Circumcision study flaws: Difference between revisions
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Bossio et al. made three recommendations: | Bossio et al. made three recommendations: | ||
# That more | # That more rigorous and consistent methodology be used. | ||
# Empirically rigorous studies of the physiological effects of neonatal circumcision are needed. | # Empirically rigorous studies of the physiological effects of neonatal [[circumcision]] are needed. | ||
# Psychosocial factors, including [[Sexual effects of circumcision| sexual correlates of circumcision]], should be studied.<ref name="bossio2014" /> | # Psychosocial factors, including [[Sexual effects of circumcision| sexual correlates of circumcision]], should be studied.<ref name="bossio2014" /> | ||
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== Statements from medical trade associations == | == Statements from medical trade associations == | ||
Medical trade associations exist to protect and advance the financial and | [[Medical trade association| Medical trade associations]] exist to protect and advance the professional, financial, business, and legal interests of their fellows (members). A few medical trade associations, whose members perform non-therapeutic circumcision, have issued statements regarding non-therapeutic circumcision of children. Circumcision policy statements frequently exclude discussions of [[Sexual effects of circumcision| sexual]], [[Psychological issues of male circumcision| psychological]], [[human rights]], ethical, and [[Circumcision legal commentary| legal]] issues, and the [[Foreskin| anatomy and functions of the foreskin]].<ref name="goldman2004">{{REFjournal | ||
|last=Goldman | |last=Goldman | ||
|first=Ronald | |first=Ronald | ||
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=== Australasia === | === Australasia === | ||
[[File:Flag_of_Australia.svg|thumb|150px|Flag of Australia]] | [[File:Flag_of_Australia.svg|thumb|150px|Flag of Australia]] | ||
The [https://www.racp.edu.au Royal Australasian College of Physicians] (2010) released a 28-page updated position statement on non-therapeutic circumcision of boys in September 2010. This statement is deeply flawed and outmoded in 2020. It seems to be designed to protect the physicians' income from performing non-therapeutic circumcision. The statement accepts at face value the false, now disproved,<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref> claims that circumcision reduces the risk of [[HIV]] by 60 percent. The statement shows only limited understanding of the functions of the foreskin. While it recognizes the protective function, it does not recognize the immunological function or sexual function, and shows only limited understanding of the erogenous function. The RACP places parental preference above child human rights. Nevertheless, public hospitals in [[Australia]] have banned performance of non-therapeutic circumcisions<ref>{{REFnews | The [https://www.racp.edu.au Royal Australasian College of Physicians] (2010) released a 28-page updated position statement on non-therapeutic circumcision of boys in September 2010. This statement is deeply flawed and outmoded in 2020. It seems to be designed to protect the physicians' income from performing non-therapeutic circumcision. The statement accepts at face value the false, now disproved,<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref> claims that circumcision reduces the risk of [[HIV]] by 60 percent. The statement shows only limited understanding of the functions of the foreskin. While it recognizes the protective function, it does not recognize the immunological function or sexual function, and shows only limited understanding of the erogenous function. The RACP places parental preference above child [[human rights]]. Nevertheless, public hospitals in [[Australia]] have banned performance of non-therapeutic circumcisions<ref>{{REFnews | ||
|title=Cosmetic circumcision banned | |title=Cosmetic circumcision banned | ||
|url=http://www.cirp.org/news/theadvertiser2007-11-12/ | |url=http://www.cirp.org/news/theadvertiser2007-11-12/ | ||
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}}</ref> | }}</ref> | ||
This statement has very serious omissions that bias it in favor of circumcision. The description of the [[foreskin]] omits important information, including its innervation, its protective functions, its immunological functions, and its sexual functions. The statement claims "potential" benefits, which exist only in someone's imagination. | This statement has very serious omissions that [[bias]] it in favor of circumcision. The description of the [[foreskin]] omits important information, including its innervation, its protective functions, its immunological functions, and its sexual functions. The statement claims "potential" benefits, which exist only in someone's imagination. | ||
The CPS statement revives the claims made by circumcision promoter [[Thomas E. Wiswell]]'s discredited studies from the 1980s in an apparent attempt to restart the [[Urinary_tract_infection#The_UTI_scare| UTI scare]]. It fails to mention that UTIS are easily treated with antibiotics.<ref name="McCracken 1989">{{REFjournal | The CPS statement revives the claims made by circumcision promoter [[Thomas E. Wiswell]]'s discredited studies from the 1980s in an apparent attempt to restart the [[Urinary_tract_infection#The_UTI_scare| UTI scare]]. It fails to mention that UTIS are easily treated with antibiotics.<ref name="McCracken 1989">{{REFjournal | ||
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The conclusion states that circumcision may be beneficial "for some boys", but fails to state which boys the CPS thinks would benefit by circumcision. | The conclusion states that circumcision may be beneficial "for some boys", but fails to state which boys the CPS thinks would benefit by circumcision. | ||
The statement seems amateurish. It seems to have been drafted by a committee of people who had no special knowledge or understanding of the human foreskin, circumcision, or the literature. It seems divorced from the reality in [[Canada]] that the health insurance plans do not pay for non-therapeutic circumcision and hospitals do not allow the performance of the non-therapeutic [[amputation]]. | The statement seems amateurish. It seems to have been drafted by a committee of people who had no special knowledge or understanding of the human foreskin, circumcision, or the literature. It seems divorced from the reality in [[Canada]] that the health insurance plans do not pay for non-therapeutic circumcision and most hospitals do not allow the performance of the non-therapeutic [[amputation]]. | ||
It appears that the CPS was seeking to | It appears that the CPS was seeking to promote more circumcisions so its members can make more money. | ||
* {{REFjournal | * {{REFjournal | ||
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=== USA === | === USA === | ||
{{AAP Policy expired}} | |||
[[File:Flag_of_USA.svg|thumb|150px|Flag of the United States of America (USA)]] | [[File:Flag_of_USA.svg|thumb|150px|Flag of the United States of America (USA)]] | ||
The United States are unique because the American medical industry has been promoting the practice of non-therapeutic circumcision since the late 19th Century.<ref>{{GollaherDL 1994}}</ref> As a result of the centuries-old promotion almost all American males were circumcised soon after birth from the 1930s through the 1980s.<ref name="laumann1996">{{REFjournal | The [[United States]] are unique because the American medical industry has been promoting the practice of non-therapeutic [[circumcision]] since the late 19th Century.<ref>{{GollaherDL 1994}}</ref> As a result of the centuries-old promotion almost all American males were [[circumcised]] soon after birth from the 1930s through the 1980s.<ref name="laumann1996">{{REFjournal | ||
|last=Laumann | |last=Laumann | ||
|first=Edward O. | |first=Edward O. | ||
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}}</ref> As a result, many Americans have never seen a human [[foreskin]] and most are profoundly ignorant of its anatomy, functions, and care. | }}</ref> As a result, many Americans have never seen a human [[foreskin]] and most are profoundly ignorant of its anatomy, functions, and care. | ||
With such an environment the medical industry has been able to develop its circumcision business into a colossus that exceeds an estimated $3 billion per year.<ref name="bollinger2012">{{REFweb | With such an environment the medical industry has been able to develop its [[circumcision]] business into a colossus that exceeds an estimated $3 billion per year.<ref name="bollinger2012">{{REFweb | ||
|url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually | |url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually | ||
|title=High Cost of Circumcision: $3.6 Billion Annually | |title=High Cost of Circumcision: $3.6 Billion Annually | ||
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}}</ref> so there is intense interest in keeping the Goose alive. [[Third-party payment]] is frequently available in the United States. | }}</ref> so there is intense interest in keeping the Goose alive. [[Third-party payment]] is frequently available in the United States. | ||
Several state Medicaid programs stopped paying for non-therapeutic circumcision in the early in the 21st Century. It is believed that this caused alarm in the circumcision industry. Shortly after ''The Lancet'' published two reports on randomized controlled trials (RCTs) from sub-Saharan Africa,<ref name="bailey2007">{{ | Several state Medicaid programs stopped paying for non-therapeutic circumcision in the early in the 21st Century. It is believed that this caused alarm in the circumcision industry. Shortly after ''The Lancet'' published two reports on [[HIV trials in Africa|randomized controlled trials (RCTs) from sub-Saharan Africa]],<ref name="bailey2007">{{RCT Bailey et al 2007}}</ref><ref name="gray2007">{{RCT Gray et al 2007}}</ref> it was announced in 2007 that the [[American Academy of Pediatrics]] (AAP) would take the lead, in association with the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] (ACOG) and the [[American Academy of Family Physicians]] {AAFP}, these being the three trade associations (stakeholders) whose members perform most of the non-therapeutic circumcisions, in developing a new circumcision policy for America.<ref>{{REFjournal | ||
}}</ref><ref name="gray2007">{{ | |||
}}</ref> it was announced in 2007 that the [[American Academy of Pediatrics]] (AAP) would take the lead, in association with the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] (ACOG) and the [[American Academy of Family Physicians]] {AAFP}, these being the three trade associations (stakeholders) whose members perform most of the non-therapeutic circumcisions, in developing a new circumcision policy for America.<ref>{{REFjournal | |||
|title=AAP reviews policy on circumcision | |title=AAP reviews policy on circumcision | ||
|journal=Relias Media | |journal=Relias Media | ||
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|first=George | |first=George | ||
|author-link=George Hill | |author-link=George Hill | ||
|publisher=Doctors Opposing Circumcision | |publisher=[[Doctors Opposing Circumcision (D.O.C.)]] | ||
|format=PDF | |format=PDF | ||
|date=2013-04 | |date=2013-04 | ||
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|last=Van Howe | |last=Van Howe | ||
|first=Robert S. | |first=Robert S. | ||
|author-link=Robert S. Van Howe | |||
|publisher=Academia | |publisher=Academia | ||
|format=PDF | |format=PDF | ||
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The AAP has a long-standing policy that its published policies and statements expire after five years unless re-affirmed. The AAP has ''not'' re-affirmed the statements below so they expired on 31 August 2017. The AAP now has ''no'' official position on non-therapeutic circumcision of boys. | The AAP has a long-standing policy that its published policies and statements expire after five years unless re-affirmed. The AAP has ''not'' re-affirmed the statements below so they expired on 31 August 2017. The AAP now has ''no'' official position on non-therapeutic [[circumcision]] of boys. | ||
* {{REFjournal | * {{REFjournal | ||
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|archived= | |archived= | ||
|contribution= | |contribution= | ||
|quote=Benefits to the infant boy from possessing an intact penis include: protection of the patient’s legal right to bodily integrity, conservation of the protective foreskin, avoidance of postsurgical complications, avoidance of persistent pain and trauma, shielding of the urethra from feces and E. coli, improved protection from ''Staphylococcus aureus'' infection in the newborn nursery (especially the increasingly present methicillin-resistant type), ease of breastfeeding initiation, with the multiple health and developmental benefits it provides, and provision of normal moisture and emollients to the mucosa of the glans penis and inner foreskin. Intact infants do not require care of a circumcision wound in the perinatal period, and do not have heightened pain responses. Financial benefits include earlier post-birth hospital discharge and a reduction of healthcare costs. | |quote=Benefits to the infant boy from possessing an intact penis include: protection of the patient’s legal right to bodily integrity, conservation of the protective foreskin, avoidance of postsurgical complications, avoidance of persistent pain and trauma, shielding of the [[urethra]] from feces and E. coli, improved protection from ''Staphylococcus aureus'' infection in the newborn nursery (especially the increasingly present methicillin-resistant type), ease of breastfeeding initiation, with the multiple health and developmental benefits it provides, and provision of normal moisture and emollients to the [[mucosa]] of the glans penis and inner foreskin. Intact infants do not require care of a circumcision wound in the perinatal period, and do not have heightened pain responses. Financial benefits include earlier post-birth hospital discharge and a reduction of healthcare costs. | ||
|last=Bollinger | |last=Bollinger | ||
|first=Dan | |first=Dan | ||
|author-link= | |author-link=Dan Bollinger | ||
|last2=Travis | |last2=Travis | ||
|first2=John W. | |first2=John W. | ||
|author2-link= | |author2-link=John W. Travis | ||
|last3=Peterson | |last3=Peterson | ||
|first3=Ken W. | |first3=Ken W. | ||
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|last4=Hill | |last4=Hill | ||
|first4=George | |first4=George | ||
|author4-link= | |author4-link=George Hill | ||
|publisher=[[International Coalition for Genital Integrity]] | |publisher=[[International Coalition for Genital Integrity]] | ||
|location= | |location= | ||
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* [[Financial incentive]] | * [[Financial incentive]] | ||
* [[Position statements on infant circumcision]] | * [[Position statements on infant circumcision]] | ||
* [[Trauma]] | |||
{{REF}} | {{REF}} | ||
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[[Category:From Intactipedia]] | [[Category:From Intactipedia]] | ||
[[Category:From IntactWiki]] | [[Category:From IntactWiki]] | ||
[[de:Mängel bei Beschneidungsstudien]] | |||