Changes

The '''New England Journal of Medicine''' (NEJM) has shifted from a balanced approach, to a one-sided, pro-circumcision stance. They have a tendency to present the purported benefits of [[circumcision]], while failing to print any letters critical of these claims, and failing to confront the ethical problems and medical complications associated with [[circumcision]].

In 1997, the ''NEJM'' printed a strongly pro-circumcision editorial by circumcision promoter Dr. [[Thomas E. Wiswell| Thomas Wiswell]],<ref name>{{REFjournal |last="wiswell1997">Wiswell |init=TE. |title=Circumcision circumspection. '' |journal=N Engl J Med'' |date=1997; |volume=336: |pages=1244-5.1245}}</ref> but did not print the alternative opinion in favor of normal anatomy (see Abstracts & Analysis). When misinformation in Wiswell's editorial was brought to the attention of the editor, there was no attempt to correct Wiswell's exaggerated benefit claims. In contrast, the ''NEJM'' had printed a Sounding Board discussion of circumcision examining the purported advantages and disadvantages of circumcision earlier in 1990.<ref name>{{REFjournal |last="schoen1990">Schoen |init=EJ. |title=The status of circumcision of newborns. '' |journal=N Engl J Med'' |date=1990; |volume=322: |pages=1308-12.1312}}</ref> <ref>{{REFjournal |last=Poland |init=RL. [ |title=The question of routine neonatal circumcision |url=http://www.cirp.org/library/general/poland/ The question of routine neonatal circumcision]. '' |journal=N Engl J Med''. |date=1990; |volume=322: |pages=1312-5.1315}}</ref>

In a previous article in the ''NEJM'', Royce ''et al''. insinuated that the [[prepuce ]] may be a risk factor for [[HIV ]] infections.<ref name>{{REFjournal |last="royce1997">Royce |init=RA, |last2=Sena |init2=A, |last3=Cates Jr |init3=W Jr, |last4=Cohen |init4=MS. |title=Sexual transmission of HIV. '' |journal=N Engl J Med'' |date=1997; |volume=336: |pages=1072-8.1078}}</ref> This factually inaccurate article was referenced in a letter to the editor as proof that circumcision protects an individual from [[HIV ]] infections.<ref name="laumann1997Laumann1997">{{REFjournal |last=Laumann |init=EO, |last2=Masi |init2=CM, |last3=Zuckerman |init3=EW. [http://www.cirp.org/library/general/laumann/ |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practices, and sexual practice] |url=http://www.cirp. ''org/library/general/laumann/ |journal=JAMA'' |date=1997; |volume=277: |pages=1052-7.1057}}</ref> The ''NEJM'' failed to mention, however, that Laumann pointed out the fallacy of this logic. "The lack of rigorous, systematic controls for co-factors relevant to the particularities of the African context, the prophylactic status of the presence or absence of the foreskin remains an open question."<ref name="laumann1997Laumann1997" />

Circumcision is losing popularity in the [[United States ]] and has been discredited by the [https://www.cps.ca/ Canadian Pediatric Society]<ref>{{REFjournal |last=[[Fetus ]] and Newborn Committee, Canadian Paediatric Society. [ |title=Neonatal circumcision revisited |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1487803/ Neonatal circumcision revisited]. '' |journal=Can Med Assoc J'' |date=1996; |volume=154: |pages=769-80.780}}</ref>and the Australasian Pediatric Surgeons<ref>{{REFweb |publisher=Australasian Association of Paediatric Surgeons. [ |title=Guidelines for circumcision |url=http://www.cirp.org/library/statements/aaps/ Guidelines for circumcision]. April |date=1996.-04}}</ref> in 1996 position papers. Taylor described the unique innervation of the preputial [[mucosa ]] in 1996, and its loss to circumcision.<ref>Taylor JR, Lockwood AP, Taylor AJ. [http://www.cirp.org/library/anatomy/taylor/ The prepuce: specialized mucosa of the penis and its loss to circumcision]. ''Br J Urol'' {{TaylorJR LockwoodAP TaylorAJ 1996; 77:291-95.}}</ref> Taddio et al. showed that circumcision with and without local anesthesia ([[EMLA]]) resulted in negative behavioral changes in a child's response to [[pain]].<ref name="taddio1997"Taddio1997>Taddio A, Katz J, Ilersich AL, Koren G. [http://www.cirp.org/library/pain/taddio2/ Effect of neonatal circumcision on pain response during subsequent routine vaccination]. ''Lancet'' {{TaddioA KatzJ IlersichAL KorenG 1997; 349:599-603.}}</ref> Laumann has shown that circumcision causes sexual behavior changes and an apparent increased risk of many venereal diseases in adult men.<ref name="laumann1997Laumann1997"/> Price has questioned whether parents can ethically change their child's genitalia.<ref>Price (Bull. Medical Ethics).</ref>

The research on [[EMLA ]] and circumcision presented by [[Anna Taddio| Taddio '']] et al''. was proclaimed as a major advance.<ref>{{REFjournal |last=Taddio |init=A, |last2=Stevens |init2=B, |last3=Craig |init3=K, |last4=Rastogi |init4=P, |last5=Ben-David |init5=S, |last6=Shennan |init6=A, |last7=Mulligan |init7=P, |last8=Koren |init8=G. |title=Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. '' |journal=N Engl J Med'' |date=1997; |volume=336: |pages=1197-1201.}}</ref> When the limitations of this form of local anesthesia was brought to the attention of the editors, they failed to print the criticism (see Abstracts & Analysis). They failed to point out that this form of local anesthesia ([[EMLA]]) did not prevent the long term negative behavioral response to [[pain ]] previously reported in the ''Lancet''. <ref name="taddio1997" Taddio1997/> The lack of effects of [[EMLA ]] on long term negative behavioral changes caused by circumcision was printed in British medical journals.<ref name="taddio1997" Taddio1997/><ref name>{{REFjournal |last="taddio1995">Taddio |init=A, |last2=Goldbach |init2=M, |last3=Ipp |init3=M, |last4=Stevens |init4=B, |last5=Koren |init5=G. [ |title=Effect of neonatal circumcision on pain responses during vaccination in boys |url=http://www.cirp.org/library/pain/taddio/ Effect of neonatal circumcision on pain responses during vaccination in boys]. '' |journal=Lancet'' |date=1995; |volume=345: |pages=291-2.292}}</ref>{{SEEALSO}}* [[Bias]]* [[HIV]]* [[Pain]]* [[Trauma]]* [[United States of America]]{{REF}}

[[Category:OrganizationsUSA]]