Circumcision (General Discussion)

It probably doesn’t prevent you catching a cold, either. :laughing:

HG

It would make more sense to promote safe sex, make free condoms widely available, promote women’s equality, convince American voters to slap down misguided moralists in the White House who attached impractical abstinence-education strings to foreign aid, and continue to humiliate irresponsible governments in Africa who actively obstruct modern medical treatment and suggest that hot showers and traditional herbal treatments are effective safeguards and cures.

That us Americans seem to be advocating abstinence and circumcision at AIDS treatment is embarrassing. (okay, that last sentence is over the top…a bit)

No, I think you’re on the money.

And as for promoting an invasive genital mutilating procedure to prevent AIDS, that’s the pinnacle of insanity. How many people may indeed become infected while undergoing the procedure itself, or suffer some hideous misdaventure? We are talking about hospitals in Africa here.

HG

Good point.

I’m no advocate of circumcision myself, but to be fair, the recommendations set forth by experts do talk about the procedure being carried out with experienced doctors and only under sanitary conditions, which they fully admit is hard to come by in Africa.

[quote=“Hobbes”]From my point of view, the issue basically comes down to a trade-off between the pain suffered by the boy, and the medical benefits to having the procedure done.

As others have mentioned, the hygiene point does appear to be something of a non-issue so long as one has decent hygiene habits generally.

The “it’s there for a purpose” idea is also beside the point. Of course it’s there for a purpose – it evolved millions of years ago to protect a sensitive part of the (naked) body from the elements. Most people today wear clothing for this purpose.

So it’s back to the trade-off, and a judgment about how you weigh the pain inflicted and the purported medical benefits derived. In the case of a measles vaccine, this trade-off is a no-brainer because the pain involved is smaller and the medical benefits FAR more well-established. In the case of circumcision, the pain is greater and the medical benefits far less conclusively proven/universally agreed. So you read up on the latest knowledge regarding the medical benefits (or lack thereof, if that’s what you conclude), weigh that against the pain of the procedure for the boy, and make the decision you think best. :idunno:[/quote]

Hobbes,

Excellent post. However, I would tie in another point that has already been made by Maoman and others: the choice of the patient. As you know well, in tort law the express consent of the patient is always required for any medical procedure, unless such a situation exists where the patient is neither able to grant consent or refuse treatment, such as when the patient is unconscious. It is perhaps a legal fiction, but even in these cases the patient is said to have given implied consent. Otherwise, regardless of the good intentions of the doctor, any medical procedures performed without consent are considered battery, and rightfully so. Now, legal guardians have the right to make this decision for minors under their charge, incompetent adults who are their wards, or even unconscious spouses (Christian Scientists often refuse to let anyone perform medical procedures on their unconscious and/or mentally incompetent loved ones)

I think it is self-evident that parents should have surgical procedures performed on their children that are medically necessary, and that must be performed before the child becomes an adult. For example, if an infant faces either getting a liver transplant or dying before its first birthday, the parents would obviously be well justified in having the procedure performed as soon as possible (and would be immoral not to). The necessity is dire, and the time frame critical. To put this into your proposed framework of perceived medical benefits vs. pain inflicted on the child, the medical benefit is life, and the pain inflicted perhaps quite terrible, as post-operative pain of invasive procedures tends to be. However, I think all would agree the former outweighs the latter.

To apply your framework to a more difficult case, imagine that a child contracts a skin disease that is slightly painful, and will remain so throughout his life, but will become fatal by his mid-20s (and only then). This particular disease, let us say, only afflicts the skin of the index finger, but unfortunately as soon as it infects the skin it immediately affects all of the other tissues and bone of the finger. The consensus of the medical community is that the only way to get rid of the disease is to amputate the finger. Now then, what are the parents to do? Applying your framework literally, we might be tempted to say that the ultimate medical benefit is saving the child’s life, but that would be misleading. Since the disease is not fatal until the mid-20s, the child himself, upon reaching the age of decision, can decide whether or not he wants the procedure done. And yet, we are still left with the pain he would experience throughout his youth due to the infected finger. So the equation becomes: the medical benefit of relieving him of this pain vs. the pain of the procedure itself and the suffering of losing a finger. Even assuming the procedure itself is painless, the parent is still faced with deciding which is the greater good: relieving the child of the pain of the diseased finger by inflicting the permanent loss of a limb, or allowing the child to keep the finger but force him to go through his youth with the pain of the disease.

Applying this reasoning to the matter at hand, circumcision, we are actually presented with a far simpler situation. Once again, it is not a matter of the perceived medical benefits of circumcision throughout life vs. the pain inflicted on the child by the procedure and suffering of losing part of the genitalia, but rather the perceived medical benefit of circumcision between the time of the procedure and adulthood vs. the pain inflicted by the procedure and the loss of a body part. It seems to me that the general consensus in the medical community, as evidenced by the information presented here by HGC and others, does not indicate any significant medical benefit of circumcision between infancy and young adulthood, at least none that good hygiene can’t confer in their place. Without any significant medical benefits, we are only left with the pain of the operation and the loss of part of the genitalia. It seems to me that to forcibly impose pain and amputation, even partial amputation, without a clear medical benefit or need, is an immoral act. We must also consider the many documented cases, as HGC has referenced, of these operations going horribly wrong. Now this would perhaps be an acceptable risk if a significant medical benefit were conferred by the procedure (between infancy and young adulthood), but this does not seem to be the case.

Others have noted there are potential benefits to circumcision, like possibly preventing AIDS and penile cancer. These issues are only relevant to the argument of child circumcision insofar as they affect boys between infancy and young adulthood. After the age of decision the young man can decide for himself if he wants to the procedure done, for these reasons or any reason at all.

I am sorry this post has gone on for so long, but I think this is a serious issue that does not really lend itself well to brevity. There are a few more points I’d like to address, as I think they are very important:

The first is the matter of operative and post-operative pain. One of the most common arguments in favor of circumcision is that we as adults will not remember the pain we experienced as infants, therefore the matter of pain is moot. But think about this carefully. Does the fact you won’t remember the pain justify others inflicting it on you? If you discovered your babysitter was regularly torturing your baby, how would you respond? I mean, after all, your baby probably won’t remember the pain as an adult. Or what if a drug could be invented that would make some forget they were tortured, or forget everything. Would it be morally acceptable to torture this person, as long as this drug were administered and they forgot all about it? Of course not. The fact of the matter is that the only reason we would ever allow a doctor or anybody else to harm our babies is that we perceive a greater good is at stake. Whether or not you believe a greater good is produced by circumcision, the he-won’t-remember-it-anyways argument is undeniably fallacious.

The second contention I want to address is the matter of a slower recovery rate for adults. Now I have no idea if that is even a medically sound statement, but just for the sake of argument we’ll assume it is. But does this make it any more persuasive? Even assuming the parents are having their son circumcised for medical benefits to be realized in adulthood (like prevention of AIDS and penile cancer), and are doing so in order that he will recover faster as an infant, the question becomes: Do they have this right? Is this their choice to make? I would argue that it is not, because in essence they are depriving him of his liberty, his right to choose for himself. If a young man does decide to have the procedure for preventative reasons, then let him deal with the consequences. For his parents to deprive him of this freedom, however good their intentions, is an affront to his liberty.

Some extremely well-considered thoughts from you, gao_bo_han. As usual.

As it happens, at the time that I wrote the post you quoted, above, my wife and I had already decided not to have our son (now 4-months old) circumcised. We were simply unconvinced by what we read that there was a significant medical benefit.

The current lack of consensus on the medical benefits came as a surprise to me, of course, having been raised in the US (and --as far as I can recall-- never having seen an uncircumcised penis until I came to Taiwan and joined a gym). I had always been under the impression that circumcision was in the same category as the immunization shots babies get, and that --like a fringe religious sect that didn’t want their baby to receive any other standard medical treatment-- one would need to have some unusual religious or personal reason not to have one’s son circumcised.

The fact that our son was born here in Taiwan, where circumcision would need to be specifically requested, allowed me to spend some time reading-up on the issue – and I am happy with the decision that we reached. It does make me wonder, though, what other bits of (what I perceive to be) ‘accepted wisdom’ deserve a closer look. I’ve never actually read any medical articles about flu shots either, for example; I’ve just always assumed that they were a good idea because everyone around me seemed to think they were. One can’t go through life without putting some trust in the collective wisdom and practices of the surrounding society, but I suppose it’s good to be reminded that the collective wisdom should be questioned as well. Ah well – balancing act.

Now what if the medical opinions that I read had convinced me that there was a significant medical benefit? To what extent then would your arguments (and those of others on this thread) regarding the right of my son to make his own decision factor in? I suppose it would depend heavily on the medical facts/opinions. I think you make some very good points, especially regarding the need to be clear about the period of time over which medical benefits should be measured in the discussion of adult circumcision. But I also get the impression that I may be more “paternalistic” than you when it comes to weighing what I consider to be in my baby’s best interest vs. the rights of my baby to make his own decisions. In this regard, it’s not that I disagree with your analysis – it’s just that I think I might weigh the two sides differently. :idunno:

[color=black]“The-won’t-remember-it-anyways argument is undeniably fallacious”[/color]

In my opinion it is undeniably fallacious if the argument claims that unremembered pain “doesn’t count”. I don’t think it is undeniably fallacious to be of the opinion that unremembered pain counts less. If a doctor said to me “We need to do a spinal tap, and can offer you no anesthetic. We can, however, give you a drug that will cause you to have no memory of it as soon as we are finished” – I’d take the “forgetting drug”. My guess is that many people would take [pain] over [pain + lasting memory of pain]. Ultimately, though, I suppose this is a question of personal preference/opinion.

In terms of slower recovery rates for adults, I have no idea whether it is true either. I would be surprised if it were not true, simply because babies’ incredible growth and tissue generation rates seem to make them heal faster in every other way, and it would seem odd for the penis to be the lone exception. Then again, as I mentioned above, I have recently been reminded that what seems like common sense to me is not always true.

I’ll close by going back to the “paternalism” point I mentioned earlier.

------- IF I was convinced that circumcision was materially medically beneficial (I’m not); and

------- IF I felt that [pain] was better than [pain + lasting memory of pain] (I do); and

------- IF I was convinced that babies heal significantly faster than adults (I’m not ‘convinced’, but it makes sense to me that they would)

------- THEN… I would probably have my baby circumcised.

I would make that decision for him. I would substitute my judgment for his judgment. I would take away his freedom to that extent. In my opinion, part of being a parent is deciding when and to what extent to substitute your own judgment for your child’s judgment.

Personally, I can never seem to get around to filing my taxes without getting an extension. I never seem to find time to schedule a dentist appointment, always thinking “Oh I’ll get around to it next month.” What are the odds that a late teens or 20s male is going to “get around” to giving up sex for two months and undergoing a horribly painful medical procedure in order to shave a few percentage points off a cancer risk 40 years later?

I have tried several times to stop smoking in order to shave a massive number of percentage points off cancer risk later in life, but have not yet “gotten around” to quitting for more than a year – even though I know that eventually I must. Let me tell you: if I could give my baby an extremely painful injection today that would, say, cause uncontrollable diarrhrea every time he inhaled a lungful of smoke directly from a cigarette for the rest of his life … I would do it. I would take away his freedom to make that decision for himself, and I would sleep well at night having done so.

At the end of the day, of course, none of this analysis ended up taking place, because I concluded that the evidence of real medical benefit wasn’t persuasive. But if it had been, I don’t think that your arguments about my baby’s right to choose for himself --legitimate though I believe them to be-- would have been dispositive.

Hobbes,

You have made some more excellent points. I will address them in turn:

Agreed, and I’ll take it a step further. From the frame of reference of the person who does not remember previously inflicted pain, and assuming there are no lasting mental or physical deflects, the previously inflicted pain is irrelevant. Or dare I say it? It doesn’t count. But from the point of view of the person experiencing the pain, the pain “counts” very much. Once again, we allow surgeons to cause us or our loved ones pain only when there is a perceived medical benefit that outweighs the pain. In the example you cited, where no anesthetic is available but a forget-it-all-afterwards drug is available, I too would elect the operation and memory drug. I think you and I agree on more than we disagree in this matter, but I take a more existential view of the inflicted pain.

[quote]I’ll close by going back to the “paternalism” point I mentioned earlier.
------- IF I was convinced that circumcision was materially medically beneficial (I’m not); and

------- IF I felt that [pain] was better than [pain + lasting memory of pain] (I do); and

------- IF I was convinced that babies heal significantly faster than adults (I’m not ‘convinced’, but it makes sense to me that they would)

------- THEN… I would probably have my baby circumcised. [/quote]

So would I. I think the matter all hinges, as you note in the first part of your syllogism, on the medical benefits derived from the procedure. It is very easy to imagine a situation where circumcision could have significant medical benefits. Perhaps in ancient Judea it actually did. In a time when potable water was scarce and many bathed semi-annually, circumcision may have prevented serious pain and suffering in that oh-so-private area. A quick search online can illustrate (literally) the unpleasant predicament that poor hygiene can inflict on the uncircumcised man.

I fully understand why you would make this decision. I do not envy the many difficult decisions parents are compelled to make in these matters. Balancing what is ultimately best for the child versus granting him or her the freedom to make bad decisions, even horrendously bad decisions, is probably one of the most anguishing aspects of parenthood. While I would not personally give the kind of injection you mentioned, even if it existed, it is easy to imagine all sorts of other situations where I would curtail my child’s freedom for their own benefit.

By the way, it’s great talking to you again. And congratulations on the birth of your son!!! :bouncy: :bouncy: :bouncy:

The CaptureSnipRelease program seem the best option.[quote]
“This is an extraordinary development,” said Dr. Kevin de Cock, director of the World Health Organization’s AIDS department. “Circumcision is the most potent intervention in HIV prevention that has been described.”

Circumcision has long been suspected of reducing men’s susceptibility to HIV infection because the cells in the foreskin of the penis are especially vulnerable to the virus.[/quote]

Listen to Dr de Cock. He’s hard on the facts.

[quote]
“Male circumcision is such a sensitive religious and cultural issue that we need to be careful,” she said.

Several African countries have already met with U.N. agencies to explore new strategies for increasing circumcision services. Swaziland, for instance, recently experimented with a series of “Circumcision Saturdays,” where existing health care facilities, normally closed on weekends, were opened by local doctors to circumcise approximately 40 men a day on certain Saturdays.[/quote]

Ooooooooooooooooow! I hope they get a lollypop.
apnews.myway.com/article/20070223/D8NF543O3.html

What’s the doctor’s name again ?

Well if cutting off a little piece of skin pleases Ms de Cock’s research so sweetly, imagine the impact of a full castration? Couple this with sewing up vaginas and I guarantee NO STDs of any kind.

Why not implement it now?

HG

Thank god…

Fewer baby boys being circumcised in the U.S.

That is great news in a way, Mer, however, a unilateral reduction in angry mutilated men may not bring the peace harvest the world hopes for. Alas, I fear the Middle East is supplying the planet with enough infuriated de-manned men, eager to prove their penile completion to ensure global conflict continues for sometime.

HG

They’ll certainly be the last ones, if ever at all, to stop snipping. Yikes, religion and foreskin. I’m glad I’m not Jewish for that reason alone. On the Muslim side of things, go figure…circumcision is not even mentioned in the Qur’an!

A goodly article, that has me pondering all over again how it has come to be “barbaric” for tribespeople to trim their lady folk’s beef curtains, yet mere fine tuning of hygeine to mutilate boys in the west.

[quote]Cutting comments: the foreskin debate
Some say it’s barbaric, others a matter of hygiene. But with babies dying from circumcision, should it continue? Our correspondent hears from the ‘intactivists’

. . . But this isn’t just about cautiously radical telegenic celebrities or grown men checking one another out at the urinals or intact males doing histrionic winces and leg-crosses at the thought of the dreaded bris. For parents, there’s a basic guilt issue at play, too. In his eloquently incensed invective against religion, God Is Not Great, the firebrand polemicist Christopher Hitchens rails against parents who have their boys circumcised.

“As to immoral practice,” he writes, “it is hard to imagine anything more grotesque than the mutilation of an infant’s genitalia.” He argues that circumcision weakens the faculty of sexual excitement and diminishes its pleasure, pointing out the significance of the operation being performed on babies rather than those who have reached the age of reason. (One study found that 92% of male infants subject to circumcision were not given anaesthetic during the procedure.)

Unconcerned that militant Jewish factions rancorously dismiss the intactivist lobby as wholly antisemitic, Hitchens states that, as recently as 2005, a mohel in New York City quite legally performed a ritual known as metzitzah (taking a mouthful of wine and then sucking the blood from the circumcision wound) on newborn babies, giving genital herpes to several small boys and causing the death of at least two.

And what happens to all those lopped-off foreskins? Believe it or not, there is a handsome profit to be made from harvested bits of young penis. The Norm UK website features the following item: “Since the 1980s, private hospitals have been involved in the business of supplying discarded foreskins to private bio-research laboratories and pharmaceutical companies, who require human flesh as raw research material. Human foreskins are in great demand for commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry.”

There is even an expensive face cream, SkinMedica, on the market, made from a formula grown from young foreskins. Yes. Really. . . [/quote]

More from Hitchens on this macabre subject:

HG

I’m just glad my child was a girl, so I don’t have to read through this whole thread and deliberate whether to mutilate my boy or leave him susceptible to nasty diseases, smegma and shame. :slight_smile:

A circumcised man is much less likely to contract a disease from an infected partner.

Fixed that for you.:wink:

Why would a knight want to carry around a blunt sword?

Having it swinging around unsheathed is simply unprofessional, in my opinion.

Sensitivity is a good goooooooooooooooooooooooooood thing.

At what age do babies normally get cut?