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Created page with "right|thumb|Have a photo? Upload it [[Special:Upload|here]] '''Aaron J. Fink''', M.D., (1926-1994) was a California urologist, and the father of the i..."
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'''Aaron J. Fink''', M.D., (1926-1994) was a California urologist, and the father of the idea that circumcision could prevent AIDS. He came up with the idea in 1986,<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=206
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote=What if circumcision protected against infection with HIV...
| accessdate=2011-02-19
}}</ref> and vehemently promoted it,<ref>{{REFjournal
| last=Weiss
| first=Helen A.
| coauthors=Quigley, Maria A.; Hayes, Richard J.
| pubyear=October 2000
| title=Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis
| journal=AIDS
| volume=14
| issue=15
| pages=2361–2370
| url=http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200010200-00018.htm
| quote=
| accessdate=
| doi=10.1097/00002030-200010200-00018
| pmid=11089625
}}</ref> long before there was any "research" to prove it. [[Valiere Alcena]] has stated that Fink's assertions "was based on my <sup>[Alcena's]</sup> idea".<ref>{{REFjournal
| last=Alcena
| first=Valiere
| coauthors=
| pubyear=October 2006
| title=AIDS in Third World Countries
| journal=PLoS Medicine
| volume=
| issue=
| pages=[online]
| url=http://medicine.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020298#r1326
| quote=
| accessdate=
| doi=10.1371/journal.pmed.0020298#r1326
}}</ref>
== Fink's Inherent Bias ==
According to Fink's son-in-law, Fink had a son who had a botched circumcision and corrective surgery, and then died at the age of four-years due to a brain tumour. Fink spent the rest of his life trying to justify his son's circumcision and the pain that he endured during the four years of his life.<ref>{{REFweb
| last=
| first=
| date=
| title=Aaron J. Fink
| url=http://www.fact-index.com/a/aa/aaron_j__fink.html
| publisher=fact index
| accessdate=2011-02-27
}}</ref>
== The Birth of the Circumcision & HIV Hypothesis ==
=== Fink's Letter: In Defense of Circumcision ===
During the 1980s, some phycisians were condemning circumcision as "barbaric and unnecessary," and only "advocated by the uninformed." In 1986, Blue Shield providers in several states decided to discontinue coverage of neonatal circumcision. In reaction to this, Fink sent a manifesto entitled "In Defense of Circumcision" to the ''New York Times'' and the ''San Francisco Chronicle'', repeating antiquated claims of benefits; many of which weren't even published.<ref>Wallerstein, Edward. ''Circumcision: An American Health Fallacy''. New York: Springer, 1980. "Circumcision: Information," 507-12.</ref>
=== Another Letter: The HIV/AIDS Hypothesis ===
In 1986, Fink sent a letter--"A possible Explanation for Heterosexual Male Infection with AIDS," where he argued that the hard and toughened glans of the circumcised male resisted infection, while the soft and sensitive foreskin and glans mucosa of the intact male were ports of entry.<ref>Fink, Aaron J. "A possible Explanation for Heterosexual Male Infection with AIDS." ''New England Journal of Medicine'' 315, 18 (1986): 1167</ref> Fink proposed in his letter: "I suspect that men in the United States, who, as compared with those in Africa and elsewhere, have had less acquisition of AIDS, have benefited from the high rate of newborn circumcision in the United States," regardless of the fact that the United States has one of the highest circumcision rates, and one of the highest HIV rates, in the western (industrialized) world (compare with European countries, Canda, and Australia).<ref>{{REFweb
| last=WHO/UNAIDS
| first=
| date=2004
| title=A global view of HIV infection
| url=http://www.who.int/hiv/facts/hiv2003/en/
| publisher=World Health Organization
| accessdate=2011-02-27
}}</ref>
=== Popularizing The Hypothesis ===
Fink's proposal appeared in media throughout the US and Canada. Asked about his idea by a United Press reporter, Fink replied "This is nothing I can prove."<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=207
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote=This is nothing I can prove.
| note=
| accessdate=2011-02-19
}} </ref> This didn't stop other physicians from conducting "research" leading to a steady stream of widely publicized articles arguing that circumcised men were less likely to contract HIV--with the result that prevention of HIV infection has now surpassed even cancer prevention as the most popular claim of circumcision advocates.
{{Citation
| Title=Fink's Own Words
| Text=This is nothing I can prove.
| Author=
| Source="This Little Operation". ''Marked in Your Flesh.'' p.206-208
}}
== Addressing Parents ==
Fink repeated his argument in a small book on circumcision, ''Circumcision: A parent's Decision for Life'', addressed to parents and published in 1988.<ref>Fink, Aaron J. ''Circumcision: A Parent's Decision for Life''. Mountain View. Calif.: Kavanah, 1988.</ref> The focus was on sexually transmitted diseases, which Fink declared to be "no longer a matter of morals but an issue of life or death." Defeating the threat, he informed prospective parents, and called for immediate action: "The facts now point to circumcision, cutting off the foreskin, as a life-sparing path to public and personal health." And lest anyone doubt the urgency of the situation, he added the questions likely to generate unease among the skeptics and human right proponents:
{{Citation
| Title=Fink's Own Words
| Text=Will your infant son have a problem practicing daily cleaning of his penis? Will he be promiscuous? Will he visit prostitutes? Will he be at greater risk of acquiring sexually transmitted diseases, including AIDS? Will he use a condom? Will he live in a tropical humid land? Will he be a diabetic?
| Author=Fink, Aaron J.
| Source=Circumcision, 3.
}}
According to Fink, if his book were to "provide the knowledge and insight that might save even one life from the tragedy of AIDS the effort was worthwhile." Since one of the book's seven chapters was entitled "Preventing AIDS: Another Benefit of Newborn Circumcision," the average reader might have concluded that this was fact and not superstition.<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=206-208
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote= This is nothing I can prove.
| note=
| accessdate=2011-02-19
}}</ref>
== Finks Appeal to Medical Associations ==
=== First Attempt ===
In 1987, Fink filed a resolution entitled "Newborn Circumcision as a Public Health Measure" with the California Medical Association, saying that "it has been recently hypothesized that a circumcision, preferably in the newborn period, may lessen the acquisition, and in turn, the spread of AIDS, a sexually transmitted disease." The association's advisory panels on pediatrics and urology concluded that the argumens for adoption were "not sufficiently convincing"; and although one panel stood by circumcision as an "acceptable preventive health measure," both panels recommended against the adoption of the resolution. The association's Scientific Board declined endorsement, and the resolution was not adopted.<ref>Aaron Fink, California Medical Association, Resolution 712-87, March 7-11, 1987; Joan B. Hodgman and Joseph B. Hart, "Report to the Scientific Board" (undated, March 1987?)</ref>
=== Second Attempt: Success ===
In 1988, Fink repeated the resolution with a new paper of the same title, but much lengthier. The Scientific Board recommended against the adoption, but the resolution passed by voice vote.<ref>Aaron J. Fink, California Medical Association, Resolution 305-88, March 5-9, 1988; Fink, ''Circumcision'', 63-65.</ref> In 1989, John W. Hardebeck presented a counter resolution entitled "Newborn Circumcision: Medical Necessity or Useless Mutilation?" stating that newborn circumcision "is a procedure without factual, demonstrable, supportable medical indications in the overwhelming majority of cases," and that "most medical authorities worldwide feel that newborn males have a right to remain 'intact' except in rare instances." This was rejected.<ref>Hardebeck, John W. "Newborn Circumcision: Medical Necessity or Useless Mutilation?" Truth Seeker I, 3 (July-August 1989)</ref><ref>Snyder, "Testimony Against Circumcision." (California Medical Association, March 4, 1989.) Truth Seeker I, 3 (July-August 1989): 51.</ref>
=== Unintended Consequence ===
In response to the controversy surrounding the Fink's resolution, and Hardebeck's attempt to counteract it, a group of circumcision opponents held a conference in a hotel across the street from the one housing the medical meeting. The conference organizer was the nation's leading opponent of infant circumcision: Marilyn F. Milos. the founder and director of the National Organization of Circumcision Information Resource Centers (NOCIRC).<ref>Marilyn Milos, personal communication with Leonard B. Glick, July 27, 2001</ref><ref>Hardebeck, John W. "Newborn Circumcision: Medical Necessity or Useless Mutilation?" Truth Seeker I, 3 (July-August 1989)</ref><ref>Snyder, "Testimony Against Circumcision." (California Medical Association, March 4, 1989.) Truth Seeker I, 3 (July-August 1989): 51.</ref> The three-day conference, labeled the First International Symposium on Circumcision, was so successful that six more symposia, resulting to date in publication of four volumes based on the proceedings, have been held since then, in locations as diverse as Lausanne, Oxford and Sidney.<ref>Denniston, George C., and Marilyn Fayre Milos, eds. ''Sexual Mutilations : A Human Tragedy''. New York: Plenum, 1997.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Male and Female Circumcision: Medical, Legal, and Ethical Considerations in Pediatric Practice''. New York: Kluwer Academic/Plenum, 1999.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Understanding Circumcision; A Multi-Disciplinary Aproach to a Multi-Dimensional Problem''. New York: Kluwer Academic/Plenum, 2001.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Flesh and Blood: Perspectives on the Problem of Circumcision in Contemporary Society''. New York: Kluwer Academic/Plenum, 2004.</ref> It could be said that Fink unintentionally created a vigorous new expression of opposition to circumcision.
== Final Letters ==
Fink sent a letter to the British medical journal, prompting two hostile replies, both from Leeds physicians.<ref>Fink, Aaron J. "Newborn Circumcision: A Long-term Strategy for AIDS Prevention" (letter). Journal of the Royal Medical Society 82 (1989): 695.</ref><ref>Waugh M.A., Spicer R.D ''Journal of the Royal Society of Medicine'' 83. (April 1990): 278.</ref> In 1991 Fink wrote another letter, claiming infants have no memory of painful events until age six months or older.<ref>Fink, Aaron J. "Circumcision and Sand." ''Journal of the Royal Society of Medicine'' 84 (November 1991): 696</ref> He died in 1994, but the campaign to link HIV infection to the foreskin continues to this day.
{{SEEALSO}}
* [[Bias]] -- Learn about pro-circumcision bias.
* [[Religion and Culture]] -- Learn how religion and culture effects ones views on circumcision.
* [[Edgar J. Schoen]] -- Veteran pro-circumcision advocate.
* [[Thomas E. Wiswell]] -- Veteran pro-circumcision advocate.
== Additional Sources ==
* Glick, Leonard (2005). Marked in Your Flesh. New York, New York: Oxford University Press. pp. 206. ISBN 0-19-517674-X.
{{REF}}
{{DEFAULTSORT:Fink, Aaron J.}}
[[Category:People]]
[[Category:Researchers]]
[[Category:Urologists]]
[[Category:CircLeaks]]
[[Category:From IntactWiki]]
'''Aaron J. Fink''', M.D., (1926-1994) was a California urologist, and the father of the idea that circumcision could prevent AIDS. He came up with the idea in 1986,<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=206
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote=What if circumcision protected against infection with HIV...
| accessdate=2011-02-19
}}</ref> and vehemently promoted it,<ref>{{REFjournal
| last=Weiss
| first=Helen A.
| coauthors=Quigley, Maria A.; Hayes, Richard J.
| pubyear=October 2000
| title=Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis
| journal=AIDS
| volume=14
| issue=15
| pages=2361–2370
| url=http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200010200-00018.htm
| quote=
| accessdate=
| doi=10.1097/00002030-200010200-00018
| pmid=11089625
}}</ref> long before there was any "research" to prove it. [[Valiere Alcena]] has stated that Fink's assertions "was based on my <sup>[Alcena's]</sup> idea".<ref>{{REFjournal
| last=Alcena
| first=Valiere
| coauthors=
| pubyear=October 2006
| title=AIDS in Third World Countries
| journal=PLoS Medicine
| volume=
| issue=
| pages=[online]
| url=http://medicine.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020298#r1326
| quote=
| accessdate=
| doi=10.1371/journal.pmed.0020298#r1326
}}</ref>
== Fink's Inherent Bias ==
According to Fink's son-in-law, Fink had a son who had a botched circumcision and corrective surgery, and then died at the age of four-years due to a brain tumour. Fink spent the rest of his life trying to justify his son's circumcision and the pain that he endured during the four years of his life.<ref>{{REFweb
| last=
| first=
| date=
| title=Aaron J. Fink
| url=http://www.fact-index.com/a/aa/aaron_j__fink.html
| publisher=fact index
| accessdate=2011-02-27
}}</ref>
== The Birth of the Circumcision & HIV Hypothesis ==
=== Fink's Letter: In Defense of Circumcision ===
During the 1980s, some phycisians were condemning circumcision as "barbaric and unnecessary," and only "advocated by the uninformed." In 1986, Blue Shield providers in several states decided to discontinue coverage of neonatal circumcision. In reaction to this, Fink sent a manifesto entitled "In Defense of Circumcision" to the ''New York Times'' and the ''San Francisco Chronicle'', repeating antiquated claims of benefits; many of which weren't even published.<ref>Wallerstein, Edward. ''Circumcision: An American Health Fallacy''. New York: Springer, 1980. "Circumcision: Information," 507-12.</ref>
=== Another Letter: The HIV/AIDS Hypothesis ===
In 1986, Fink sent a letter--"A possible Explanation for Heterosexual Male Infection with AIDS," where he argued that the hard and toughened glans of the circumcised male resisted infection, while the soft and sensitive foreskin and glans mucosa of the intact male were ports of entry.<ref>Fink, Aaron J. "A possible Explanation for Heterosexual Male Infection with AIDS." ''New England Journal of Medicine'' 315, 18 (1986): 1167</ref> Fink proposed in his letter: "I suspect that men in the United States, who, as compared with those in Africa and elsewhere, have had less acquisition of AIDS, have benefited from the high rate of newborn circumcision in the United States," regardless of the fact that the United States has one of the highest circumcision rates, and one of the highest HIV rates, in the western (industrialized) world (compare with European countries, Canda, and Australia).<ref>{{REFweb
| last=WHO/UNAIDS
| first=
| date=2004
| title=A global view of HIV infection
| url=http://www.who.int/hiv/facts/hiv2003/en/
| publisher=World Health Organization
| accessdate=2011-02-27
}}</ref>
=== Popularizing The Hypothesis ===
Fink's proposal appeared in media throughout the US and Canada. Asked about his idea by a United Press reporter, Fink replied "This is nothing I can prove."<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=207
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote=This is nothing I can prove.
| note=
| accessdate=2011-02-19
}} </ref> This didn't stop other physicians from conducting "research" leading to a steady stream of widely publicized articles arguing that circumcised men were less likely to contract HIV--with the result that prevention of HIV infection has now surpassed even cancer prevention as the most popular claim of circumcision advocates.
{{Citation
| Title=Fink's Own Words
| Text=This is nothing I can prove.
| Author=
| Source="This Little Operation". ''Marked in Your Flesh.'' p.206-208
}}
== Addressing Parents ==
Fink repeated his argument in a small book on circumcision, ''Circumcision: A parent's Decision for Life'', addressed to parents and published in 1988.<ref>Fink, Aaron J. ''Circumcision: A Parent's Decision for Life''. Mountain View. Calif.: Kavanah, 1988.</ref> The focus was on sexually transmitted diseases, which Fink declared to be "no longer a matter of morals but an issue of life or death." Defeating the threat, he informed prospective parents, and called for immediate action: "The facts now point to circumcision, cutting off the foreskin, as a life-sparing path to public and personal health." And lest anyone doubt the urgency of the situation, he added the questions likely to generate unease among the skeptics and human right proponents:
{{Citation
| Title=Fink's Own Words
| Text=Will your infant son have a problem practicing daily cleaning of his penis? Will he be promiscuous? Will he visit prostitutes? Will he be at greater risk of acquiring sexually transmitted diseases, including AIDS? Will he use a condom? Will he live in a tropical humid land? Will he be a diabetic?
| Author=Fink, Aaron J.
| Source=Circumcision, 3.
}}
According to Fink, if his book were to "provide the knowledge and insight that might save even one life from the tragedy of AIDS the effort was worthwhile." Since one of the book's seven chapters was entitled "Preventing AIDS: Another Benefit of Newborn Circumcision," the average reader might have concluded that this was fact and not superstition.<ref>{{REFbook
| last=Glick
| first=Leonard
| year=2005
| title=Marked in Your Flesh
| url=
| editor=
| edition=
| volume=
| chapter="This Little Operation", Jewish American Physicians and Twentieth-Century Circumcisoin Advocacy
| pages=206-208
| location=New York
| publisher=Oxford University Press
| isbn=0-19-517674-X
| quote= This is nothing I can prove.
| note=
| accessdate=2011-02-19
}}</ref>
== Finks Appeal to Medical Associations ==
=== First Attempt ===
In 1987, Fink filed a resolution entitled "Newborn Circumcision as a Public Health Measure" with the California Medical Association, saying that "it has been recently hypothesized that a circumcision, preferably in the newborn period, may lessen the acquisition, and in turn, the spread of AIDS, a sexually transmitted disease." The association's advisory panels on pediatrics and urology concluded that the argumens for adoption were "not sufficiently convincing"; and although one panel stood by circumcision as an "acceptable preventive health measure," both panels recommended against the adoption of the resolution. The association's Scientific Board declined endorsement, and the resolution was not adopted.<ref>Aaron Fink, California Medical Association, Resolution 712-87, March 7-11, 1987; Joan B. Hodgman and Joseph B. Hart, "Report to the Scientific Board" (undated, March 1987?)</ref>
=== Second Attempt: Success ===
In 1988, Fink repeated the resolution with a new paper of the same title, but much lengthier. The Scientific Board recommended against the adoption, but the resolution passed by voice vote.<ref>Aaron J. Fink, California Medical Association, Resolution 305-88, March 5-9, 1988; Fink, ''Circumcision'', 63-65.</ref> In 1989, John W. Hardebeck presented a counter resolution entitled "Newborn Circumcision: Medical Necessity or Useless Mutilation?" stating that newborn circumcision "is a procedure without factual, demonstrable, supportable medical indications in the overwhelming majority of cases," and that "most medical authorities worldwide feel that newborn males have a right to remain 'intact' except in rare instances." This was rejected.<ref>Hardebeck, John W. "Newborn Circumcision: Medical Necessity or Useless Mutilation?" Truth Seeker I, 3 (July-August 1989)</ref><ref>Snyder, "Testimony Against Circumcision." (California Medical Association, March 4, 1989.) Truth Seeker I, 3 (July-August 1989): 51.</ref>
=== Unintended Consequence ===
In response to the controversy surrounding the Fink's resolution, and Hardebeck's attempt to counteract it, a group of circumcision opponents held a conference in a hotel across the street from the one housing the medical meeting. The conference organizer was the nation's leading opponent of infant circumcision: Marilyn F. Milos. the founder and director of the National Organization of Circumcision Information Resource Centers (NOCIRC).<ref>Marilyn Milos, personal communication with Leonard B. Glick, July 27, 2001</ref><ref>Hardebeck, John W. "Newborn Circumcision: Medical Necessity or Useless Mutilation?" Truth Seeker I, 3 (July-August 1989)</ref><ref>Snyder, "Testimony Against Circumcision." (California Medical Association, March 4, 1989.) Truth Seeker I, 3 (July-August 1989): 51.</ref> The three-day conference, labeled the First International Symposium on Circumcision, was so successful that six more symposia, resulting to date in publication of four volumes based on the proceedings, have been held since then, in locations as diverse as Lausanne, Oxford and Sidney.<ref>Denniston, George C., and Marilyn Fayre Milos, eds. ''Sexual Mutilations : A Human Tragedy''. New York: Plenum, 1997.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Male and Female Circumcision: Medical, Legal, and Ethical Considerations in Pediatric Practice''. New York: Kluwer Academic/Plenum, 1999.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Understanding Circumcision; A Multi-Disciplinary Aproach to a Multi-Dimensional Problem''. New York: Kluwer Academic/Plenum, 2001.</ref><ref>Denniston, George C., Frederick Mansfield Hodges, and Marilyn Fayre Milos, eds. ''Flesh and Blood: Perspectives on the Problem of Circumcision in Contemporary Society''. New York: Kluwer Academic/Plenum, 2004.</ref> It could be said that Fink unintentionally created a vigorous new expression of opposition to circumcision.
== Final Letters ==
Fink sent a letter to the British medical journal, prompting two hostile replies, both from Leeds physicians.<ref>Fink, Aaron J. "Newborn Circumcision: A Long-term Strategy for AIDS Prevention" (letter). Journal of the Royal Medical Society 82 (1989): 695.</ref><ref>Waugh M.A., Spicer R.D ''Journal of the Royal Society of Medicine'' 83. (April 1990): 278.</ref> In 1991 Fink wrote another letter, claiming infants have no memory of painful events until age six months or older.<ref>Fink, Aaron J. "Circumcision and Sand." ''Journal of the Royal Society of Medicine'' 84 (November 1991): 696</ref> He died in 1994, but the campaign to link HIV infection to the foreskin continues to this day.
{{SEEALSO}}
* [[Bias]] -- Learn about pro-circumcision bias.
* [[Religion and Culture]] -- Learn how religion and culture effects ones views on circumcision.
* [[Edgar J. Schoen]] -- Veteran pro-circumcision advocate.
* [[Thomas E. Wiswell]] -- Veteran pro-circumcision advocate.
== Additional Sources ==
* Glick, Leonard (2005). Marked in Your Flesh. New York, New York: Oxford University Press. pp. 206. ISBN 0-19-517674-X.
{{REF}}
{{DEFAULTSORT:Fink, Aaron J.}}
[[Category:People]]
[[Category:Researchers]]
[[Category:Urologists]]
[[Category:CircLeaks]]
[[Category:From IntactWiki]]