision, the judges and the jury will not care in the least about all those medical details that you are so fond of. By then, better evidence will have emerged and scientific consensus may be drastically different. They will only care about one thing: Did organization XY recommend the practice or not? Did doctors circumcise despite the practice not being recommended by their respective medical association? Dabljuh 16:26, 13 January 2006 (UTC)

You are certainly free to believe that, as long as you understand that saying that in the text of the encyclopedia is impermissible, as "proof by hypothesis based on lawsuits I personally think will be filed at some point in the future" is original research. Nandesuka 16:43, 13 January 2006 (UTC)

Nevertheless, the article in its current form violates WP:NPOV as it does not give an accurate representation of the scientific consensus and instead overrepresents fringe view, pro circumcision arguments. My overhaul may not be perfect, but in terms of the WP:NPOV violation, readability, usefulness and information content, in short, in every aspect, I think my version is superior. Which is why I argue for the replacement of the current article with my overhauled one. Since I do not seem to get much support from the users here (and no constructive criticism or effort to achieve a consensus) I have filed an RFC to get an outside view into the issue. Dabljuh 16:56, 13 January 2006 (UTC)

It's not correct to state that you have received no constructive criticism. I gave you some detailed comments with suggestions for improvements above. Jakew 17:45, 13 January 2006 (UTC)

I perceived that rather as filibustering me with endless and often unneeded requests for sources. I understand constructive criticism different. You have overhauled the "What is circumcision" thing tho. That was good. Dabljuh 17:54, 13 January 2006 (UTC)

What can I say? As WP:FAITH suggests, if you fail to assume good faith, it is impossible to work with others. Jakew 18:06, 13 January 2006 (UTC)

May I remind you? You admitted you *could* have contributed in a productive manner, but have consciously chosen not to.

Sure, I know the research well, and in some cases I could source comments, but what's the point? If you edit the main article I'm happy to do so, but on the little 'Dabljuh's version' backwater, what good will it do?

Dabljuh 18:52, 13 January 2006 (UTC)

That makes me sick

http://pediatrics.aappublications.org/cgi/content/full/101/6/e5

Memorable quote:

In summary, reasons given for not using anesthesia have been answered by research and experience. Thus, there is no reason for these myths to be perpetuated to the detriment of these infant boys. As stated in 1988,5 if regulations require all animals involved in research surgery to be anesthetized, are we not morally obligated to provide the same care for infant humans?

Thanks to Kasreyn

Unhappy. Dabljuh 11:37, 16 January 2006 (UTC)

You and me both. -Kasreyn 05:39, 17 January 2006 (UTC)

Beginning to replace the old article with the new one

Hello alls.

Following this post, I will begin replacing the old article with the new one. I will do so section for section, as has been suggested by User:Benami. While I do not think that this is going to be particularly useful, it may allow a better overview about the changes in detail. I certainly hope, you will agree that every single section is replaced with a superior one.

In the following, I will explain my rationale to rewrite the article in the first place.

The old article carries an unbearable amount of WP:NPOV violations. It does not fairly represent the scientific consensus which makes it clear that the benefits of the procedure of routine infant circumcision do not outweight the risks, and is not recommended. It unfairly stresses pro circumcision arguments without setting them in a fair context with the risks and the various diseases that circumcision prevents. And lastly, it almost completely omits the view of the genital integrity movement.

Additionally, the article is mutilated and scarred from age old POV/edit wars. Relevant information has gone completely missing, because it potentially offended either side. The structure is lacking. The flow and an unifying vision of the article have gone totally overboard. But most noticeable is of course the WP:NPOVUW violation.

It is very hard to maintain an NPOV with a topic as sensitive as this. The major problem is, that while there is definitely a good argument for circumcision both being beneficial and a human rights violation, the medical consensus, the mainstream view, is that while the procedure does have benefits, they do not outweight the risks, circumcision is therefore not recommended and must be regarded as a purely social and cultural practice. Also, the mainstream has begun to accept and acknowledge the ethical issues surrounding neonatal circumcision. The genital integrity movement doesn't want to hear about the miniscule advantages of circumcision and instead recognizes it variously as a male genital mutilation, sex crime, or child sexual abuse. Circumcised guys, and circumcision advocates in general on the other hand, do not want hear about any adverse effects, and certainly not about it being anything bad whatsoever, and cling on to the positive aspects of circumcision.

One of my biggest complaints about the original article was its lack of relevant information, gross negligence towards the risks of circumcision and indifference to the medical consensus. We have three aspects here that need to be balanced, and even NPOV itself is barely enough to treat the subject in a fair and sensitive way. But I think I have managed to rewrite the article, so that all sides can be reasonably happy.

First and foremost, routine circumcision is not a medically indicated practice. This needs to be stressed, anything else would be misleading, counterfactual, and violating WP:NPOV. The benefits of circumcision simply do not outweight the risks of the procedure, period.

Secondly, we have the competing interests of the intactivists and the circumcision advocates. Intactivists want to see the practice outlawed as soon as possible, as they recognize the mainstream view of circumcision not being medically recommended, and full of ethical issues, and as that circumcision does indeed have adverse effects on the adult sexuality.

Thirdly, we have the circumcision advocates, that I mainly identify as guys circumcised themselves. Circumcised guys do not want to read about how bad a procedure, that they did most likely not have a say in, is for their sexual performance, instead, they want to read about how great circumcision is. This is in direct opposition to the medical consensus. Even worse, when they did have a say in it, and now cannot admit any adverse effects.

I have decided to balance the three major points of view the following way:

1. The mainstream argument receives the highest prominence. Circumcision as a non-therapeutic medical procedure is not medically recommended, and the indications for a therapeutic treatment is indeed rare, and unfortunately, often overdiagnosed.
2. Intactivists merely get a critical view of their argument of adverse effects in the adult. Instead, the ethical issues and the procedural risk factors - that the mainstream acknowledges, are too great to continue routine infant circumcision - are emphasized.
3. Advocates will get a reasonable rundown on the positive aspects of circumcision, even though these are miniscule when viewed as a lifetime risk. Provided, of course, the article does properly convey, that medically, the risks of the procedure do not outweight the benefits, and while they might have gotten lucky with their circumcision, the ethical aspects and most importantly, the risks, do not warrant continuation of the procedure as anything but a cultural / social rite.

In short: - Adverse long term sexual, emotional and health effects are subdued (so advocates have no reason to complain because it offends them) - Risks are emphasized (necessary to comply with WP:NPOV that demands that the medical consensus is represented as such, as well as making the intactivists happy) - Ethical issues are emphasized (Fair representation of the intactivist POV) - Medical benefits are over-emphasized (Sensitive representation of the advocacy POV)

I think it is not possible to achieve an NPOV version that everyone can be happy with, as long as intactivists try to stress the long term sexual, emotional and health effects, or advocates subdue the procedural risks or convey the image there would be medical reason to continue routine neonatal circumcision. What I have created is a compromise, but I think it's the only sensible, and sensitive way. The picture that has to be conveyed is, that while circumcision does have "significant" health benefits, the risks are too great to recommend the practice as a medical operation. This is *exactly* the mainstream POV, and thus in my opinion, the only way this article can comply with WP:NPOV in the long run. Any variation from this formula will result in edit wars and arguments.

Intactivists: You can't tell every circumcised male who will read this article that he's mutilated and less of a man or shit like that. People don't want to hear that, they will simply convince themselves that "Wikipedia spreads nothing but lies" or some shit, even though your argument is perfectly valid! Yes, circumcision is wrong. Every major medical organization will tell you so. But the way to convince people is to stress the risks, and not the long term adverse effects. The risks of the procedure of circumcision itself. Tell them, "Wow, you still got a penis, lucky you!" that will make them think twice about passing this stupid rite on to their children.

Advocates: You cannot possibly convey the image that this procedure would be medically legitimate. It is a social rite, where the risks of the PROCEDURE are greater than the medical benefits. The article will tell you, fairly, about the various medical benefits that you get, but you will have to accept that this must not stop the article from explaining, very clearly, that the RISKS of the PROCEDURE do not warrant a medical recommendation for routine infant circumcision. I understand the desire to tell everyone how great this is, to make yourself feel better, but to distort how the medical consensus is represented in Wikipedia, I cannot tolerate. And according to WP:NPOV, Wikipedia cannot tolerate this, either.

My first and most important rule of thumb for articles on Wikipedia is: Write useful articles, articles that are useful to readers. When you offend half the male population that possibly is reading Wikipedia, the article isn't useful to them - not even to your soapbox arguments - they will simply dismiss the entire article. But if you write a misleading, biased article, that just reinforces common and outdated misconceptions, then the article is ultimately not useful to anyone. Except for people who want to feel better about themselves. If that's what you need, I recommend heroin. Not Wikipedia.

For sensitive topics like these, a balance needs to be maintained.

Dabljuh 19:34, 16 January 2006 (UTC)

All done. You can review the old version here, or the very old version (before I started moaning) here! (Old version). What I updated the page with can be reviewed here (Dabljuh's version). Enjoy! Dabljuh 20:00, 16 January 2006 (UTC)

A word about your lumping circumcised men together as "circumcision advocates." I think you are simply wrong. I doubt most circumcised men have an opinion one way or the other about the medical benefits of circumcision - it's simply a non-issue. As I understand it, those circumcised men who have a non-religious opinion about the subject generally base it on aesthetics, not medicine. The vast majority of circumcised men do not sit around pining for our lost foreskins, and find the (IMNSHO) hysterical claims of anti-circumcision zealots to be pure bunk. It's not that our fragile egos can't bear to hear that we've been "mutilated", but rather that our experience tells us otherwise. Circumcision has made my penis less sensitive to sexual pleasure? Thank God, then - because personally, if sex felt any better my head would explode! You are also incorrectly interpreting the medical information at hand. Every major medical organization does not, as it happens, say that "circumcision is wrong." As Jakew has pointed out repeatedly, not making a recommendation is just that - not recommending. It is not the same as condemning. As a matter of fact, the American Academy of Pediatrics' policy statement says, "In the pluralistic society of the United States in which parents are afforded wide authority for determining what constitutes appropriate child-rearing and child welfare, it is legitimate for the parents to take into account cultural, religious, and ethnic traditions, in addition to medical factors, when making this choice."Benami 20:06, 16 January 2006 (UTC)

Oh, let me translate that to polemic, plain english: "Circumcision isn't a good idea, medically. But: In the US, there's forms of sexual child abuse that are protected by the law *cough freedom of religion cough* so since you can do whatever the hell you like to your kids, you better bring them to us before you kill them yourself." Dabljuh 20:10, 16 January 2006 (UTC)

(A) This is your own spin on the statement, not the statment itself. (B) You're putting too much emphasis on the religious aspect of it. Most parents who opt for circumcision do not do so because of religion, but for other cultural reasons, like aesthetics. (C) Am I right in reading the history tht you have now completely replaced the article with the one of your own writing? If so, that's not what I meant by replacing it "a section at a time." Benami 20:16, 16 January 2006 (UTC)

If you carefully read the statement, you will find that the amount of "spin" I gave it, sadly is minimal. I didn't replace history, I barely changed anything there, I just shortened it significantly to dumb it down to the relevant parts. My rationale: If you want to read it in such excruciating detail, you better go read the real History of circumcision article. I don't know why it shows up so cropped in the diff, you might want to give the sandbox a try - or just read it... Dabljuh 20:25, 16 January 2006 (UTC)

Coptic, Ethiopian practice

I really think that the proclamations of the Council of Florence are out of place in this section, since they have no bearing whatsoever on either Coptic or Ethiopian Orthodox practice. The Council was part of a reunion plan between the Greek Orthodox Church and the Roman Catholics, was finally rejected by the Orthodox, and did not have, AFAIK, the Copts or the Ethiopians in mind. I don't know enough about Coptic/Ethiopian circumcision to add anything to the section, though. Benami 20:39, 16 January 2006 (UTC)

I agree. The stuff you removed was fairly unrelated trivia, at best. But someone with more expertise on Coptic/Orthodox rites may want to look into it. Dabljuh 21:18, 16 January 2006 (UTC)

False dichotomy

The article's intro seems to split the world into two groups: members of the genital integrity movement, and circumcision advocates. I really think that it ought to be noted that, at least here in the States, circumcision simply isn't on the radar screens of the majority of the population. It is not an important issue one way or the other.Benami 21:29, 16 January 2006 (UTC)

That is probably so, but of those that do have an opinion, they're necessarily either against or in favor of circumcision, or so I would think. I have tried to make it very, very, very clear what the medical mainstream thinks of the practice (as the 3rd group and somewhat beacon of reason). Since so many males in the US and world wide are circumcised, I do think it is relevant to provide a rundown of the different views. Another thing is that some arguments are only supported by one side or the other, and I have tried to provide the medical mainstream opinion as a gauge for either. The reader should be familiar with the more particular camps before he reads - out of the blue - for example that the genital integrity movement has laywers that want to sue doctors. Or so. Dabljuh 21:37, 16 January 2006 (UTC)

Or... is what you mean, that the article fails to mention that most people don't give a flying shmock about circumcision? I don't think that is particularly necessary, but how would you suggest to do that? Dabljuh 21:43, 16 January 2006 (UTC)

I'm not even sure that it's true that among those who have an opinion, genital integrist or circ advocate are the only two options. For example, I think that most Jews are probably indifferent to RIC among the general population, but concerned about continued Jewish freedom to circumcise our children (and not, of course, because for any perceived medical reasons). Benami 21:47, 16 January 2006 (UTC)

Another thing that springs to mind is that a surprisingly high number of males (not jews, obviously) are unaware of their circumcision status. (Which is another reason why I am fond of having many penis pics)

We could add a section to the overview, something like this:

"Many males and females in the USA however, circumcised as infants, continue to be unaware of their circumcision status or the circumcision or lack thereof of their partners. Jews, on the other hand, tend to be concerned about legislation that restricts their perceived freedom of religion, to practice the brit milah, the traditional jewish form of circumcision."

I have tried to keep the jews somewhat out of the article, as there already is the quite extensive article about the brit milah. I think the issue of legislation may deserve mentioning in the cultural section about jews as well. Do what you feel is sensible. If you improve the article and make it more useful, I'm all the happier. Be bold! Dabljuh 21:57, 16 January 2006 (UTC)

The reason why I was somewhat reluctant to include too much jewish POV into the article, was mainly because I would find it somewhat un-neutral not to add islamic POV of the same magnitute as well. I am totally unfamiliar with the islamic POV, and I can't see an islamic writer anywhere, so ... I wanted to avoid discriminating muslims over jews. I hope you try to factor that in. Dabljuh 22:03, 16 January 2006 (UTC)

I'll have to mull this over. I don't know what the Muslim POV is - since theirs is a prosyletizing religion, I suppose it's conceivable that some might be in favor of RIC among non-Muslims in order to facilitate later conversion to Islam, but that's just a wild supposition.Benami 22:16, 16 January 2006 (UTC)

See, I don't even know what prosyletischmo means. That's your job then. Dabljuh 22:18, 16 January 2006 (UTC)

Prosyletizing. It means that Muslims, like Christians, actively try to convert others to their religion, unlike Jews, who no longer do so. I've contacted one of the pillars of the Muslim Guild and asked them to take a look at the article.Benami 22:32, 16 January 2006 (UTC)

"Uncircd vs intact"

Ok, here's my take on the issue: Uncircumcised when used out of the blue is a POV word. I've tried to replace it with "not circumcised" and "intact" in various places. But on the other hand, "not circumcised" is heavy-handed and thus should be used sparingly, and "intact" is also a POV term.

I've figured the following mode of operation useful:

• When you have a sentence like "Circumcised guys like apples, uncircumcised guys prefer pears" then "uncircumcised" is not a POV term, because it stands in direct contrast to "circumcised". As such, it becomes a technical term, and isn't POV anymore.
• When, in order to point out differences, you instead compare "circumcised" guys with "intact" or "not mutilated in ways that make one useless to a woman" or similiar bullshit then "intact" is a POV term, that implies there was something wrong with circumcised guys.
• In some cases, the attribute of not being uncircumcised is fairly alone, there is no circumcised guys "nearby" to directly contrast. When used in this fashion, "not circumcised" and "intact" are preferrable, as they do not directly have a "circumcised" nearby that they can make look bad
• When on the other hand the term "uncircumcised" is used in places where it is not a comparison with circumcised guys, the term circumcised would become POV, implying there was something wrong with the uncut guys.

So in short:

• When circ'd and uncirc'd guys are directly compared, use 'uncircumcised'
• When uncirc'd guys are talked about without a direct reference to circd guys, use 'intact'
• If you're not sure, or its some sort of grey area, try to use 'not circumcised'.

I hope this helps to avoid future, idiotic, "intact" vs "uncirc" wars that are totally missing the point.

Ultimately you are not supposed to use the same term for the same thing over and over. That makes the whole thing boring to read, regardless of POV issues. Dabljuh 11:54, 17 January 2006 (UTC)

Wikipedia:Requests for comment/Dabljuh

Some people might want to check out the accusations at this RFC Wikipedia:Requests for comment/Dabljuh.

While presented as a dispute of multiple users with Dabljuh it is actually an ongoing editing conflict between two groups with a POV difference. I'd say the accusations are one sided, taken out of context, and totally ignore the uncooperative behavior of the accusing editors and their unwillingness to reach consensus. --ZimZum 15:16, 17 January 2006 (UTC)

Explanation?

ZimZum, you removed the following from the article, on the mysterious grounds that it is 'biased':

The American Medical Association comments that "Debate on the wisdom of routine circumcision centers on the possible benefits offered by circumcision, and whether they medically justify the risks associated with the procedure."[39]

Can you please explain? The preceding sentence states that the procedure is controversial. Why is it biased to expand on that with a quotation from a notable, relevant organisation?

I personally think it should be restored, but I wanted to give you a chance to explain your thinking. Jakew 18:59, 17 January 2006 (UTC)

No, Jake. I know you probably won't understand it, but that's not how it works. Why quote entire sentences? Ultimately [40] you [41] can [42] convey [43] any [44] POV [45] that [46] you [47] want [48] by [49] citing [50] out [51] of [52] context. The text has to make clear that no major medical organization recommends circumcision, that everyone agrees that the benefits do not outweight the risks. Fuck, why am I even trying. Dabljuh 19:05, 17 January 2006 (UTC)

So you removed the quote from the article because you believe that the debate on the wisdom of routine circumcision does not center on risk-benefit analysis? Work with me here. I don't understand what about the quote is POV. You say it is POV, so explain how, so that I can understand. I agree with you that one can quote things out of context to make them appear to say things that they are not saying, but I don't see how that's applicable here. Please, explain it to me. Thanks. Nandesuka 19:12, 17 January 2006 (UTC)

Citing there that this introductionary sentence of the AMA paper would convey the image that there still isn't a clear consensus on the issue of the risk-benefit analysis (which, subsequently removed, furthers that POV). Yes there is debate, but there is always debate. When you read the medical statements about the risk analyses of ALL organizations, they all state, unisono, that the benefits of the procedure do not outweight the risk. To convey any other picture - for example, to convey the picture that some do recommend the procedure, or to convey the picture that the medical consensus has not yet settled on that particular issue - would be an NPOV violation.

In addition to that, you seem to confuse me with User:ZimZum who removed that sentence, not me. Dabljuh 19:21, 17 January 2006 (UTC)

Both the AMA and AAFP (and others, too) state that routine infant circumcision is controversial. To state that there is consensus otherwise directly contradicts them. Frankly, even if we could cite your opinion, I think that two large medical organisations would be more likely to know about the medical consensus than some guy called Dabljuh, don't you?

Next, it is simply not true to say that all organisations state that the benefits do not outweigh the risks. Some do, some do not comment. I understand that you believe the two positions to be equivalent, and you're entitled to that view, but it does not belong in the article. It is true, however, that none explicitly recommend it, and that fact is fine to include. We even have a source, so it isn't OR: "Recent policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns.5,8-10"[53] Jakew 19:30, 17 January 2006 (UTC)

Add an explanation like "on the basis that the benefits do not outweight the risks" and it's fine. You do not have to absolutely source every damn sentence, by the way. Ultimately an article isn't just a couple sentences stolen from elsewhere hurled together. If people wanted to read other people's sentences, they can go read them in the external links. Dabljuh 19:37, 17 January 2006 (UTC)

We cannot say 'on the basis that the benefits do not outweigh the risks' since only a few organisations have given that justification. We can't claim to know the reasoning used by the others unless they themselves say so. And sourcing claims is not only necessary, but vital in order to comply with policies. That's especially true with such a controversial subject. Jakew 19:46, 17 January 2006 (UTC)

I find it selective quoting. I think the almost exclusively American POVs should be excluded from the intro since it in no ways expresses the POV of (for example) most European hospitals who oftenly refuse to perform the surgery on persons under age one. Another problem is that the article was linked twice already in the same paragraph, and that the issue of risks vs benefits was also already mentioned in the article, so basicly the same thing was said twice. Regardless, I think the intro needs more work so it doesn't look odd to non American readers. --ZimZum 20:04, 17 January 2006 (UTC)

I see no harm in citing any position from one of these hospitals, but you haven't answered the fundamental question. What is wrong with expanding on the statement that it is controversial by quoting a notable source on the subject? The controversy is not limited to Americans. The BMA (Britain), for example, states: "Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA’s membership. ... There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself." Jakew 20:18, 17 January 2006 (UTC)

I think the BMA quote better describes the current controversy, how about we use that one or something mutual instead? --ZimZum 20:31, 17 January 2006 (UTC)

Possibly of less relevance, since the BMA is relatively smaller. I think the AMA quote should be used. How about a compromise:

Both the American Medical Association and the British Medical Association have commented on the controversy surrounding circumcision. The BMA states that "circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA’s membership. ... There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself."[54] The AMA remarks that "Debate on the wisdom of routine circumcision centers on the possible benefits offered by circumcision, and whether they medically justify the risks associated with the procedure."[55] Jakew 20:56, 17 January 2006 (UTC)

Jake quotes the British Medical Association (BMA) as saying, "There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself." This quote is from the section on non-therapeutic circumcision, i.e. "circumcision that is performed for any reason other than physical clinical need." The BMA says non-therapeutic circumcision is sometimes called "ritual" circumcision. In other words non-therapeutic circumcision is primarily Muslim and Jewish religious circumcision. On the other hand, the BMA clearly states that circumcision for medical reasons is "unethical and inappropriate" when there are effective non-invasive methods of treatment available. The debate centers on circumcision performed on children for cultural or religious reasons, not circumcision for therapeutic reasons, i.e. "physical clinical need". -- DanBlackham 09:00, 18 January 2006 (UTC)

Obviously, yes. Why would there be any debate when there was a clinical need? Jakew 12:38, 18 January 2006 (UTC)

Jake quotes the American Medical Association (AMA) as saying, "Debate on the wisdom of routine circumcision centers on the possible benefits offered by circumcision, and whether they medically justify the risks associated with the procedure." The AMA then discusses three possible medical benefits of circumcision: reduction in urinary tract infections, penile cancer, and HIV infection and sexually transmitted diseases. Regarding penile cancer the AMA says, "because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified." Regarding HIV infections and sexually transmitted diseases the AMA says, "behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, and circumcision cannot be responsibly viewed as 'protecting' against such infections." -- DanBlackham 09:16, 18 January 2006 (UTC)

Yes, the AMA acknowledge that there is a debate, then state their own position. Correspondingly, we acknowledge that there is a debate, then identify stances of various participants, including the AMA. Jakew 12:38, 18 January 2006 (UTC)

That raises the question, Jake, what was wrong with my version again? I.e, why did you change it? Dabljuh 20:48, 17 January 2006 (UTC)

Your version was more POV and it was unsourced. It did not describe the controversy. It put words into the mouths of the medical organisations. Jakew 20:56, 17 January 2006 (UTC)

I wrote this:

Routine, non-therapeutic infant circumcision is controversial. Most medical organisations state that routine infant circumcision is not medically recommended, and that it is to be performed for cultural, religious and aesthetic reasons. The genital integrity movement condemns non-therapeutic infant circumcision as a human rights violation on par with female genital cutting, while circumcision advocates usually stress the medical benefits of the procedure.

Ok... how exactly was this POV? I used the qualifier "Most", aware that only 5 of 7 reviewed medical organizations here explicitely do not recommend the practice, one of them even condemning it (*the AMA restates the AAP position). And even the two organizations that do not make a recommendation either way, state that it is rather a cultural practice than a medical one. Dabljuh 21:12, 17 January 2006 (UTC)

I said it was more POV, Dabljuh. It stated that they said it was not recommended. Nor do they state reasons why it should be performed (except the AAP, which comments that it is legitimate to take account of cultural, etc, factors in addition to the medical factors). In fact, these statements are simply your interpretation, to which you have a perfect right, but it doesn't belong in the article. It is completely true, however, to state that they do not recommend it. Furthermore, stating that they do not recommend it without commenting that they suggests informed decision making creates the false impression that they are opposed to non-routine circumcision. Jakew 21:47, 17 January 2006 (UTC)

More POV? You mean, as in, more POV than what you wrote?

The medical associations are not opposed to non-routine circumcision (except for the AAPS), they simply *do not recommend it*. You might want to compare it to a vaccine? Everyone does recommend vaccines. Vaccines also have benefits and risks, and there is certainly also a debate going on. But as the benefits of the vaccine outweights its risk, they do recommend vaccines. Circumcision's benefits do not outweight its risks. They do not recommend circumcision. Simple matter, really. Trepanation also has benefits and risks, although there is probably not a debate going on. No major health association recommends routine infant trepanation. But they aren't opposed to it either, right? Dabljuh 22:42, 17 January 2006 (UTC)

It doesn't increase readability when a paragraph mainly exists of quotes. I must again repeat that stating that circumcision is a medical issue is biased, there's a large ethical controversity. I still suggest adding something along the line of "Circumcision of male babies and children at the request of their parents is an increasingly controversial area of strongly opposing views". Many readers might not be aware of the controverse. --ZimZum 23:35, 17 January 2006 (UTC)

Reimer case

I'm bothered by the mention of David Reimer in the risks of circumcision section. The issue in the Reimer case doesn't seem to be circumcision so much as medical malpractice - he didn't lose his penis as the result of a routine circumcision, but because his doctor grossly misused a piece of surgical equipment not designed for circumcisions. I've tried to come up with a succinct sentence noting that, but I'm having writer's block. Suggestions?Benami 21:49, 17 January 2006 (UTC)

Just say it was a "badly performed" circumcision? I mean, the chance of losing the penis due to circumcision is about 1:1000000 according to some aussies, the real tragedy of the case is that he was used as some sort of sex theory experiment by a fame-crazy psychologist...Dabljuh 21:59, 17 January 2006 (UTC)

Gairdner study

Just how relevant is a study from 1949? Especially when most of the deaths it discusses would seem to have happened under general anesthesia, which is not the norm today? The lesson of the Gairdner study would not seem "Don't circumcise your children" so much as "Don't circumcise your children in a 1940's British hospital."Benami

Yep. The problem is, gairdner's study are hard numbers. And they already had antibiotics in the 1940s. Everything the AAP got are very conservative estimates (= read: numbers out of a qualified ass). Because of the lack of hard numbers, I had added the cosmetical surgery death rate, performed in healthy adults, of 1:57000. Dabljuh 22:16, 17 January 2006 (UTC)

I think that study was highly influential in steering some countries away from routine circumcisions, so that makes it historically relevant to say the least. --ZimZum 01:00, 18 January 2006 (UTC)

This is simply untrue. Gairdner's figures are no more 'hard' than those from other studies.

To quote a previous post of mine on the subject: Baker´s[1] estimate of 229 circumcision-related deaths per year in the US is based on Gairdner´s[2] value of 16 deaths in 90,000 circumcisions.

This is inappropriate. Gairdner´s deaths were mostly caused by complications of general anaesthesia, which is much more dangerous than local anaesthesia. General anaesthesia is not used for neonatal circumcision.

Wiswell and Geschke[3] 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[4] reviewed the records of 566,483 circumcised infants, and found one death.

Gee and Ansell[5] reviewed the records of 5,521 circumcised infants, and found no deaths.

King[6] reported on 500,000 neonatal circumcisions, with no fatalities.

Trevino[7] reports that no deaths occurred in 650,000 circumcised boys.

1 http://www.cirp.org/library/general/baker1/ 2 http://www.cirp.org/library/general/gairdner/ 3 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. 4 Speert H. Circumcision of the newborn: an appraisal of its present status. Obstet Gynecol. 1953; 2: 164-172 5 Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics. 1976 Dec;5(6):824-7. 6 King LR. Neonatal circumcision in the US in 1982. J Urol. 1982; 128: 1135-36 7 Trevino S. Personal communication to Wiswell T. 1987

The difference, of course, is that Gairdner studied deaths of children of any age, and these included deaths due to general anaesthesia, which is not used in infancy.

Please only intend replies by one level, btw. It makes it easier to follow nested replies. Jakew 22:38, 17 January 2006 (UTC)

(Thats false: In most ... death has occurred for no apparent reason under anaesthesia [56] Please, I told you to be more careful when playing number's games with children's lifes! Dabljuh)

And please don't insert them in the middle of mine! It makes it almost impossible for people to read. Jakew 23:09, 17 January 2006 (UTC)

Here's a couple numbers I just gathered out of interest, the Male infant mortality rate according to the CIA world factbook of some randomly selected industrialized nations:

(Sorted in ascending order)

1. Sweden: 2.93 deaths/1,000 live births
2. Japan: 3.52 deaths/1,000 live births
3. Germany: 4.61 deaths/1,000 live births
4. France: 4.76 deaths/1,000 live births
5. Switzerland: 4.9 deaths/1,000 live births
6. Canada: 5.21 deaths/1,000 live births
7. United Kingdom: 5.76 deaths/1,000 live births
8. USA: 7.17 deaths/1,000 live births
9. Israel: 7.77 deaths/1,000 live births

Notice a pattern here? Dabljuh 22:27, 17 January 2006 (UTC)

Use of aggregate statistics in a certain way, otherwise known as an ecological study, to prove a point? Jakew 22:40, 17 January 2006 (UTC)

It's also worth noting that in each case the female rate closely approximates that of the male.[57] Jakew 22:43, 17 January 2006 (UTC)

I'm guessing that the US rate reflects the shameful fact that we don't have universal health care, rather than anything having to do with circumcision. And surely Israel's infant mortality rate reflects the conditions of the Israeli Arab population, who (according to this study had an infant mortality rate of 8.6 per 1000 live births in the year 2000 (down from 32 per 1000 births in 1970. Benami 23:00, 17 January 2006 (UTC)

We? I thought you were Swiss? Anyway, I suspect you're probably right on both of those guesses. Jakew 23:09, 17 January 2006 (UTC)

Swiss? Moi (or je, or whatever)? Chas v'shalom - my country of origin is Texas, and now I live in Rhode Island. That's a state about sixty miles south of Boston. Dabljuh is Swiss, non/nein? Benami 00:53, 18 January 2006 (UTC)

My apologies, Benami. I wrote that while trying to tidy up three consecutive edit conflicts, and got a little confused. Jakew 12:39, 18 January 2006 (UTC)

Benami: Well that's true of course. Even if 100% of males were circ'd and even if Gairdner's figure is simplified down to 1:5000 and would apply to the modern US rates, this would not affect the rates by more than 0.2 deaths / 1000 live births.

Jake, I'll explain you again: The system for gathering the death toll in the USA is flawed. The numbers are estimates. Gairdner's figure may be lower nowadays, in the US, but not by an order of magnitude of 100. Dabljuh 23:05, 17 January 2006 (UTC)

I know you believe this. Jakew 23:09, 17 January 2006 (UTC)